Outcomes of combined hamstring release and rectus transfer in children with crouch gait.

Background: Our aim was to evaluate the outcomes of combined hamstring release and rectus transfer in children with crouch gait using physical examination and gait analysis.

Materials And Methods: A total of 19 patients (38 knee joints) with crouch were evaluated by static examination and computerized analysis with dynamic EMG. The Ely test was positive together with prolonged and increased activity in the rectus muscle bilaterally in all patients. These patients underwent hamstring release and rectus transfer. Intensive rehabilitation was provided following the surgery and the patients were evaluated again by static examination and gait analysis after an average of 6.3 (4-7.5) months after surgery. The preoperative and postoperative static examination findings, knee and ankle joint kinematics and time-distance parameters were compared in 19 children.

Results: There was a significant improvement in static examination findings, knee and ankle kinematics and time-distance parameters. However, there was no significant difference between the preoperative and postoperative swing phase peak knee flexion.

Conclusions: This study demonstrated that static parameters, time-distance parameters, knee and ankle kinematics were improved following combined hamstring release and rectus transfer in children with cerebral palsy without any cases of stiff knees.