Final Case Studies Flashcards
T or F: Adults with CP have higher rates of depression than adults without CP
T
_
_______ is most frequently seen in
individuals with spastic diplegic CP who use a crouch-type gait pattern.
patella alta
________ increases strength in youth and young
adults with CP.
progressive resistance exercise
What is a rotationplasty
ROTATIONPLASTY: Surgical procedure in which the tibia is rotated 180°
so that the toes point posteriorly allowing the anatomical ankle to function as the knee in order to create a below-knee amputation level
What is a SYME AMPUTATION
Ankle disarticulation; in children with more significant presentation of PFFD (PROXIMAL FEMORAL FOCAL DEFICIENCY), this procedure creates a functional above-
the-knee amputation.
PFFD (PROXIMAL FEMORAL FOCAL DEFICIENCY) Precautions
Osteopenia, which increases risk of fractures; pin site infection; hypertrophic scarring; loss of ROM; muscle
atrophy; increased risk of falls; decreased overall conditioning
PFFD Complications during physical therapy:
Fractures at lengthening site, pin site infection, emotional lability related to multiple surgeries, fear of
movement and falls
The femoral head is present in what aitken classifications?
A and B
PFFD characteristics
shortened
limb, thick bulbous thigh that has a ship’s funnel appearance, abducted and flexed femoral segment, and possibly a longitudinal deficiency of the fibula.
PFFD associated impairments:
knee instability with absence of the
cruciate ligaments, genu valgus, fibula deficiency with talocalcaneal coalition
and foot deformity, bilateral PFFD, and associated upper limb anomalies
There are three main surgical options for individuals with PFFD:
(1) femoral osteotomy with staged limb lengthenings
(2) femoral osteotomy, knee fusion, and Syme amputation (creating an above-knee prosthetic functional level
(3) femoral osteotomy with tibia
rotationplasty (below the knee prosthetic functional level)
Note: for PFFD a femoral osteotomy always precedes each procedure
syme amputation has a _________ knee prosthesis functional level
rotationoplasty has a ___________ knee prosthesis functional level
above the
below the
what has better functional outcomes between the syme amputation and the rotationoplasty
rotationplasty
The most common first intervention for a 14-month-old toddler with left
Aitken Type C PFFD is:
Extension prosthesis with prosthetic knee
What is the most appropriate inpatient physical therapy intervention for
a 6-year-old male immediately after limb lengthening and application of
unilateral external fixator?
Active and active assisted hip, knee, and ankle ROM, bed mobility
and transfers, and weightbearing to tolerance using assistive device
Pt’s with external fixators get immediate WBing!!!
