Meningomyelocele is a congenital defect involving the central nervous system which is one of the most common among those compatible with life. Children affected by this condition present neurological, orthopedic, rena...Meningomyelocele is a congenital defect involving the central nervous system which is one of the most common among those compatible with life. Children affected by this condition present neurological, orthopedic, renal and urogenital complications, needing lifelong healthcare provisions. The aim of this study was to analyze the reality experienced by children and adolescents with meningomyelocele and their families in the city of Belo Horizonte and its metropolitan area, Brazil. A descriptive and exploratory study was conducted via three home visits and a scripted interview with 16 children and adolescents with meningomyelocele and their families. It was observed that mean age of children and adolescents was 12 years old, most of them did not walk (n = 10), and depended on wheel chairs and parental care. Mothers represented the main caregivers and most (n = 12) had to leave their formal work outside of the home, compromising family income. It concluded that the families had socioeconomic levels aggravated by difficulties in purchasing materials needed for their children’s care. Some social challenges included barriers to education and the acquisition of medications and materials, demonstrating the need for planning public policies aimed at integrating different health services.展开更多
Calcaneovalgus foot deformities are present in up to 35% of patients with lumbar spina bifida. Resultant heel weight bearing causes complications include those associated w让h pressure ulcers. Early surgical reconstru...Calcaneovalgus foot deformities are present in up to 35% of patients with lumbar spina bifida. Resultant heel weight bearing causes complications include those associated w让h pressure ulcers. Early surgical reconstruction is advocated to prevent deformity progression and rigidity. Several surgical techniques in paediatric populations have been described, but there remains a paucity of literature regarding reconstruction of chronic calcaneovalgus feet in adults. This case report describes our experience using the Ilizarov technique in the reconstruction of an adult presenting with chro nic calcaneovalgus feet. This is a 34-year-old lady with myelomeningocoele spina bifida of lumbar level 5 who presented with a history of multiple admissions for cellulitis and infections of bilateral heel pressure sores. Rigid calcaneovalgus deformities of both feet (45° on the right, 40° on the left) were noted on clinical examination and radiological investigations. Reconstruction with an Ilizarov frame allowed for gradual correction of both soft tissue and bone, correcting heel weight bearing ambulation, with the aim of preventing further complications from infected heel ulcers. While the correction of bony deformities is crucial, management of chronically contracted soft tissue must not be overlooked. An Ilizarov frame requires both an experienced surgeon and a motivated patient, but it allows for accurate reconstruction of bony deferm让ies, while allowing management of surrounding chronic soft tissue contractures with good functional outcome.展开更多
文摘Meningomyelocele is a congenital defect involving the central nervous system which is one of the most common among those compatible with life. Children affected by this condition present neurological, orthopedic, renal and urogenital complications, needing lifelong healthcare provisions. The aim of this study was to analyze the reality experienced by children and adolescents with meningomyelocele and their families in the city of Belo Horizonte and its metropolitan area, Brazil. A descriptive and exploratory study was conducted via three home visits and a scripted interview with 16 children and adolescents with meningomyelocele and their families. It was observed that mean age of children and adolescents was 12 years old, most of them did not walk (n = 10), and depended on wheel chairs and parental care. Mothers represented the main caregivers and most (n = 12) had to leave their formal work outside of the home, compromising family income. It concluded that the families had socioeconomic levels aggravated by difficulties in purchasing materials needed for their children’s care. Some social challenges included barriers to education and the acquisition of medications and materials, demonstrating the need for planning public policies aimed at integrating different health services.
文摘Calcaneovalgus foot deformities are present in up to 35% of patients with lumbar spina bifida. Resultant heel weight bearing causes complications include those associated w让h pressure ulcers. Early surgical reconstruction is advocated to prevent deformity progression and rigidity. Several surgical techniques in paediatric populations have been described, but there remains a paucity of literature regarding reconstruction of chronic calcaneovalgus feet in adults. This case report describes our experience using the Ilizarov technique in the reconstruction of an adult presenting with chro nic calcaneovalgus feet. This is a 34-year-old lady with myelomeningocoele spina bifida of lumbar level 5 who presented with a history of multiple admissions for cellulitis and infections of bilateral heel pressure sores. Rigid calcaneovalgus deformities of both feet (45° on the right, 40° on the left) were noted on clinical examination and radiological investigations. Reconstruction with an Ilizarov frame allowed for gradual correction of both soft tissue and bone, correcting heel weight bearing ambulation, with the aim of preventing further complications from infected heel ulcers. While the correction of bony deformities is crucial, management of chronically contracted soft tissue must not be overlooked. An Ilizarov frame requires both an experienced surgeon and a motivated patient, but it allows for accurate reconstruction of bony deferm让ies, while allowing management of surrounding chronic soft tissue contractures with good functional outcome.
