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Related Experiment Videos

Lower extremity alignment in children with spina bifida.

J G Wright1, M B Menelaus, N S Broughton

  • 1Division of Orthopaedics, Hospital for Sick Children, Toronto, Ontario, Canada.

Journal of Pediatric Orthopedics
|March 1, 1992
PubMed
Summary

Children with spina bifida develop mild lower extremity valgus over time, unlike typical development. Interventions like orthotics or walking do not significantly alter this natural progression.

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Area of Science:

  • Orthopedics
  • Pediatric Neurology
  • Developmental Biology

Background:

  • Spina bifida is a congenital condition affecting spinal cord development.
  • Lower extremity alignment is a common concern in pediatric patients with spina bifida.
  • Understanding the natural history of limb alignment is crucial for effective management.

Purpose of the Study:

  • To describe the natural history of lower extremity alignment in patients with spina bifida.
  • To identify factors influencing the development of angular deformities.
  • To evaluate the efficacy of interventions such as orthotics and ambulation.

Main Methods:

  • Prospective evaluation of spina bifida patients from birth to 23 years.
  • Serial examinations conducted at two major children's hospitals since the 1970s.

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  • Data collected from 434 patients with spina bifida.

    • Main Results:

    • Lower limbs in spina bifida patients exhibit neutral alignment at birth, progressing to mild valgus (average 6 degrees).
    • Severe valgus ( >10 degrees) occurred in only 6% of patients.
    • Walking, above-knee orthosis use, and neurosegmental level did not significantly impact angular deformity.

    Conclusions:

    • The natural progression of lower extremity alignment in spina bifida is characterized by mild valgus.
    • Above-knee orthoses to prevent malalignment are not warranted.
    • Continued ambulation does not significantly contribute to lower extremity deformity in these patients.