[Orthopedic problems of the lower extremities excluding the hips, in meningomyelocele]

Four types of problems relating to the lower limbs, hips excluded are reviewed in connection with myelomeningocele. These are essentially deformities and instability. Deformities follow three patterns: prenatal due to uterine pressure on paralyzed limbs, postnatal either postural or secondary to muscular imbalance. Various means of preventing these deformities are exposed. Lower limb stabilization by means of more or less extensive bracing according to the level of the initial lesion is described. Emphasis is put on early weight bearing and gait training in these patients. Problems of skin lesions and of spontaneous fractures are mentioned.