RECTUS FEMORIS SURGERY IN CHILDREN WITH CEREBRAL-PALSY .1. THE EFFECTOF RECTUS FEMORIS TRANSFER LOCATION ON KNEE MOTION

Rectus femoris transfer was performed in 78 children (105 sides) with cerebral palsy (CP) at the same time as other surgical procedures as a ppropriate. The transfer was either medial to the sartorius (62 sides) , semitendinosus (19 sides), or the gracilis (14 sides) muscles, or la terally to the iliotibial band (10 sides). Gait analysis performed bef ore and 1 year after operation demonstrated increased knee range of mo tion (ROM) with increased extension at initial contact and in midstanc e and maintained knee flexion in swing. There were no statistically si gnificant differences between the four transfer sites in the effect on those variables. Therefore, the choice of rectus femoris transfer sit e can be dictated by surgical preference or by the nature of other sim ultaneous procedures. There was no consistent change in transverse pla ne motion of the hip or foot progression angles between the two gait a nalyses, suggesting that rectus femoris transfer does not affect gait abnormalities observed in the transverse plane.