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Rectus femoris transfer
Rectus femoris transfer
Rectus femoris muscleOriginAnterior Inferior Iliac Spine and Ilium above toe acetabulum
InsertionQuadriceps tendon to base of patella and onto tibial tuberosity via the patellar tendonNerve to muscleFemoral nerve (L2-L4)
Stiff knee gait
One of m/c gait abnormality in patients with spastic CP
Typical findingDecreased ROM of knee during swing phaseFoot clearance problemReduced gait velocityReduced step length
Rectus femoris transferConventional treatment IndicationPositive Duncan-Ely sign
Gait analysis
Decreased knee flexion in swingDecreased and delayed peak knee flexion in sweing
Dynamic electromyographyPathological increased activity of the rectus femoris muscleOP technique
Outcome
Keep the rectus as a hip flexorConvert the rectus into a knee flexor???Elimination of the rectus femoris activityStudy planPatients321 ptsFactors affecting the results of RFTAgeGenderAnatomical typeFunctional scale (GMFCS level)SEMLS concomitant with RFT
Long term resultsLMM?Gait analysis (knee sagittal motion)GDI
MRI study SNUBH
Isokinetic muscle strength
Isometric muscle strengthHip Flexion/extensionAdduction/abductionKneeFlexion/extensionAnkleDorsiflexion/plantarflexionInversion/eversionThank you!!