DOI: https://doi.org/10.15674/0030-59872018324-28
Open Access Open Access  Restricted Access Subscription Access

Articulated abducted hip brace and the method of its use in children with spastic paresis

Volodymyr Petrov, Stanislav Shevchenko, Pavel Baev, Sergey Korneev, Viktoriya Nagornaya

Abstract


Rehabilitation of patients with spastic paresis with restora­tion of walking function is an actual problem. There are more than 23 000 children with cerebral palsy in Ukraine, morbidity — 0.15 %, prevalence — 2.62 %. The main reason of severe hip instability in children with cerebral palsy is muscular imbalance with flexion and adduction contracture in the hip joint. Bracing is one of the prophylaxis and treatment method.

Objective: to determine the feasibility of abducted hip braces in children with spastic palsy accompanied with rehabilitation measures.

Methods: we used articulated abducted hip brace which consists of lumbar sleeve with double front bandage, individual hip cuffs, and articulated femoral rack with diameter of 8 mm, knots for adjusting the position of the hip cuffs and abducted racks. The basic effect of the brace is to reduce the hypertonicity of adducted muscles, due to this it is possible to abduct the femur, align the body, to provide hip extension. Abducted hip brace provides hip joint stability, normalize distribution of pressure between the femoral head and acetabulum, and decreases the probability of femoral dislocation in two times. We present the order of brace usage. Clinical assessment of its efficacy is made in 49 patients.

Results: the best effect of the treatment patients have got in cases of combination of abducted hip brace with orthopaedic shoes or ankle joint and feet braces.

Conclusions: articulated abducted hip brace allows to correct body posture and to decrease muscles spastic. It is possible to extend hip joint and align the body, femur and crus muscles begin to load, it is important for reliable body support.


Keywords


dysplasia; subluxation; hip; child cerebral palsy; abducted brace

References


Klimovitsky, V. G., Voropayev, V. M., Ilyushenko, Yu. K., & Kholodarev, O. P. (2003). Rehabilitation of invalids from childhood with neuroorthopedic patholog. Social pediatrics: Sov. sciences works. Kyiv: Intermed. (in Ukrainian)

Martynyuk, V. Yu., & Zinchenko, S. M. (2005). Fundamentals of medical and social rehabilitation of children with organic lesions of the nervous system: teaching method. manual. Kyiv: Intermed. (in Ukrainian)

Voropayev, V. N., Kireev, A. V., & Shamdrin, I. A. (2005). The character of the pathology of the locomotor system in children with cerebral palsy. Bulletin of the Reseratology and Physiotherapy, 3, 11. (in Ukrainian)

Nenko, A. M., & Vlasenko, S. V. (2009). Diagnosis and treatment of neuroorthopedic syndromes in children with cerebral palsy (algorithms for choosing treatment tactics): manual for doctors. Evpatoria. (in Ukrainian)

Gavrankapetanovic, I., Cobeljic, G., Bajin, Z., Vukasinovic, Z., & Gavrankapetanovic, F. (2006). Developmental dysplasia of the hip in cerebral palsy–surgical treatment. International Orthopaedics, 31(4), 561–568. doi:10.1007/s00264-006-0224-6

Korolkov, A. I., Lyutkevich, N. I., Khashchuk, A. V. (2013) Conceptual approaches to diagnosis and preventive treatment of hip subluxation and dislocation in children with infantile cerebral palsy. Orthopedics, traumatology and prosthetics, 3, 20–27. - doi: 10.15674 / 0030-59872013320-27. (in Ukraine)

Pountney, T., & Green, E. M. (2006). Hip dislocation in cerebral palsy. BMJ: British Medical Journal, 332 (7544), 772–775. doi: 10.1136/bmj.332.7544.772

Samilson, R. L., Tsou, P., Aamoth, G., & Green, W. M. (1972). Dislocation and Subluxation of the Hip in Cerebral Palsy. The Journal of Bone & Joint Surgery, 54(4), 863–873. doi:10.2106/00004623-197254040-00017

Danilov, A. A., Neh, A. A., Balitskaya, Yu. L., & Motsya, M. A. (2013). Treatment of flexural contracture of the knee joints in patients with cerebral palsy. Сollection of scientific works XVI Congress of Orthopedic Traumatologists of Ukraine. Kharkiv. (in Ukrainian)

Korolkov, O. I., Shevchenko, S. D., Lyutkevich, M. I., & Rikun, M. D. (2013). Clinical verification of the algorithmic system of treatment orthopedic pathology in children suffering from cerebral infantile paralysis (cerebral palsy). Сollection of scientific works XVI Congress of Orthopedic Traumatologists of Ukraine. Kharkiv. (in Ukrainian)

Lukban, M. B., Rosales, R. L., & Dressler, D. (2009). Effectiveness of botulinum toxin A for upper and lower limb spasticity in children with cerebral palsy: a summary of evidence. Journal of Neural Transmission, 116(3), 319-331. doi:10.1007/s00702-008-0175-8

Fuchs, A. (2008). Techno-orthopedic support for patients with cerebral palsy who can walk. Orthopаdie-Technik, 1, 20–25. (in Russian)

Apparatus SVOSH (for treatment of erebral palsy). (n.d.). Retrieved from http://www.persey-orto.ru/articles/swosh.php

Wynter, M., Gibson, N., Kentish, M., Love, S., Thomason, P., & Kerr Graham, H. (2011). The development of Australian Standards of Care for Hip Surveillance in Children with Cerebral Palsy: how did we reach consensus? Journal of Pediatric Rehabilitation Medicine, 4(3), 171–182. doi: 10.3233/PRM-2011-0173

Elkamil, A. I., Andersen, G. L., Hägglund, G., Lamvik, T., Skranes, J., & Vik, T. (2011). Prevalence of hip dislocation among children with cerebral palsy in regions with and without a surveillance programme: a cross sectional study in Sweden and Norway. BMC Musculoskeletal Disorders, 12(1). doi:10.1186/1471-2474-12-284




Copyright (c) 2018 Volodymyr Petrov, Stanislav Shevchenko, Pavel Baev, Sergey Korneev, Viktoriya Nagornaya

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.