Al-Oraibi Saleh
Rehabilitation Department, Applied Medical Sciences College, King Saud University for Health Sciences, Saudi Arabia.
J Phys Ther Sci. 2014 May;26(5):793-5. doi: 10.1589/jpts.26.793. Epub 2014 May 29.
[Purpose] The purpose of this case report is to describe for the first time, the use of serial casting in the management of knee joint flexion contracture for a young child with spina bifida. [Case Description] The child was 6 years old, and had L3-L4 spina bifida level lesion with quadriceps muscle strength grade 3 +. The child had previously received weekly physiotherapy including stretching for knee flexion contracture on both lower limbs, but without improvement. [Results] The knee flexion contracture, which was not corrected with passive stretching, improved with casting from -40° knee extension to -5° knee extension as measured by a standard goniometer over a period of 4 weeks. Careful measures were taken to ensure skin integrity. At follow up after one-year, the child could ambulate independently with the help of walking aids. [Conclusion] The outcome indicates that using serial casting and follow-up with the use of bracing may be useful for enhancing the walking ability of a young child with spina bifida with knee flexion contractures. Further investigations of serial casting as well as investigation of serial casting with other interventions are warranted.
[目的] 本病例报告的目的是首次描述在一名患有脊柱裂的幼儿膝关节屈曲挛缩症管理中使用系列石膏固定法。[病例描述] 该患儿6岁，患有L3 - L4水平的脊柱裂病变，股四头肌肌力为3 +级。患儿此前每周接受物理治疗，包括对双下肢膝关节屈曲挛缩进行拉伸，但未见改善。[结果] 通过标准测角仪测量，在4周时间内，被动拉伸未能矫正的膝关节屈曲挛缩，经石膏固定后从膝关节伸展-40°改善至膝关节伸展-5°。采取了谨慎措施以确保皮肤完整性。在一年后的随访中，患儿能够借助助行器独立行走。[结论] 结果表明，使用系列石膏固定法并随后使用支具进行随访，可能有助于提高患有膝关节屈曲挛缩的脊柱裂幼儿的行走能力。有必要对系列石膏固定法以及系列石膏固定法与其他干预措施联合进行进一步研究。
