PDF(Pubmed)
Abstract：
Contracture of quadriceps femoris muscle is an uncommon condition in clinical practice. It was suggested that intramuscular injections into the thigh for children are sometimes the cause of this condition.
METHODS: The case presents a new surgical technique for the treatment of isolated rectus femoris muscle contracture. The patient is a 6- year-old boy complaining of external rotation of the left leg when he walks and inability to squat. Clinical examination showed positive Ely\'s test which indicated isolated rectus femoris muscle contracture. The patient underwent proximal lengthening of rectus femoris muscle.
CONCLUSIONS: Quadriceps femoris muscle contracture in children can be congenital or acquired. The identified causes of this case are multiple intramuscular injections, trauma or ischemia. The recommended treatment is proximal release in the early stage if contracture is diagnosed and distal lengthening of quadriceps tendon in the late stage. Surgical techniques that preserve continuity of the rectus femoris muscle have better outcomes, and give opportunity for second lengthening surgery if needed. This article presents a surgical technique of proximal rectus femoris muscle release that depends on using the length of the indirect head by transferring its attachment to the distal end of the direct head.
CONCLUSIONS: Quadriceps femoris contracture in children leads to limited knee flexion. Proximal release in the early stage gives excellent result. The technique used in this research gives an opportunity to restore knee flexion and a chance for second release if needed.
METHODS: The case presents a new surgical technique for the treatment of isolated rectus femoris muscle contracture. The patient is a 6- year-old boy complaining of external rotation of the left leg when he walks and inability to squat. Clinical examination showed positive Ely\'s test which indicated isolated rectus femoris muscle contracture. The patient underwent proximal lengthening of rectus femoris muscle.
CONCLUSIONS: Quadriceps femoris muscle contracture in children can be congenital or acquired. The identified causes of this case are multiple intramuscular injections, trauma or ischemia. The recommended treatment is proximal release in the early stage if contracture is diagnosed and distal lengthening of quadriceps tendon in the late stage. Surgical techniques that preserve continuity of the rectus femoris muscle have better outcomes, and give opportunity for second lengthening surgery if needed. This article presents a surgical technique of proximal rectus femoris muscle release that depends on using the length of the indirect head by transferring its attachment to the distal end of the direct head.
CONCLUSIONS: Quadriceps femoris contracture in children leads to limited knee flexion. Proximal release in the early stage gives excellent result. The technique used in this research gives an opportunity to restore knee flexion and a chance for second release if needed.
摘要：
股四头肌挛缩在临床实践中并不常见。有人建议，肌肉注射到儿童大腿有时是这种情况的原因。
方法：该病例提出了一种治疗孤立性股直肌挛缩症的新手术技术。患者是一个6岁的男孩，抱怨走路时左腿向外旋转，无法下蹲。临床检查显示Ely's试验阳性，表明股直肌挛缩。患者接受了股直肌近端延长术。
结论：儿童股四头肌挛缩症可以是先天性的或获得性的。这种情况的确定原因是多次肌肉注射，外伤或缺血。如果诊断为挛缩，推荐的治疗方法是早期近端释放，晚期股四头肌腱远端延长。保持股直肌连续性的手术技术有更好的结果，并在必要时给予第二次延长手术的机会。本文介绍了一种近端股直肌释放的外科技术，该技术取决于通过将间接头的附件转移到直接头的远端来使用间接头的长度。
结论：儿童股四头肌挛缩导致膝关节屈膝受限。在早期的近端释放给出了极好的结果。这项研究中使用的技术提供了恢复膝关节屈曲的机会，并在需要时提供了第二次释放的机会。
方法：该病例提出了一种治疗孤立性股直肌挛缩症的新手术技术。患者是一个6岁的男孩，抱怨走路时左腿向外旋转，无法下蹲。临床检查显示Ely's试验阳性，表明股直肌挛缩。患者接受了股直肌近端延长术。
结论：儿童股四头肌挛缩症可以是先天性的或获得性的。这种情况的确定原因是多次肌肉注射，外伤或缺血。如果诊断为挛缩，推荐的治疗方法是早期近端释放，晚期股四头肌腱远端延长。保持股直肌连续性的手术技术有更好的结果，并在必要时给予第二次延长手术的机会。本文介绍了一种近端股直肌释放的外科技术，该技术取决于通过将间接头的附件转移到直接头的远端来使用间接头的长度。
结论：儿童股四头肌挛缩导致膝关节屈膝受限。在早期的近端释放给出了极好的结果。这项研究中使用的技术提供了恢复膝关节屈曲的机会，并在需要时提供了第二次释放的机会。
