Articulated abducted hip brace and the method of its use in children with spastic paresis

Abstract

Rehabilitation of patients with spastic paresis with restora­tion of walking function is an actual problem. There are more than 23 000 children with cerebral palsy in Ukraine, morbidity — 0.15 %, prevalence — 2.62 %. The main reason of severe hip instability in children with cerebral palsy is muscular imbalance with flexion and adduction contracture in the hip joint. Bracing is one of the prophylaxis and treatment method.Objective: to determine the feasibility of abducted hip braces in children with spastic palsy accompanied with rehabilitation measures.Methods: we used articulated abducted hip brace which consists of lumbar sleeve with double front bandage, individual hip cuffs, and articulated femoral rack with diameter of 8 mm, knots for adjusting the position of the hip cuffs and abducted racks. The basic effect of the brace is to reduce the hypertonicity of adducted muscles, due to this it is possible to abduct the femur, align the body, to provide hip extension. Abducted hip brace provides hip joint stability, normalize distribution of pressure between the femoral head and acetabulum, and decreases the probability of femoral dislocation in two times. We present the order of brace usage. Clinical assessment of its efficacy is made in 49 patients.Results: the best effect of the treatment patients have got in cases of combination of abducted hip brace with orthopaedic shoes or ankle joint and feet braces.Conclusions: articulated abducted hip brace allows to correct body posture and to decrease muscles spastic. It is possible to extend hip joint and align the body, femur and crus muscles begin to load, it is important for reliable body support.