At 19:22 31/03/99 +0800, you wrote:
>Hi everyone,
>First, I would like to thank those of you who responded to my enquiry. To
>answer Margs' question: yes I tried taping but to achieve some degree of
>correction considerable force directed medially had to be applied. My patient
>managed only few hours with the tape on and took if off with skin
irritation and
>few blisters.
>We started electric stimulation of the VMO's yesterday.
>I also heard about surgury where they scrap the articular surface of the
patella
>and implant some plastic button to provide gliding movement. I suppose
with the
>surgical lateral release it could work, but I worry about the length of rehab
>and have in mind that she had a stroke. Any thoughts?
>Tom
>
----------------------------------------
Tom, it's going to be all in the weigh up of the pros and cons for a lass of
her age. It seemed from your earlier report that the hemiplegia was not a
big limitation. How fit she is in regard to anaesthesia may play a bigger
role. The choice then gets down to level of pain and functional limitation:
if she can't bear the pain or she is unsafe in her environment then an op
might be an imperative. Otherwise, quads function and gait balance can be
expected to drop off considerably and rehab time will depend on time not
mobile post op. I would expect up to 8 weeks ordinary rehab plus multiply
every week not mobile by three to independent safe mobility in most
environments with aid, then some further time to full potential. Perhaps
reviewing up to six months. So it is best to have good quads activation and
safe gait on the level. I would tend to be putting off operation until this.
Owen Allen
Atherton Hospital
P.O. Box 183
Atherton 4883
Queensland, Australia.
Ph: 07 40910261
F: 07 40913502
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|