Article

OBJECTIVE: To report muscle strength, power, and function after limb-lengthening
surgery performed by using the Ilizarov technique. DESIGN: Prospective,
longitudinal observational study of a cohort of consecutive patients who
underwent limb-lengthening distraction followed up for 2 years after surgery.
SETTING: National Health Service hospital specializing in orthopedic surgery.
PARTICIPANTS: Patients (N=16) who had undergone limb-lengthening surgery
performed by using the Ilizarov method (11 men, 5 women; mean age=27 y; range,
13-56 y). INTERVENTIONS: None. MAIN OUTCOME MEASURES: Muscle strength and power
were assessed by using 2 validated measures: isokinetic concentric strength of
the quadriceps and hamstrings measured by using a dynamometer and leg extensor
power. Measures were recorded preoperatively and at 6, 12, and 24 months after
the completion of lengthening. Function was measured by 2 timed tests of
functional performance: stair climbing and sit-to-stand. RESULTS: Overall results
were good with high reports of function and satisfactory clinical examination.
Both concentric muscle strength and leg power showed a clear pattern of decreased
muscle strength at 6 months after frame removal, improving throughout the study
period until it was within 3% of the preoperative value at 2 years. By 2 years,
self-reported function and ability to complete timed functional tests had
returned to or improved on the preoperative values. Muscle strength remained
slightly below the preoperative value; this was more pronounced in the quadriceps
than the hamstrings. There was no association between muscle strength and the
amount of lengthening that had been undertaken. CONCLUSIONS: This study suggests
that there is a small residual decrease in muscle strength and power after
limb-lengthening surgery but that these do not adversely impact on a patients'
ability to perform everyday functional activities.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS