PDF(Pubmed)
Abstract：
UNASSIGNED: In children with cerebral palsy, flexion deformities of the knee can be treated with a distal femoral extension osteotomy combined with either patellar tendon advancement or patellar tendon shortening. The purpose of this study was to establish a consensus through expert orthopedic opinion, using a modified Delphi process to describe the surgical indications for distal femoral extension osteotomy and patellar tendon advancement/patellar tendon shortening. A literature review was also conducted to summarize the recent literature on distal femoral extension osteotomy and patellar tendon shortening/patellar tendon advancement.
UNASSIGNED: A group of 16 pediatric orthopedic surgeons, with more than 10 years of experience in the surgical management of children with cerebral palsy, was established. The group used a 5-level Likert-type scale to record agreement or disagreement with statements regarding distal femoral extension osteotomy and patellar tendon advancement/patellar tendon shortening. Consensus for the surgical indications for distal femoral extension osteotomy and patellar tendon advancement/patellar tendon shortening was achieved through a modified Delphi process. The literature review, summarized studies of clinical outcomes of distal femoral extension osteotomy/patellar tendon shortening/patellar tendon advancement, published between 2008 and 2022.
UNASSIGNED: There was a high level of agreement with consensus for 31 out of 44 (70%) statements on distal femoral extension osteotomy. Agreement was lower for patellar tendon advancement/patellar tendon shortening with consensus reached for 8 of 21 (38%) of statements. The literature review included 25 studies which revealed variation in operative technique for distal femoral extension osteotomy, patellar tendon advancement, and patellar tendon shortening. Distal femoral extension osteotomy and patellar tendon advancement/patellar tendon shortening were generally effective in correcting knee flexion deformities and extensor lag, but there was marked variation in outcomes and complication rates.
UNASSIGNED: The results from this study will provide guidelines for surgeons who care for children with cerebral palsy and point to unresolved questions for further research.
UNASSIGNED: level V.
UNASSIGNED: A group of 16 pediatric orthopedic surgeons, with more than 10 years of experience in the surgical management of children with cerebral palsy, was established. The group used a 5-level Likert-type scale to record agreement or disagreement with statements regarding distal femoral extension osteotomy and patellar tendon advancement/patellar tendon shortening. Consensus for the surgical indications for distal femoral extension osteotomy and patellar tendon advancement/patellar tendon shortening was achieved through a modified Delphi process. The literature review, summarized studies of clinical outcomes of distal femoral extension osteotomy/patellar tendon shortening/patellar tendon advancement, published between 2008 and 2022.
UNASSIGNED: There was a high level of agreement with consensus for 31 out of 44 (70%) statements on distal femoral extension osteotomy. Agreement was lower for patellar tendon advancement/patellar tendon shortening with consensus reached for 8 of 21 (38%) of statements. The literature review included 25 studies which revealed variation in operative technique for distal femoral extension osteotomy, patellar tendon advancement, and patellar tendon shortening. Distal femoral extension osteotomy and patellar tendon advancement/patellar tendon shortening were generally effective in correcting knee flexion deformities and extensor lag, but there was marked variation in outcomes and complication rates.
UNASSIGNED: The results from this study will provide guidelines for surgeons who care for children with cerebral palsy and point to unresolved questions for further research.
UNASSIGNED: level V.
摘要：
未经证实：脑瘫儿童，膝关节屈曲畸形可通过股骨远端伸直截骨术联合髌腱前移或髌腱缩短治疗。这项研究的目的是通过专家骨科意见建立共识，使用改良的Delphi程序描述股骨远端延伸截骨术和髌腱前移/髌腱缩短的手术指征。还进行了文献综述，以总结最近关于股骨远端延伸截骨术和髌腱缩短/髌腱推进的文献。
未经授权：一组16名小儿骨科医生，在脑瘫患儿的外科治疗方面有超过10年的经验，已建立。该组使用5级Likert型量表记录与有关股骨远端延伸截骨术和the肌腱前移/the肌腱缩短的陈述的同意或不同意。通过改良的Delphi方法，获得了股骨远端延伸截骨术和the肌腱前移/the肌腱缩短的手术适应症的共识。文献综述,总结股骨远端伸直截骨术/髌腱缩短/髌腱前移的临床结果的研究，2008年至2022年出版。
UNASSIGNED：关于股骨远端延伸截骨术的44项声明中有31项（70％）达成了高度共识。髌腱前移/髌腱缩短的一致性较低，在21个陈述中有8个（38％）达成共识。文献综述包括25项研究，这些研究揭示了股骨远端延伸截骨术的手术技术差异，髌腱前移,髌骨肌腱缩短。股骨远端伸直截骨术和髌腱前移/髌腱缩短通常可有效纠正膝关节屈曲畸形和伸肌滞后，但结局和并发症发生率存在显著差异.
UNASSIGNED：这项研究的结果将为照顾脑瘫儿童的外科医生提供指导，并指出有待进一步研究的问题。
未经授权：一组16名小儿骨科医生，在脑瘫患儿的外科治疗方面有超过10年的经验，已建立。该组使用5级Likert型量表记录与有关股骨远端延伸截骨术和the肌腱前移/the肌腱缩短的陈述的同意或不同意。通过改良的Delphi方法，获得了股骨远端延伸截骨术和the肌腱前移/the肌腱缩短的手术适应症的共识。文献综述,总结股骨远端伸直截骨术/髌腱缩短/髌腱前移的临床结果的研究，2008年至2022年出版。
UNASSIGNED：关于股骨远端延伸截骨术的44项声明中有31项（70％）达成了高度共识。髌腱前移/髌腱缩短的一致性较低，在21个陈述中有8个（38％）达成共识。文献综述包括25项研究，这些研究揭示了股骨远端延伸截骨术的手术技术差异，髌腱前移,髌骨肌腱缩短。股骨远端伸直截骨术和髌腱前移/髌腱缩短通常可有效纠正膝关节屈曲畸形和伸肌滞后，但结局和并发症发生率存在显著差异.
UNASSIGNED：这项研究的结果将为照顾脑瘫儿童的外科医生提供指导，并指出有待进一步研究的问题。
