Orthopedic Care with Special Neuromuscular Disorders

22.11.2016
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Important orthopedic information for children with special neuromuscular disorders.

I recently had an e-mail from an individual who told me of the painful and unorthodox treatment a child had for arthrogryposis, a disorder where a baby is born with fixed joints. It may just be the hands or feet or several joints can be involved. In most pedatric orthopedic training program, emphasis is placed on conditions like cerebral palsy, sometimes spina bifida, and other non-progressive disorders. When a child has a neuromuscular disorder, most orthopedists are at a loss. Unfortunately even in well-known medical centers, the treatment may not be correct. The greatest problem is the orthopedists have not been taught that they must get these patients mobilized as quickly as possible. For example, after spinal surgery for a curvature of the spine in spinal atrophy a child should begin to have physical therapy as soon as it can be tolerated and be up sitting and moving right away. One of the worst cases I have seen was when an orthopedist, who technically was very good, would not allow a child to be mobilized for almost a year. The child's life, as well as the family's life, were changed forever. The doctor also signed the child out of the hospital as having ceerbral palsy. I was appalled.  

Another problem is when hip dislocation occurs in children with spinal atrophy who do not walk, most orthopedists immediately want to do surgery to put the hip back in place. What they don't understand is that because of the muscle weakness, the hip will come out of the joint once again. I have seen this happen in several  patients and some kids have had their hips dislocate again after repeated surgeries.

 

Article last time updated on 27.02.2017.

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