Conventionally, patients are placed in plaster shorts – known as a spica – for six to eight weeks. These hold the hip in place but limit movement, causing muscle wastage, delaying the start of therapy treatment and preventing them from standing or walking for a minimum of three months.
Many children born with cerebral palsy, a brain disorder which causes the muscles to tighten and pull the hip joint out of place or lead to dislocation, need hip surgery to allow them to stand and walk or, if permanently in a wheelchair, to move freely and sit in comfort.
Under accelerated rehabilitation, patients are placed in their brace at night or during periods of rest following surgery, allowing early movement and early standing to preserve muscle strength or comfortable seating to allow a quicker return to school.
The programme has also been introduced for children with severe spina bifida, where a series of birth defects affect the development of the spine and nervous system, as they can require radical surgery to straighten the hips and enable them to sit well in a wheelchair or, in some cases, stand.
“With a standard rehabilitation programme using the a hip spica, children would be off their feet for around six to eight weeks and unable to fully weight bear and walk until around three months after surgery, leaving them homebound and losing power in already weak muscles,” said Miss Edwards, who has a specialist interest in cerebral palsy and neuromuscular disorders.
“Now, for the first time, we are seeing children who have undergone major, invasive surgery return to school with the aid of a wheelchair less than two weeks later and some stand or walk extremely well by six weeks, which is unprecedented.”
Source: University Hospital Southampton NHS Foundation Trust