Stair-shaped Achilles tendon lengthening in continuity — A new method to treat equinus deformity in patients with spastic cerebral palsy

Li, Zhengxun; Ning, Zengping; Wang, Yang; Cao, Songhua; Zheng, Hongbo; Hu, Yong

doi:10.1016/j.fas.2017.10.012

Cited by 2 publications

(1 citation statement)

References 13 publications

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“…After an operation, the immobilization period varies from three to seven weeks to ensure healing before returning to full function or exercise [8]. Blaiser and White have recommended three weeks of immobilization after percutaneous sliding heel-cord lengthening [6], whereas Renshaw et al have recommended six weeks in a short leg cast [9].…”

Section: Introductionmentioning

confidence: 99%

In Vivo Evaluation of the Mechanical Strength of a Slide Lengthening Technique With a Locking Mechanism Using a Rabbit Model

Iwase¹,

Uchida²,

Metoki³

et al. 2020

Cureus

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BackgroundThere are many reports of Achilles tendon lengthening procedures for equinus deformity of the ankle. We previously modified an Achilles tendon lengthening to prevent overextension with a locking mechanism suture before performing a sliding lengthening. The purpose of this study was to compare the biomechanical properties of the locking mechanism suture with sliding lengthening (L-SL) and Z-lengthening (ZL) using a rabbit model. MethodsThirty-six male Japanese white rabbits were assigned to two groups -half undergoing the L-SL technique and half undergoing the ZL technique on the flexor hallucis longus (FHL) tendon. Six rabbits in each group were sacrificed at one week, three weeks, and six weeks postoperatively and evaluated, while five rabbits underwent radiographical and biomechanical evaluation and one underwent histological evaluation. ResultsIn extension length, L-SL was significantly lower than ZL one week postoperatively. In the L-SL group, elongation one week postoperatively was significantly lower than that three and six weeks postoperatively. In the ultimate failure load, L-SL was significantly higher than ZL one and three weeks after lengthening. In the L-SL group, the ultimate failure load one week postoperatively was significantly lower than that three and six weeks postoperatively. In the ZL group, there were significant differences at all time points. ConclusionL-SL had higher mechanical property in vivo.

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Section: Introductionmentioning

confidence: 99%

In Vivo Evaluation of the Mechanical Strength of a Slide Lengthening Technique With a Locking Mechanism Using a Rabbit Model

Iwase¹,

Uchida²,

Metoki³

et al. 2020

Cureus

View full text Add to dashboard Cite

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Nonsurgical Treatment Options for Muscle Contractures in Individuals With Neurologic Disorders: A Systematic Review With Meta-Analysis

Svane

Nielsen

Lorentzen

2021

Archives of Rehabilitation Research and Clinical Translation

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Objective To investigate whether nonsurgical treatment can reduce muscle contractures in individuals with neurologic disorders. The primary outcome measure was muscle contractures measured as joint mobility or passive stiffness. Data Sources Embase, MEDLINE, Cumulative Index to Nursing and Allied Health, and Physiotherapy Evidence Database in June-July 2019 and again in July 2020. Study Selection The search resulted in 8020 records, which were screened by 2 authors based on our patient, intervention, comparison, outcome criteria. We included controlled trials of nonsurgical interventions administered to treat muscle contractures in individuals with neurologic disorders. Data Extraction Authors, participant characteristics, intervention details, and joint mobility/passive stiffness before and after intervention were extracted. We assessed trials for risk of bias using the Downs and Black checklist. We conducted meta-analyses investigating the short-term effect on joint mobility using a random-effects model with the pooled effect from randomized controlled trials (RCTs) as the primary outcome. The minimal clinically important effect was set at 5°. Data Synthesis A total of 70 trials (57 RCTs) were eligible for inclusion. Stretch had a pooled effect of 3° (95% CI, 1-4°; prediction interval (PI)=−2 to 7°; I 2 =66%; P <.001), and robot-assisted rehabilitation had an effect of 1 (95% CI, 0-2; PI=−8 to 9; I 2 =73%; P =.03). We found no effect of shockwave therapy ( P =.56), physical activity ( P =.27), electrical stimulation ( P =.11), or botulinum toxin ( P =.13). Although trials were generally of moderate to high quality according to the Downs and Black checklist, only 18 of the 70 trials used objective measures of muscle contractures. In 23 trials, nonobjective measures were used without use of assessor-blinding. Conclusions We did not find convincing evidence supporting the use of any nonsurgical treatment option. We recommend that controlled trials using objective measures of muscle contractures and a sufficiently large number of participants be performed.

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Stair-shaped Achilles tendon lengthening in continuity — A new method to treat equinus deformity in patients with spastic cerebral palsy

Cited by 2 publications

References 13 publications

In Vivo Evaluation of the Mechanical Strength of a Slide Lengthening Technique With a Locking Mechanism Using a Rabbit Model

In Vivo Evaluation of the Mechanical Strength of a Slide Lengthening Technique With a Locking Mechanism Using a Rabbit Model

Nonsurgical Treatment Options for Muscle Contractures in Individuals With Neurologic Disorders: A Systematic Review With Meta-Analysis

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