Abstract
Introduction: During the last decade the Ilizarov method of limb lengthening has provided a solution for many patients with short stature, suffering not just from cosmetic problems, but having functional disability as well. The aim of this presentation is to discuss our experience of physiotherapy at all stages of treatment, from pre-operative evaluation to the final adaptation of the patient to his new limb condition and the problems that evolved and our solution to them.
Patients and Methods: Over the past six years, five patients underwent limb lengthening. Two had achrondoplasia, one had proximal focal femoral dysplasia and two had metaphysical dysplasia. Physiotherapy was given to prevent pulmonary complications, maintain joint mobility and muscle strength, stretch the soft tissue, encourage weight bearing and improve gait. The main complications that occurred were short quadriceps tendon, short Achilles tendon causing equines, excessive anterior pelvic tilt, restriction of the knee joint due to tightness of the iliotibial band and non-compliance of the patient.
Results: After the completion of treatment all patients walked independently and returned at least to their pre-operative functional level. Their posture and self-confidence were improved. Average lengthening of the lower limb was 28 cm.
Discussion: Careful selection of patients, maintenance of maximal range of motion of all joints involved at every stage of the treatment and long term physiotherapy after the removal of the external fixators are essential for success. It may be important to halt the lengthening process if adequate joint motion is not achieved. It can be concluded that despite the fact that this is a lengthy and painful procedure, the end results make it worthwhile.
The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.
