Hesperian Health Guides
Secondary Problems to Look for with Polio
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By secondary problems, we mean further disabilities or complications that can appear after, and because of, the original disability.
TYPICAL CONTRACTURES IN POLIO
A child with paralysis who crawls around like this and never straightens her legs will gradually develop contractures so that her hips, knees, and ankles can no longer be straightened.
OF ANKLE AND FOOT
OF ANKLE AND FOOT
|bending down at ankle (tiptoe) contracture)||bending down at mid-foot||bending out at ankle||bending in at ankle|
CONTRACTURES OF JOINTS
A contracture is a shortening of muscles and tendons (cords) so that the full range of limb movement is prevented.
Unless preventive steps are taken, joint contractures will form in many paralyzed children. Once formed, often they must be corrected before braces can be fitted and walking is possible. correction of advanced contractures, whether through exercises, casts, or surgery (or a combination), is costly, takes time and causes discomfort. Therefore early prevention of contractures is very important.
OTHER COMMON DEFORMITIES
Weight bearing (supporting the body’s weight) on weak joints can cause deformities, including:
foot out of line with knee(when knee points forward, foot points to the side)
|partly or completely dislocated joints (especially knee, foot, hip, shoulder, elbow, thumb)||partly dislocated knee|
|partly dislocated foot|
WARNING! Dislocations like these are sometimes caused by stretching contractures incorrectly.
|Minor curve of spine can be caused by tilted hips,as a result of a short leg.||More serious curve of the spine is caused by muscle weakness of the back or body muscles. The curve can become so severe that it endangers life by leaving too little room for the lungs and heart.|
|a severely paralysed child|
elbow bent backward
apparent hunchback from bulge of ribs
|At first, the spinal curve straightens when the child is positioned better. But in time the curve becomes more fixed (will not straighten any more). For information on spinal curves, see Chapter 20.|