F.M. SAID^1, 2, I.F. AKHTYAMOV^2, 3, D.M. LURIE², L.V. DZYUMENKO¹, R.A. SHARIPOVA¹

 ¹Children’s Republic Clinical Hospital, Kazan

²Kazan Medical State University, Kazan

³Republic Clinical Hospital, Kazan

 Contact details:

Said F.M. — PhD (medicine), Assistant Lecturer of the Department of Traumatology, Orthopedics and Surgery of Extreme States

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7-993-405-40-80, e-mail: firassss86@gmail.com

 Cerebral palsy (CP) is the most common cause of early disability worldwide, which determines the significance of the problem for public health. Up to 32% of children with cerebral palsy at the age of 5 do not yet walk. Late diagnosis affects the development of the musculoskeletal system and, as a result, the quality of life of patients. Prevention of orthopedic deformities, timely treatment of concomitant orthopedic manifestations, rehabilitation courses and multidisciplinary care are crucial in the effectiveness of the treatment of these patients.

The purpose — to improve the results of conservative treatment of children with cerebral palsy with secondary orthopedic symptoms on the feet and ankle.

Material and methods. The article presents a clinical case of the treatment of a patient with orthopedic deformities of the foot and ankle joint against the background of cerebral palsy. After examination, the diagnosis was made: cerebral palsy, spastic form, hemiplegia of the left lower limb, plano-valgus deformity of the left foot, shortening of the left lower limb by 13 mm (GMFCS 2), neurogenic S-shaped scoliosis of the 2^nd degree. Further treatment was divided into stages. At the first stage, the child underwent a course of physiotherapy and the drug tolperisone (Mydocalm) was prescribed. At the second stage, the lower limb was plastered in phase manner. After the removal of the plaster, a second course of physiotherapy was carried out. The last stage was the treatment aimed at correcting the concomitant lesions.

Results. The patient underwent a course of combined treatment to restore the function of the lower limb. The assessment of the functional state before and after treatment was carried out according to the functional motor activity scale (FMS). At the last follow-up examination 18 months after the treatment, the FMS score was 6–6–6 points. On the control plate electromyography, no data for recurrence was revealed.

Conclusion. Combined rehabilitation treatment of children with cerebral palsy GMFCS 1–2 with repeated courses of rehabilitation is an effective method of treatment.

Key words: cerebral palsy, planovalgus feet, rehabilitation, phase plastering.

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