Rectus femoris transfer 분당서울대학교병원 이승열

Rectus femoris muscle Origin –Anterior Inferior Iliac Spine and Ilium above toe acetabulum

Insertion –Quadriceps tendon to base of patella and onto tibial tuberosity via the patellar tendon Nerve to muscle –Femoral nerve (L2-L4)

Stiff knee gait

One of m/c gait abnormality in patients with spastic CP Typical finding –Decreased ROM of knee during swing phase Foot clearance problem Reduced gait velocity Reduced step length

Rectus femoris transfer Conventional treatment

Indication Positive Duncan-Ely sign

Gait analysis Decreased knee flexion in swing Decreased and delayed peak knee flexion in sweing

Dynamic electromyography –Pathological increased activity of the rectus femoris muscle

OP technique

Outcome

Keep the rectus as a hip flexor Convert the rectus into a knee flexor??? Elimination of the rectus femoris activity

Study plan Patients –321 pts Factors affecting the results of RFT –Age –Gender –Anatomical type –Functional scale (GMFCS level) –SEMLS concomitant with RFT

Long term results –LMM? Gait analysis (knee sagittal motion) GDI

MRI study 진행상황

SNUBH 근력측정 기기

Isokinetic muscle strength Isometric muscle strength

Hip –Flexion/extension –Adduction/abduction Knee –Flexion/extension Ankle –Dorsiflexion/plantarflexion –Inversion/eversion

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