Nonoperative treatment of XXXX : orthotic and mobility management.

@entity1 @entity170 @entity53897 @entity85 @entity6926
The problem of @entity170 superimposed on the basic collagen defect of @entity6926 has been approached by the use of plastic containment orthoses for the lower limbs, in addition to developmentally staged mobility devices that assist early standing and walking. The purpose of forcing early weight-bearing is to provide stress to the lower limb bones in order to minimize @entity170 , prevent @entity85 , and curb subsequent immobilization @entity170 , thus breaking a vicious cycle. Management goals are based upon adult needs for independence: efficiency in daily living activities and in mobility. These goals were reached in most of our @entity1 via use of plastic orthoses, early weight-bearing, and electrically powered wheelchairs. Manual osteoclasis of the tibia followed by plastic orthoses utilizing principles of fluid compression to support fractured or structurally weak bones appeared successful at the time of follow-up. Intramedullary rodding of the femur was necessary in most of the 12 @entity1 with @entity53897 . Supplementary plastic orthoses have reduced the refracture rate in both the tibia and the femur. Social integration of the @entity1 was reflected by the fact that among the 12 OI congenita cases, ten were attending regular educational institutions. Twelve @entity6926 @entity1 fared well, all attaining complete independence in daily living, mobility and ambulation. Seven of this group were treated with intramedullary rodding of the femur or tibia and with plastic orthoses. Five @entity1 required no treatment.
