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[Walking in children after poliomyelitis]
1Service de Chirurgie des Scolioses et d'Orthopédie Infantile, C.H.U., Besançon, France.
Insights
This study on childhood poliomyelitis found that surgical interventions, primarily soft tissue release and triple arthrodesis, significantly improved mobility in children with residual paralysis. Early surgical treatment, especially before age 12, yielded the best outcomes for regaining walking ability.
Area of Science:
- Orthopedic Surgery
- Pediatric Neurology
- Rehabilitation Medicine
Context:
- Poliomyelitis, a viral disease, often results in residual paralysis affecting children's mobility.
- Surgical interventions are crucial for managing long-term sequelae of polio.
- This study examines surgical outcomes in a cohort of children treated for polio-related paralysis.
Purpose:
- To evaluate the effectiveness of surgical interventions in children with poliomyelitis-induced paralysis.
- To determine the impact of surgery on regaining ambulation and functional independence.
- To identify factors influencing treatment success, including age at intervention.
Summary:
- 630 children with poliomyelitis sequelae were analyzed, with 252 undergoing surgery (soft tissue release, triple arthrodesis).
- Average treatment duration was 3 months, with complications including vascular issues, sciatic nerve palsy, and fractures.
- Of 100 non-ambulatory children reviewed post-operation, 65 regained the ability to walk and attend school.
Impact:
- Surgical management significantly enhances functional recovery and ambulation in children with polio-related paralysis.
- Early surgical intervention, particularly before age 12, is associated with superior outcomes.
- Improved mobility facilitates school attendance and enhances the quality of life for affected children.
Abstract:
Between 1983 and 1990 the authors examined 630 children who had suffered from poliomyelitis, mostly between the age of one and three, at an average age of 9 years 3 months. Half were unable to walk because of residual paralysis. Operation was carried out on 252 children. Most underwent soft tissue release at the hips, knees or tendo Achilles. Triple arthrodesis was carried out on 24. Calipers, produced locally, were used, and trunk bracing was not employed. The average duration of treatment was 3 months, with gradual achievement of correction. Vascular complications occurred in one leg, there were 5 paralyses of the sciatic nerve and 4 fractures of the upper tibia. One hundred children who were not able to walk before operation were reviewed. Sixty five were walking and able to go to school. The best results were achieved before the age of 12.