Myelomeningocele: a new functional classification.

Purpose: In myelomeningocele, several classifications have been used. The present manuscript proposes a new functional classification to better assess the prognosis and management of these patients.

Methods: The manual muscle test is what defines the actual group in which the patient should be included.

Hip Power and "Stiff Knee" Gait: A Tool for Identifying Appropriate Candidates for Rectus Transfer.

Background: Rectus femoris transfer (RFT) is performed in children with cerebral palsy to treat stiff-knee gait. However, the results are variable in part because there is no gold standard to identify appropriate candidates. Hip flexion kinematics and kinetics are important factors in the determination of peak knee flexion during gait.

Long-term retrospective study of patients with idiopathic clubfoot treated with posterior medial-lateral release.

Background: It has been demonstrated that an important component of clubfoot deformity is related to pathologic external rotation of the talus with respect to the remainder of the foot. The purpose of the present study was to review the long-term results for a cohort of patients with idiopathic clubfoot who were managed by a single surgeon with a uniform surgical protocol consisting of extensive posterior medial-lateral release in addition to the use of a temporary Kirschner wire to derotate the talus prior to fixation.

Methods: Eighty patients (120 clubfeet) with idiopathic clubfoot without previous surgery were managed with posterior medial-lateral release.

Do the hamstrings operate at increased muscle-tendon lengths and velocities after surgical lengthening?

Children with crouch gait frequently walk with improved knee extension during the terminal swing and stance phases following hamstrings lengthening surgery; however, the mechanisms responsible for these improvements are unclear. This study tested the hypothesis that surgical lengthening enables the hamstrings of persons with cerebral palsy to operate at longer muscle-tendon lengths or lengthen at faster muscle-tendon velocities during walking. Sixty-nine subjects who had improved knee extension after surgery were retrospectively examined.

Trunk kinematics and the influence on valgus knee stress in persons with high sacral level myelomeningocele.

Historically, trunk movement has been thought to be reactionary to lower body motions. The excessive trunk movement in patients with myelomeningocele may be a primary mechanism during ambulation. The purpose of this study was to quantify three-dimensional trunk movement in patients with myelomeningocele.

Gait analysis in low lumbar myelomeningocele patients with unilateral hip dislocation or subluxation.

The surgical indications for the treatment of unilateral hip dislocations or subluxations in patients with low lumbar myelomeningocele remain highly debatable. This study examines the influence of unilateral hip dislocation or subluxation on the gait of these patients using three-dimensional gait analysis. Twenty patients with a diagnosis of low lumbar myelomeningocele underwent three-dimensional gait analysis.