Hip weakness with functional ankles

Hip weakness with functional ankles

8/29/2014

I've been called in on a most unusual case. The client s a
retired physician who under went elective surgery for spinal
stenosis at T-10-11. The surgery was followed by bleeding
resulting in a subdural hematoma effecting all spinal levels
distal to the surgery. He is now two months post-op. He is
able to dorsiflex and plantarflex the ankle functionally
although there is weakness present. He is able to extend
the right knee against gravity but just barely. He cannot
bear weight on either knee without external stabilization.
 Hip flexors and extensors show profound weakness but are
detectable. There is end range tightness in both hamstrings
and hip flexors. In stance his hips tend to drop into
flexion. He is in physical therapy but is approaching the
end of his part A stay in the rehab facility. Upper
extremity strength is very good and there is no history of
rotator cuff problems.

Obviously it is still early in his recovery and we expect
further progress. Our goal is to provide the ability to
stand and ambulate short distances in the home without
inhibiting the return of function. Control of excessive hip
flexion and knee is necessary but I would like to avoid
locking the hips if I can.

Your thoughts and suggestions are requested.

Ted A. Trower CPO,
A-S-C Orthotics & Prosthetics
Jackson, MI
www.amputee.com