The semitendinous rerouting, first described by Baker and Hill in 1964. was designed to correct the intoeing gait resulting from increased femoral anteversion and spastic hamstring muscle. In order to evaluate the efficacy of semitendinous
rerouting, we
selected 32 cases(21 patients) among the patients, who had been treated with this method due to intoeing gait, according to the following criteria ; (1) the main cause of intoeing was not due to internal tibial torsion or metatarsus adductus, (2)
the
patient was younger than ten years of age at the time of operation and the follow up period was more than 1 year. The mean age at the time of surgery was 5.5 years (2 years and 11 months-9 years) and the mean follow-up period was 2.2 years,
ranging
from
1 year to 8 years. There were 13 paraplegia (23 cases). 4 hemiplegia (4 cases). 3 diplegia (4 cases) and 1 triplegia(1 case). We divided the 32 cases into the 3 Groups as follows; (1) Group 1(14 cases); Semitendinous rerouting alone was
performed.
(2)
Group 2(11) cases); semitendinous rerouting and hasmtring release were combined. (3) Group 3(7 cases) ; semitendinous rerouting and adductor tenotomy were combined. The rating of result was made according to the following criteria : (1)
Satisfactory ;
intoeing gait was converted to outtoeing or at least to minimal intoeing, so that the patient and parents were satisfied, and secondary procedures were not needed. (2) Unsatisfactory : intoeing gait was not improved or only minimally improved, so
that
patient and parents were not satisfied or secondary procedures were required.
@ES The results were as follows;
@EN 1. Ten cases (71.4%) had a satisfactory result in Group 1, nine case (81.8%) in Group 2, and four cases (57.2%) in Group 3.
2. Satisfactory results could be obtained in the cases of which the foot progression angle was less than 15 degrees of intoeing, the external rotation of hip more was than 50 degrees, and the femoral anteversion was less than 40 degrees.
3. Genu recurvatum was newly developed or aggravated in three extremities postoperatively when the semitendinosus rerouting was combined with distal hamstring release.
4. In conclusion, the Baker-Hill's semitendinous rerouting can be applied for correction of intoeing gait, especially when combined with hamstring release, in young cerebral palsy patients whose deformities are not severs.
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