86 chapter 8
HIP CONTRACTURES
Hip ‘flexion’ contractures (in which the thighs stay bent forward at the hips) are
often difficult to straighten and require special techniques.
Advanced hip
contractures
like this
often require
surgery.
Less advanced hip
contractures like this
can sometimes be
straightened using
positioning and straps.
The child lies face down with a wide strap pulling his butt
down.
cushion under thighs
(Avoid pressure on knees.)
The child should spend as many hours as possible each day
in this position. And if possible, also at night. Knees should
be checked for early signs of pressure sores every hour or so.
(See Chapter 24.)
Life can be made more interesting for the child during the weeks or months of
stretching by using a lying frame on which she can move about.
A rack or
bookholder so
she can play
or read.
casts to straighten
knees and ankles
A bar fastened between the 2
leg casts helps keep them in a
stable position (and also helps
prevent contractures that pull
the legs together).
For other
designs
see p. 618.
large bicycle
wheels
extra strong axles and
hubs (See p. 623.)
‘caster’
rear wheels,
for turns
CAUTION: When stretching contractures this
way, be careful to prevent pressure sores (bed
sores), especially on the knees. If the child
complains a lot, loosen the strap a little. For
eating, bathing, toilet, and exercise she can
be unfastened and moved into convenient
positions. But it is best that she remain
strapped down about 20 out of each 24 hours.
The child with more severe contractures at the hips may need to be strapped on an
angled frame.
strap
plywood or wood
sponge
wood frame
old tires or
anything to
lift body
The angle of the leg boards is set to give gentle but continuous
pressure against the thighs. As the contracture is gradually
corrected, the angle is changed by raising the leg boards or by
lowering the body board.
Leather or
canvas strips
work as hinges
that support legs.
For children with different
angles of contracture in
each hip, the 2 leg boards
can be adjusted differently.
For additional information on contractures relating to different disabilities, aids, and
equipment, see the INDEX under ‘Contractures’. For methods to correct contractures,
see Chapter 59.
Disabled village Children