Experience of the treatment of the patients with polio consequences by Ilizarov's method in Pakistan

This study was conducted in the Midciti hospital, Karachi; Tahir Medical Center, Karachi; Majee Hospital, Hyderabad from Dec.2004 to Apr 2006 to show actuality of the problem of rehabilitation of Post Polio patients in Pakistan and efficiency and advantages of Ilizarov's Method in this matter. During the study period 100 patients were operated, all of them by Ilizarov's Method. Of these 62 were male and 38 females. Combined contracture of hip and knee joints with different degree of extremity shortening and foot deformity or instability were found in 26 cases; 62 patients had knee contracture with leg shortening and foot deformity or instability without hip contracture. Almost all of them were not able to walk without additional support. Some of them used orthopedic brace or crutches, others used to lock their knee by hand or by internal or external extremity rotation in combination with hand support. Two patients could move using wheel chair only and were crawling. Three-segment simultaneous surgical intervention was most common. In 90% of cases good and fair results where achieved and patients were satisfied. Deformities were corrected and required lengthening performed. After treatment most of the patients started to walk without any additional support; crawling and wheel chair patients are able to walk by using orthopaedic brace with sticks. It is concluded that Ilizarov's method is very affective and advanced for the treatment of Post-Polio patients and with well-skilled proper approach and application it is not so cumbersome as considered

Simultaneous correction of post-polio hip and knee joints contractue and foot deformity with limb lengthening by Ilizarov's method

We are presenting the case report of twelve years old girl, who had Post-Polio flexionabduction-external rotation contracture of hip joint, flexion contracture of knee joint, equines deformity of foot and limb shortening. She was treated by Ilizarov's Method in one stage and got excellent result

Miotomia seletiva de flexores do quadril em pacientes com paralisia cerebral. Analise retrospectiva a longo prazo / Selective myotomy of hip-flexors in patients with cerebral palsy: long term retrospective analysis

O autor analisou os resultados de miotomias seletivas de flexores do quadril em 42 pacientes com paralisia cerebral espástica num período de no mínimo três e no máximo 17 anos. Trinta e seis dos 42 pacientes que podiam caminhar tiveram maus resultados. Dificuldade para fletir as coxas, membros rodados para fora e maior amplitude de oscilaçäo lateral do tronco foram as características das dificuldades locomotoras pós-operatórias. Dentre as variáveis analisadas, somente deficiência do controle motor seletivo teve importância estatística (p<0,001) quanto aos resultados funcionais. Idade, capacidade pré-operatória de locomoçäo, padräo de comprometimento e imobilizaçäo pós-operatória tiveram influência irrelevante sobre os índices de recidiva ou hipercorreçäo.

Retraçäo do músculo quadríceps por injeçöes: análise comparativa de 12 pacientes operados / Retraction of the quadriceps muscle due to IM injection: comparative analysis of 12 patients

Os autores avaliam os resultados pós-operatórios de 12 pacientes com retraçäo do músculo quadríceps, devido a injeçöes intramusculares na face anterior da coxa (15 joelhos), submetidos a oito quadricepsplastias do tipo desinserçäo-deslizamento e a sete do tipo alongamento (Williams, Bennett). Foram analisados a força (torque máximo), a potência média e o trabalho total pela máquina do tipo Cybex 350, comparando-os aos critérios clínicos para graduaçäo de força. Concluem que os pacientes operados pela primeira técnica apresentaram melhor recuperaçäo funcional em relaçäo aos demais, que a avaliaçäo pela Cybex é mais precisa que os critérios clínicos e que a avaliaçäo isocinética é útil para fins comparativos nos casos unilaterais.