Postoperative Myofibrotomy Orthotic treatment of the neuromuscular child
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Abstract
One of the techniques of surgical approach in cases of neuromuscular spasticity at the level of the lower limb for equine attitude or equine varus, is myofibrotomy. Normally, good joint mobilization is obtained postoperatively, but the patient may relapse due to spasticity and lack of mobilization. The postoperative mobilization steps can be of orthotic type or rigid mobilization with Ponsetti-type buttocks and then orthoses. The best results are obtained by Ponsetti buttock immobilization followed by orthosis. Orthoses are a necessity in approaching the deficit-compensation treatment of the neuromuscular patient. One of the major post-operative deficits is dorsiflexion control, which can lead to rotational compensations with a negative impact on walking.
Abstract (Romanian)
Una din tehnicilie de abordare chirurgicala in cazurile spastice neurmousculare la nivelulul membrului inferior pentru atitudinea equina sau varus equin, este miofibrotomia. In mod normal post operator se obtine o buna mobilizare articulara dar pacientul poate recidiva datorita spasticitatii si lipsei de mobilizare. Pasii de mobilzare postoperator pot fi de tip ortotic sau mobilizare rigida cu fese tip Ponsetti si apoi ortezare. Cele mai bune rezultate se obtin prin imobilizarea cu fese tip Ponsetti urmata de ortezare. Ortezele sunt o necessitate in abordarea tratamentului deficit-compensatie al pacientului neuromuscular. Unul din deficitele majore post operatorii este controlul dorsiflexiei care poate duce la compensatii rotatorii cu impact negativ asupra mersului.
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