Conservative & Surgical Treatments

Question 1

musculoskeletal symptoms associated with NM problems

Answer 1

contractures, bony malalignment, rotational deformities, hip subluxations/dislocations, limb length discrepancy, club foot, vertical talus

Question 2

types of tendon surgeries to repair MSK issues

Answer 2

tendon releases, lengthening, and transfers

Question 3

types of bone surgeries to repair MSK issues

Answer 3

wedge, rotation, locations: pelvis, femur, tibia, limb length/shortening surgeries, surgeries to fix dislocations, club foot, vertical talus

Question 4

conservative treatment for contractures

Answer 4

stretching, exercise, dynamic splinting, serial casting

Question 5

surgical treatment for contractures

Answer 5

tenotomy, tendon lengthening, release, transfer, spasticity management (meds, baclofen pump, SDR, etc)

Question 6

common tendon lengthening surgeries

Answer 6

– adductor tenotomy
– adductor transfer to ischium
– psoas release
– hamstring lengthening, release, or transfer
– distal rec fem transfer or release
– plantar flexor release

Question 7

precautions for all tenotomies

Answer 7

– initially NWB
– start with AROM
– doc recommendations for PROM, stretching, ROM in WB, and strengthening
– pt will need movement training using their new ROM
– back off if you cause pain

Question 8

PT treatment for most releases

Answer 8

– splinting, casting, orthotics
– improve/maintain AROM, followed by PROM and stretching
– WB but no twisting

Question 9

What is the main contracture that would lead to hamstring release surgery?

Answer 9

knee flexion contracture