I would appreciate some input from this list for managing a particularly
challenging pediatric knee deformity. Jennifer is an active,
neurologically normal 11 year old. However, she has a renal
insufficiency that our physiatrist feels is contributing to a Right
Q-angle of 30 degrees (non weight bearing).
For the past 3mos. she has faithfully worn a nocturnal orthosis that
exerts a varus force on her knee. There was no improvement. Because of
her age, great compliance, and severity of deformity we are considering
going to a fulltime orthosis for correction.
I would like to know if anyone has had exposure to managing this type
of renal related deformity.
* what is the physiology behind the deformity
* why would it affect only one knee
* which treatment works best; K.O., K.A.F.O., knee joint(s), best way to
generate varus force, etc.
* how might her knee respond to treatment
any info. you have would be greatly appreciated
sincerely,
Jason Goodnough, C.P.(c), O. intern(c)
