The corticosteriods in the treatment of Duchenne’s or Becker’s muscular dystrophies causes muscular weakness and osteoporosis characteristic of these patients and result in different fractures which are of difficult resolution because prolonged immobilization increases morbidity. How can this problem be solved in highly risk patients? The diverse models of external fixators have given us the possibility of treating them without immobilization and in consequence obtain a quicker return to previous functional status including gait . 4 patients with Duchenne’s and Becker’s muscular dystrophies were treated. 1 patient recovered its ambulatory ability and the rest maintain their gait. 1 of them still has an external fixator but he is able to walk. Patients presented a diaphyseal fracture of the femur, a proximal fracture of the tibia, an introchanteric fracture of the hip and a supracondylar fracture of the femur. We consider that external fixators open an endless range of options, not very much used until recently, that help our patients to extend their functional status and gait. Patients accept them easily because they give them independence and avoid the depression that stems from the loss of capabilities.
We evaluated 28 patients, 52 feet with flaccid paraparesis (27 MMC, 1 neonatal paraplegia) in which a posterior transference of the tibialis anterior was performed for talus deformities. Between 1987 and 2001 in two institutions. Mean age at surgery 6+6 ( from 0+4 to 12+10) 16 males, 12 females, Neurological last level functioning was 1 Toracic, 2 lower lumbar, 25 sacral
There where 23 bilateral cases Asociated surgeries 17 extension calcaneal osteotomies 5 peroneal z plasties, 4 short peroneal to posterior tibialis transfer, 2 vertcal talus correction, 2 Evans lenghtenings, 1 IF arthrodesis Follow up in 25 patients (3 lost) was 3+11 (0+3 to 12+1)
All patients were independent walkers at follow up.
