Final Case Studies + Scoliosis 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
- 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
- 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!!!
When is scoliosis screening typically recommended
Middleschool
Boys:13-14
Girls: 10 AND 12
What is the test for scoliosis called
Adams test
When should we refer a child to a pediatrician for scoliosis + the amount to be diagnosed with scoliosis
For a curve over 10 degrees
How is scoliosis named
For the convex side
What gender has a higher incidence of scoliosis
Females 7:1
What is the basic therapeutic intervention for scoliosis
Schroth treatment
stretch the shortened side, strengthen the lengthened side
What are the 3 key indicators of scoliosis prognosis
sex, riser sign/age, degree of curve
What degree of curve is orthotic intervention recommended for scoliosis
25-45
What degree of curve is surgical intervention recommended for scoliosis
35+
