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Year : 2004  |  Volume : 38  |  Issue : 4  |  Page : 226-232

Management Of Post Polio Residual Paralysis Of Lower Limb In Present Indian Scenario

Correspondence Address:
A. K Das

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Rational and relevant management to post polio residual paralysis of lower limb is important in India for accumulated number of them in this endemic zone over last 50 years is in millions. Majority of them are afflicted with paralysis of lower limb causing disorders of gait, deformities and disabilities of different degrees. Many of them still require detection, assessment, treatment and vocational rehabilitation. We treated thousands of them with institutional care and this is a report of the commonly practiced methods in lower limb polio and their follow up results since 1961. It has got relevance considering their subsequent vocational training and rehabilitation. Early recognition, postural care, physiotherapy, corrective plastering, traction and orthosis were useful in many. Many more required surgical interventions, like release of contractures of joint by fasciotomy, capsulotomy, suitable muscle transfer, osteotomy and arthrodesis of joint considering their disabilities and residual power of muscles. We performed external oblique abdominis muscle transfer for glutel paralysis with or without varus osteotomy of femur in 24 and hamstrings transfer of paralysis of knee extensors of 215 patients. Results were satisfactory. In the immature and supple foot transfer of suitable power yielded satisfactory results for prevention and correction of deformities. Patients with altered bony configurations often required osteotomy also. Fixed deformities of feet with articular incongruity after bony maturity were treated by triple arthrodesis in 190 patients with or without muscle transfer. Results were gratifying. In flail foot with stable hip and knee pantalar arthrodesis was performed in 171 patients. Most of them gained stable, painfree, plantigrade foot. Limb length discrepancy of more than two cm was treated by lengthening of shorter leg by tibial lengthening successfully in 110 patients with minor complications in 33 (30%). Many of our patients had the opportunity of vocational training as well as suitable rehabilitation after surgical management.

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