The Journal of Bone and Joint Surgery, Vol 61, Issue 6 927-933, Copyright © 1979 by Journal of Bone and Joint Surgery, Inc
Stiff-legged gait in hemiplegia: surgical correction
RL Waters, DE Garland, J Perry, T Habig and P Slabaugh
Selective tenotomy of one or two heads of the quadriceps based on
electromyographic criteria improved knee flexion in hemiplegic patients who
walked with a unilateral stiff-legged gait. The improvement was greatest in
eight patients in whom the rectus femoris was released, either with or
without release of the vastus intermedius, with activity in pre-swing
stance and initial swing confined to those heads of the quadriceps; in
these patients knee flexion improved an average of 20 degrees. Knee flexion
improved an average of only 8 degrees in five patients in who activity was
present in one head of the quadriceps that was not surgically released. No
improvement in knee flexion occurred in seven of eight patients in whom
activity was present in two or more of the quadriceps heads that were not
surgically released.