Recumbent-Support Orthosis for Control of Hip and Knee Deformities in Children with Neuromuscular Disabilities

J. MARTIN CARLSON, CPO**Saint Paul, Minnesota

Children with severe cerebral palsy and myelomeningocele have a strong tendency to develop knee and hip deformities. In the otherwise marginal ambulators these deformities can prevent ambulation. In non-ambulators hip deformities (rotational and abduction-adduction) progress to the point of negatively affecting sitting posture, comfort and appearance. Hip and knee deformities even limit the positioning options in bed and make ulcer prevention more difficult. Hip and knee deformities develop in accordance with the child's usual sleeping posture. During the past seven years we have developed a simple, adjustable orthosis which supports the hips and knees in a preferred alignment while the child is sleeping. We use this orthosis for both non-operative control of deformities and as a postoperative position-control device.

**Gillette Children's Hospital, 200 East University, Saint Paul, MN 55101