[Reinforcement of the tension of the knee extensor apparatus in triple-flexion gait in children with motor disorders].

Surgical reinforcement of the knee extensor mechanism produces improvement in gait in children with cerebral palsy who walk with a crouch gait with flexion of the hips and knees. In these patients, the defect is related to excessive length of the patellar tendon as shown by the presence of greater passive extension than active extension of the knee, and a high position of the patella on lateral radiographs of the knee. Surgical treatment combines shortening of the patellar tendon with lengthening of the hamstrings and tenotomy of the rectus femoris. In a series of eighteen patients, the authors obtained fifteen satisfactory results, the procedures being performed bilaterally. The average follow up was four years. These results are compared with those obtained by other methods.