Schiltenwolf M, Carstens C, Bernd L
Abteilung für Orthopädie im Kindesalter, Orthopädische Universitätsklinik, Heidelberg.
Geburtshilfe Frauenheilkd. 1992 Aug;52(8):449-53. doi: 10.1055/s-2007-1023787.
Shortly before or shortly after the delivery of a child suffering from congenital paraplegia (myelomeningocele or spina bifida) the obstetrician is obliged to give advice as to what will follow after neurosurgical closure of the cele and shunting of the hydrocephalus. The parents' understanding of therapy and integration of the patient is developed to assess and utilise the future chances of the disabled child. Integration of children with congenital paraplegia is performed by an interdisciplinary team of therapists. However, the obstetrician's advice is of great value in preparing the parents for their decision for or against total care post partum. They must in fact be fully aware of the chances, that the disabled child actually has with regard to integration in life, and of what can be done in this respect. Besides the neurological, paediatric and urological care, it is the task of the orthopaedist to preserve or even to improve verticalization and mobility in paraplegic patients. In this manner he exercises an influence on the quality of life of the disabled children and on their social integration. Improvement and further development of physiological orthoses for walking enable even children suffering from a thoracic level of paralysis to walk independently and to achieve integration into society. Orthopaedic aspects of integration must be part of the information given to the parents by the obstetrician, so that they may be able to assess in what way their disabled children can participate in the future at various levels of everyday life.
在患有先天性截瘫（脊髓脊膜膨出或脊柱裂）的患儿分娩前不久或分娩后不久，产科医生有义务就脊髓脊膜膨出的神经外科闭合及脑积水分流术后的后续情况提供建议。要培养父母对治疗方法的理解以及对患儿融入社会的认识，以便评估并利用残疾儿童未来的机会。患有先天性截瘫的儿童的融入由一个跨学科治疗团队来完成。然而，产科医生的建议对于让父母做好决定是否在产后提供全面护理的准备具有重要价值。实际上，他们必须充分了解残疾儿童在生活中融入社会的实际机会，以及在这方面可以采取哪些措施。除了神经科、儿科和泌尿科护理外，矫形外科医生的任务是保持甚至改善截瘫患者的直立能力和活动能力。通过这种方式，他会对残疾儿童的生活质量及其社会融入产生影响。用于行走的生理性矫形器的改进和进一步发展，使即使是患有胸段瘫痪的儿童也能够独立行走并融入社会。融入社会的矫形外科相关内容必须成为产科医生向父母提供的信息的一部分，这样他们就能评估自己的残疾儿童在未来日常生活的各个层面可以以何种方式参与其中。
