Polio

Note

Selective affection of AHC in an un-immunized child causes asymmetrical motor paralysis with intact sensation.

It produces

Aim

  • Correct deformity
  • Grant muscle balance
  • Restore stability
  • Equalize limbs

Non-Surgical Management

Orthotics

Deformities

Hip

  • FABER Hip
    • Release TFL, Sartorius, and Deep Fascia

Knee

  • Flexion and ER (External Rotation)
  • Posterior Subluxation
  • ‘Yount’s Procedure’
    • Transection and excision of part of ITB
    • Hamstring Transfer

Cavus Foot

Steindler Procedure- Tpost, Medial Calcaneal Vessels & Nerve are at risk

Equinus Deformity

Z Plasty Elongation of Achilles Tendon

Equino cavus

JESS Fixator

Muscle Imbalance

Gluteal Paralysis

Leads to Strong Iliopsoas and Dislocation

Musculo-Aponeurotic Transfer of External Oblique Muscle

Psoas Transfer- can cause injury to femoral nerve, AVN hip and weak flexion

Knee

Quadriceps Weakness

Hamstring Transfer

MRC ≥ 4

No Knee Contracture

Hip Flexion ≥ 3 (Biceps & ST Transfer)

Supracondylar Extension Osteotomy

  1. Hamstring ≤ 3
  2. Flexion Contracture < 20°
  3. Bring Weight-Bearing Axis Anterior to Knee

Foot & Ankle

  • EDL Transfer
  • Tibialis Anterior Transfer
  • Triple Arthrodesis
Back to top