Polio sequelae and the use of orthopedic devices

Poliomyelitis is an acute infectious disease caused by a neurovirus. It mainly damages the anterior horn cells of the spinal cord, causing motor nerve fiber degeneration and producing flaccid paralysis of the innervated muscles. The paralysis is characterized by flaccid, bilateral asymmetry, not distributed according to the innervation area of the peripheral nerve trunk, and is not accompanied by uneven sensory impairment. The disease occurs in children under the age of 5 years, so it is called “poliomyelitis” and the sequelae can be partially restored by orthopedic devices and the deformity can be corrected. 1. Acute phase: From the onset of the disease to the resolution of the fever, about 2 weeks. It is important to protect the painful muscles while treating the whole body; try to make the paralyzed muscles recover early and prevent the deformity of limb joints. 2. Recovery period: from the disappearance of systemic symptoms to the point where the paralyzed muscles no longer recover, about 2 years. The principle of treatment in this phase is to support and protect the limb so that the muscles with reduced strength are not strained to avoid contracture or deformity. In the early stage, during the bed rest phase, the support can be in the form of metal joints with plastic orthoses. The advantage is that they are easy to remove and replace and facilitate functional exercise. In cases of lower limb paralysis, appropriate orthoses are still required to help the patient stand and walk to prevent and correct deformities. The limb with deformity should be prevented from further development of deformity and from developing into a fixed deformity. 3.After 2 years after the onset of the disease is the posterior period. After entering this period, the paralyzed muscles cannot be restored and some patients have deformities. The treatment method is to continue functional exercise and wear a lightweight orthotic protection. Limb paralysis caused by the sequelae of pediatric anesthesia: the upper and lower limb joints are involved, the muscles of the upper limb (shoulder, elbow and wrist joints) are atrophied; muscle strength is lost; the joints are deformed. The lower limbs (hip, knee, ankle) have muscle atrophy, loss of muscle strength, and joint deformation. Lower limb deformities are more common, mainly manifested as: unequal length of both lower limbs, dislocation of the affected hip, inward and outward knee hyperextension deformity, foot inversion and horseshoe foot deformity, etc. Pediatric anesthesia sequelae assembly orthosis is generally applicable to alleviate the control of deformity, provide normal biomechanical alignment function of the lower extremities, compensate for the unequal length of the lower extremities, etc. The following is a comparison chart between not wearing orthotics and wearing: Pediatric anesthesia sequelae orthotics can largely solve the patient’s standing and walking problems, get rid of crutches, improve the quality of life, and make their due contribution to the family and society.