Limb Reconstruction
What is Limb
Reconstruction?
Limb reconstruction involves the use of an external fixator such
as a Taylor spatial frame or the ilizarov apparatus to lengthen
bones and/or correct deformity. Internal devices can also be used
for lengthening in the older child.
The main reasons for limb reconstruction are:
- Congenitally short limbs
- Growth plate injuries or disturbances due to trauma or
infection. E.g. Meningococcal septicaemia.
- Metabolic disorders such as hypophosphataemic rickets
- Congenital limb deformities.
- Persistent foot deformities such as CTEV.
- Trauma
What might physio involve?
If you are considering limb reconstruction surgery you will be
seen in clinic by the orthopaedic consultant, orthopaedic nurse
specialist and specialist physiotherapist to discuss the options
available. The physiotherapist and nurse specialist will go through
the principles and practicalities of limb reconstruction including
what will happen when you come into hospital, clothing, mobility,
getting back to school, physiotherapy on the ward and as an
outpatient, dressing changes, how to make adjustments to the frame
to lengthen your bone/correct a deformity and how to manage at home
whilst the frame is in situ.
The physiotherapist will look at your mobility, joint movement,
muscle length and power and, if indicated, give you exercises to
work on before your surgery. You may also be measured for a
wheelchair which will be ordered before your surgery to help you
with longer distances and getting back to school. They will also
discuss your home set-up and refer you to an occupational therapist
to see if there is any equipment that may help you manage at home
whilst the frame is on.
If you live outside of Bristol the physio will also refer you a
local physiotherapist to see you after your operation to help you
maintain your joint movement, progress your mobility and work on
improving your muscle strength.
Physiotherapy on the wards
After your operation the physiotherapist will come and see you
on the ward to make sure you are resting with your leg in the best
position to prevent any stiffness developing. If you have a frame
on your lower leg you will have a special shoe put on your foot and
tied up with a band to hold your foot in the best and most
comfortable position to prevent your leg muscles getting tight. The
physiotherapist will then help you to get out of bed and mobilise
using a Zimmer frame or crutches. The physiotherapist or doctor
will let you know how much weight you can take through your leg. If
you have stairs at home you will practice going up and down the
stairs before you are discharged. You will be given exercises on
the ward which you will need to continue with at home.
Physiotherapy as an outpatient
Whilst you have the frame on you will need to be seen regularly
by a physiotherapist (local to where you live) and complete a daily
exercise programme. This is especially important whilst you are
doing your adjustments as your muscles have to stretch to keep up
with the bone lengthening or deformity correction. If your
muscles become tight, then your joints may become stiff and the
adjustments may need to be slowed or stopped for a short period of
time.
You will be seen regularly in clinic in Bristol by the
consultant, specialist physiotherapist and nurse specialist. If
your physiotherapy is not based at Bristol Children's your local
physiotherapist will be kept up to date.
You may be seen in the physiotherapy gym or hydrotherapy pool
and the length/frequency of your sessions will be adapted according
to your progress.
Physiotherapy Contacts
- Niamh O'Mahony - 01173428525
