Limb length discrepancy is a common orthopaedic problem, frequently requiring surgical intervention. This thesis is concerned with one method of limb equalisation, leg lengthening surgery. It investigates the effect of leg lengthening surgery on the muscle function and rehabilitation of patients. Qualitative research methodologies demonstrated that there is considerable uncertainty about the best physiotherapy management of patients treated by the Ilizarov method. There is little evidence-basedre search into the rehabilitation of patients treated by this method of surgery. A clinical cohort study was conducted which examined different aspects o f rehabilitation. These included the effects of leg lengthening surgery on joint range of motion, muscle strength and on the ability to perform functional activities. The study of the effect of surgery on joint range of motion highlighted the need for repeatable measurement techniques. It found that there was a significant loss of joint range of motion in the latent period prior to distraction of the bones starting. Factors that influenced loss of joint range in the subjects included in this study included the rate of lengthening, the age and the diagnosis of the patient. A mathematical model was developed to assist in predicting the loss of joint range, at the pre-operative examination. The ability to perform functional activities and the effect on muscle strength were investigated and found to recover for up to 2 years following surgery and the removal of the Ilizarov fixator. Muscle strength recovered to within 5% of the baseline value by 2 years. This emphasises the need for a prolonged period of rehabilitation for patients treated by this method of surgery. Finally a Delphi survey was conducted to produce Clinical Guidelines about the physiotherapy management of patients treated by the Ilizarov method.
Permanent link to this resource: https://doi.org/10.24384/5y8e-m682
Barker, Karen L.
Supervisors: Lamb, Sallie
Faculty of Health and Life Sciences
Year: 2001
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