Pediatric dwarfism clinic
On MRI examination, Sang-Il had multiple abnormalities and an underlying disease that was beyond neurological and musculoskeletal measures upon gathering all the examinations and radiological sources. I am personally suspecting “Charcot-Marie-Tooth Disease” but it is not a certain diagnosis yet. He not only has mental retardation and epilepsy, but also musculoskeletal problems such as bilateral in-toeing gait, genu valgum, and cavus caused by muscular dystrophyand bilateral femoral anteversion in his limbs. Also, after a fall in August, 2008, he had fractures on his upper right humerus and femur. During the recovery period, he had a refracture in the right tibia and an additional fracture in the femoral supracondyle. Due to the trauma around the right knee joint, his knee joint became very rigid, causing limitation in knee flexion and LLD, right lower limb being shorter than the left lower limb. Also, as an accompanying problem to the right humeral fracture we observed an osteophyte on the right elbow. Upon this heterotopic ossification, the elbow joint became rigid, causing restriction in movement.
Since Sang-Il had congenital deformities and deformities cause by various reasons later on, it was decided that only parts of his deformities would be operated. Since bilateral femoral deformity, right knee joint contracture, and left genu valgum were not the aim of the surgery, the deformities still remain the same. The elbow joint, which was one of the operated areas, was restricted due to contracture, allowing only to 100 degrees of motion, making it difficult for him to pick up food and put it in his mouth. So he had to use a spoon to barely put food in his mouth. Therefore he had to use his left arm most of the time for daily activities. But after the surgery, the contracture was eliminated, allowing the elbow joint 120 degrees of movement. So now he is able to put food in his mouth with right hand as well, and uses his right hand for eating most of the time.
Through “right tibial osteotomy and Ilizarov device application”, the right genu valgum, which used to be more severe the left, has been perfectly corrected. Also, thanks to lengthening of the right tibia, the LLD has decreased. The narrow step width caused by contracture in the femoral adductors has improved as well, showing stable walking posture. However, equinovarus was seen as a side of effect of the Ilizarovtibial lengthening surgery. This is actually the most common side effect of the surgery. The right ankle dorsiflexion has been recovered to 0 degrees after persistent rehabilitation therapies, but varus deformity is still remaining. I have talk to Professor Song about this after the surgery, and he told me that we should wait and see rather than have a second surgery, since it is not so sever.
I ask for continuous support
Our family members at Chungbuk Rehabilitation Center are still getting therapies here and will be going to Professor Song for outpatient in spring of 2012. For us who live in social service facilities, another trip to Seoul will be a new memory and experience for us. Also, there are other family members at our center who are looking forward to having the surgery. So I would like to ask for your continuous support for all the disabled people in the nation.
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