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腦性麻痺의 痙直性馬足變形矯正을 爲한 Silfverskio··ld氏 手術例에 對한 考察

Silfverskiold Operation for Spastic Equinus Deformity in Cerebral Palsy

최신의학 1970년 13권 8호 p.71 ~ 76
申廷淳, 鄭仁熙,
소속 상세정보
申廷淳 (  ) - 延世大學校 醫科大學 整形外科學敎室
鄭仁熙 (  ) - 延世大學校 醫科大學 整形外科學敎室

Abstract


Spastic equinus contracture is the most common deformity of the lower extremity in cerebral palsied chidren. In 1924, Silfverskiold divided spastic equinus contracture into two groups, one of which is passively correctable by flexion of the knee to a right angle. The gastrocnemius function is the primary r= deforming factor in this group.
We have performed ´ the Silfverskiold- operation (gastrocnemius-muscle recession with partial neurectomy) in thirty instances, from April, 1965 to April, 1970, and wish to report our results to the present.
The average age at the time of operation was ten years with a range of three years to seventeen years. Twenty children had unilateral operations and five had bilateral operations(ten gastrocnemius recessions with partial neurectomies). Twelve children had hemiplegic involvement; six, paraplegia; four, quadriplegia; and three, triplegia. Two children presented an associated athetosis, and these were all in the quadriplegic children.
The postoperative follow-up period has ranged from four months to four years and ten months with an average follow-up of one year and ten months. The results have been followed for three years or longer after seven operations, for two to three years after seven operations, for six months to two years after twelve operations, and for less than six months after four procedures.
Four failures(recurrence of equinus deformity) have been observed in our present series of thirty operations. The Silfverskiold opeartion is an effective and reliable prccedure for spastic equinus deformity, if the indications are properly met.

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