polio - stance control

Jeff and Diane Conuel

Description

Title:

polio - stance control

Creator:

Jeff and Diane Conuel

Date:

1/26/2006

Text:

Presenting a 77 yo man who had polio affecting R LE at age 3. He is
6'2, 190#. He reports he briefly wore a brace, but has not for at
least 70 years. He has zero quad strength. All other muscle groups are
virtually unaffected (dorsiflexion, hip flexion are 4/5. hip extension,
plantar flexion are 5/5 (and therefore he has good calf definition)).
Over the years, the patient has been very active (even downhill skiing!),
and learned to always keep his weightline anterior to knee center when
weightbearing on R. He uses R knee flexion in swing to clear floor
nicely; knee snaps back as he comes into single limb support. Patient
does report a few incidences over the 70 years where he has inadvertently
stepped on a rise with his R heel and buckled, with nasty falls.

Today, his complaint is PAIN due to recurvatum at R knee. He is also
concerned of the occasional fall, as he knows that at his age it could
easily result in a hip fx or the like. Pt is still very active with
walking 4-5 miles and easy hiking. ROM at all joints is normal, except
for the 20 degrees of recurvatum at R knee in weightbearing.

I have many ideas for this patient, but am very interested in the list's
input. He is an engineer and is very interested in the BEST design for
him -- he is in no hurry, and wants to carefully consider the options --
he is not sure he will be able to tolerate a brace.

Your thoughts on 1) KO vs KAFO (patient very concerned about ankle
flexibility for driving)?
2) Stance control brace that also controls recurvatum?
3) Is stance control really better for him, or is posterior offset knee
joints and recurvatum control simpler/more effective?
3) Lightweight, least cumbersome design for this very active, never worn
a brace guy?

TIA,
Diane Tormey CO

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Citation

Jeff and Diane Conuel, “polio - stance control,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 22, 2024, https://library.drfop.org/items/show/226042.