Diz fleksiyon kontraktüründe tedavi yaklaşımları

Beyin felcinde en çok etkilenen eklem diz eklemidir. Diz fleksiyon kontraktürü, çömelme pozisyonunda yürümeye, basma fazında stabilite kaybına, ayakta durma ve oturmada ve günlük yaşam aktivitelerinde zorluklara yol açar. Ayrıca, genç erişkin dönemde, patella alta, patellofemoral eklem dejenerasyonu, patella ve tüberküler kırıklarına da neden olabilir. Bu çocuklar ileri yaşlarda, yüksek enerji gerektirdiği için yürümeden bile vazgeçebilirler. Bu yazıda, beyin felçli çocuklarda diz fleksiyon kontraktürlerinin nedenleri, klinik ve radyolojik değerlendirmeler ve tedavi prensipleri gözden geçirildi. Ayrıca, yapılan çalışmalar ve yürüme analizi verileri ışığında diz fleksiyon kontraktürünün biyomekaniksel nedenleri ayrıntılı olarak tartışıldı.

Anahtar Kelimeler:

Çocuk, Kas, iskelet, Diz eklemi, Yürüyüş şekli, Kontraktür, Beyin felci, Tendonlar

Treatment approaches to ﬂexion contractures of the knee

The knee is the most affected joint in children with cerebral palsy. Flexion contracture of the knee is the cause of crouch gait pattern, instability in stance phase of gait, and difﬁculties during standing and sitting, and for daily living activities. It may also cause patella alta, degeneration of the patellofemoral joint, and stress fractures of the patella and tibial tubercle in young adults. Children with cerebral palsy may even give up walking due to its high energy demand in the adult period. The purpose of this article is to review the causes of the knee ﬂexion contractures, clinical and radiological evaluations, and treatment principles in children with cerebral palsy. The biomechanical reasons of knee ﬂexion deformity are discussed in detail in the light of previous studies and gait analysis data.

Keywords:

Child, Muscle, Skeletal, Knee Joint, Gait, Contracture, Cerebral Palsy, Tendons,

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