- See:
-
Equinovalgus
-
Anterior Horn Cell Disorders:
-
outside links:
-
Polio Resources:
-
Lincolnshire Polio Network
- Discussion:
- caused by death of anterior horn cells of spinal cord or brain stem by an acute viral (polio) infection;
-
diff dx:
-
spinal cord tumor
- Guillain Barre Syndrome:
- this syndrome can be distinguished from polio using CSF examination;
- in Guillain Barre, CSF is notable for increased protein levels and relatively normal cell count;
- in polio CSF shows upto 300 nucleated cells (PMNS early, lymphocytes late) w/ relatively normal protein levels;
- Clinical findings:
- there is fever, stiffness of the neck (nuchal rigidity), and a plecocytosis in cerebrospinal fluid;
- profound asymmetrical muscle weakness develops;
- initial phase is typically followed by some recovery of muscle strength, but permanent weakness results from necrosis of
anterior horn cells;
- foot and ankle:
- calcaneocavus (hindfoot cavus) which occurs as a result of a weak gastrocnemius;
- foot intrinsics are typically spared in polio;
-
claw toes: results from relative overactivity of the long toe flexors and extensors (to compensate for weakness of the triceps);
- Post-polio Syndrome:
- years following a polio infection, pts develop slowly progressive muscle weakness in the already involved muscles;
- common finding is weakness of the quadriceps and calf muscles;
- when occurring individually, the quadriceps can help compensate for for a weak calf;
- w/ triceps weakness, the ability to decelerate the tibia is lost and therefore, flexion of the knee will persist throughout
stance phase; (see:
gait)
- inorder to prevent this, the patient may attempt to compensate with increased quadriceps activity during a larger portion of stance phase;
- in the case of a weak quadriceps and triceps, the occurance of an equinus contracture or a hinged AFO w/ dorsiflexion block will both prevent excessive
knee flexion and excessive ankle dorsiflexion during stance phase;
- avoid the pitfall of lengthening of the Achilles tendon in these patients;
- these patients may require an ischial bearing, double upright locked knee orthosis, which helps prevent the knee from buckling during gait;
The postpolio syndrome. An overuse phenomenon.
Findings in post-poliomyelitis syndrome. Weakness of muscles of the calf as a source of late pain and fatigue of muscles of the thigh after poliomyelitis.
Orthotic Management of the Late Postpolio Patient
C. Pritham et al. Orthotics and Prosthetics. Vol 33. No 1. p 55-59. Martch 1979.
Calcaneal osteotomy and tendon sling for the management of calcaneus deformity.
Posterior Tibial Tendon Transfer: Results of Fixation to the Dorsiflexors Proximal to the Ankle Joint
