In 17 myelomeningocele patients with subluxating or dislocated hips, 31 posterolateral iliopsoas were treated by transfers, as described by Sharrard, in addition to complimentary procedures to balance muscle power and center the hip joint. Surgical goals are to stablize the hips within the acetabulum and prevent the occurrence of severe fixed flexion and adduction contractures of the hip and secondary lumbar lordosis. Surgery is performed at about 1 year of age with bilateral adductor transfer to the ischium, followed in 2 weeks by the posterolateral transfer of the iliopsoas muscle, first on one hip and 2 weeks later following with the other hip. Adductor transfer to the ischium reduces the adductor and secondary flexor power of the adductor longus and anterior fibers of the adductor brevis. After transfer it provides some extensor power. The range of abduction is increased. The transferred iliopsoas muscle has a better mechanical advantage in its new function as an abductor and extensor, and the hips were better centered radiographically than the cases with iliopsoas transfer alone. Fewer bony procedures were required to center the hips when the iliopsoas transfer was performed in children before the age of 1 1/2 years.

Braces↗

PubMedDate not supplied

Measurement of plantar flexor spasticity during treatment with tone-reducing casts.

The purpose of this study was to examine the hypothesis that treatment with short-leg, tone-reducing casts will alter resistance of the plantar flexors to dynamic and static stretch. The torque resisting passive dorsiflexion was measured at angular velocities of 0, 12, 60, and 120 degrees/s for 16 spastic extremities. The short-term changes in dynamic sensitivity and static sensitivity were not significant. Longer-term wearing resulted in significant decreases in both dynamic sensitivity and static sensitivity. Thus, a change in resistance to stretch did occur with longer-term casting.

Casts, Surgical↗

PubMedDate not supplied

Varus and valgus foot in cerebral palsy and its management.

Varus and valgus foot, often associated with equinus, are common problems in cerebral palsy. These deformities can interfere with standing or walking, aggravate shoe wear, and lead to painful calluses on pressure areas of the foot. The deformities are caused by a basic muscle imbalance. If the posterior or anterior tibial muscles are overactive, the foot will swing into varus. If the peroneal muscles predominate, the foot assumes a valgus position. However, the alignment of the hip and knee play an important role in the production of deformity. Correction of the deformity must be preceded by assessment of the deforming forces. In the younger child, simple muscle releases weaken the overpowering muscles and help restore muscle balance. In some instances, muscle transfers, either whole or split, not only alleviate the deforming force but also may provide needed support for the weaker muscles. Once bone deformities are established, they must be corrected either prior to or simultaneously with muscle procedures. The purposes of this article is to outline the evaluation of the deformity and the various soft tissue and bone operations which can be performed to correct them in order to obtain a satisfactory plantigrade foot.

Arthrodesis↗

PubMedDate not supplied

Conservative treatment of sickle cell avascular necrosis of the femoral head.

Treatment of avascular necrosis of the femoral head in adolescents with sickle cell anemia has not yet been standardized. In this study we review the literature and report on three patients with the Legg-Perthes-type avascular necrosis associated with sickle cell disease. These patients were successfully treated by partial weight-bearing with crutches and active range-of-motion exercises. We have examined physiologic and anatomic factors in this specific disease syndrome, which suggest that this may be the preferred method of treatment.

Adolescent↗

PubMedDate not supplied

Corrective therapy medical rehabilitation report: camp American Legion.

Explore the source record for details and available documents.

Camping↗