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A Study of Three Methods of Operative Correction

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1. In a prospective study of sixty patients with cerebral palsy and contracture of the hamstrings, 112 operations were performed by three different techniques after any necessary correction of flexion contracture of the hip or equinus of the ankle.

2. Transposition by the method of Eggers has been abandoned because simple lengthening has been found to have several advantages.

3. Proximal lengthening, at or near the ischial tuberosity, is employed when fixed flexion of the knee does not exceed 5 degrees, and is now the standard method. A transverse incision in the natal fold avoids cheloid formation.

4. Distal lengthening behind the knee is reserved for cases in which the fixed flexion exceeds 5 degrees.

5. After lengthening and weakening of the hamstrings, these spastic patients could stand more easily and walk with straighter knees, the length ofstride became greater, stairs could be climbed more easily, the feet could be lifted more from the ground, and the wear on the front of the sole became less. In addition the sitting position often improved because flexion of the hips became normal.

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