Early prosthetic and orthopedic assistance in medical rehabilitation of children with congenital and amputation defects of the lower limbs

Susliaev V.G., Shcherbina K.K., Smirnova L.M., Zamilatsky Y.I., Koltsov A.A., Sokurov A.V., Ermolenko, T.V.

Abstract


Introduction
The quality of medical rehabilitation and habilitation of children with lower limb defects depends on early prosthetic and orthopedic care.
Purpose
Analysis of the provision of prosthetic and orthopedic care for children with orthopedic pathology of the lower extremities at the Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht.
Methods
The results of rehabilitation and habilitation of 261 children with orthopedic pathology of the lower extremities were studied. Methods of clinical examination, radiography, physiological and biomechanical study were applied. Statistical analysis was carried out.
Results
In 261 cases studied, the causes of defects were congenital anomalies (82 %) and amputation defects (18 %). Surgical preparation for prosthesis application was performed in 85 cases (33 %). More than half of the patients who sustained interventions had a defect at the hip level. The anatomical and functional features of stumps in children with abnormal development of the lower extremities were studied and the principles of prosthesis and orthosis application were developed.
Discussion
Delay in prosthesis application leads to negative effects on the child's body. The supply of children with technical means of rehabilitation is not regulated in due manner by the current legislation, which leads to the complexity of the purpose of the product and the delay in the timing of prosthesis and orthosis fitting. Early prosthetic and orthopedic care for children with orthopedic pathology of the lower limb is a prerequisite for normal development of their growing body. Due to subjectivity of child's assessment of the results of prosthetic fitting, there is high risk of secondary deformities of the child's musculoskeletal system; for children using limb prostheses and orthoses, it is necessary to use an objective instrumental assessment of the results of prosthesis application; dispensary observation; monitoring of motor loads and the technical condition of the prosthesis. Early prosthetic and orthopaedic assistance to children should be conducted not only according to the rules of registration of the individual program for rehabilitation and habilitation (IPRH), but also followed to disability with the aim of preventing the development of complications, injuries, diseases of the musculoskeletal system, and impairment of functional disorders.

Keywords


medical rehabilitation, children, orthesis, prosthesis, lower limb

Full Text

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DOI: http://dx.doi.org/10.18019/1028-4427-2020-26-2-198-205

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