Communication Affichée: Best of poster

Le 01/12/2022 de 09:00 à 10:30

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Analyse de la Marche chez un enfant atteint de Déficience Fémorale Focale Proximale (DFFP) : évaluation fonctionnelle et étude des stratégies thérapeutiques

Luisa Medeiros (Cascais, Portugal)

Objective : PFFD is a rare congenital disorder affecting the development of hip and proximal femur. Treatment may vary from compensation of mild limb length discrepancy to selective amputations. In children, growth and development should be considered and gait alterations affect functionality. In this clinical case, Gait Analysis (GA) was crucial for clinical management of PFFD.

Material / Patients and Methods : We present a 7-year-old girl with PFFD AITKEN D: absence of proximal femoral epiphysis and acetabulum, reminiscent distal femoral portion with absent knee joint without skeletal leg or foot abnormalities. Gait was possible without aids in all planes and autonomy was normal for her age. An inpatient program in our center was proposed.

Results : An evaluation at GA Laboratory showed reduced gait cadence, severe limb length discrepancy with pattern of extreme triple flexion of non-affected limb during the whole gait cycle and increased pelvic excursion in the three planes. To reduce the discrepancy an orthoprosthesis was adapted and GA was re-performed evidencing static and dynamic pelvic stabilization, near kinematics normalization of non-affected hip, knee and ankle and more physiological articular amplitudes.

Discussion - Conclusion : The situation described requires a careful follow-up regarding orthoprosthesis, with readjustments whenever necessary and clinicians should be aware of possible surgical indications depending on osteoarticular maturity. Although this child was previously independent, more physiological patterns and better posture were obtained with orthoprosthesis. In PFFD objective documentation allows temporal comparison and rehabilitation plan adaptation. Therefore, GA is important for functional assessment and study of therapeutic strategies in PFFD patients over time.

Keywords : Gait Analysis- Congenital Musculoskeletal Disorders- Prothesis and Orthotics- Growth and Development