title: [Myelomeningocele--what can be done? Aids for evaluating rehabilitation from the orthopedic viewpoint].
abstract: Shortly before or shortly after the delivery of a child suffering from congenital paraplegia (myelomeningocele or spina bifida) the obstetrician is obliged to give advice as to what will follow after neurosurgical closure of the cele and shunting of the hydrocephalus. The parents' understanding of therapy and integration of the patient is developed to assess and utilise the future chances of the disabled child. Integration of children with congenital paraplegia is performed by an interdisciplinary team of therapists. However, the obstetrician's advice is of great value in preparing the parents for their decision for or against total care post partum. They must in fact be fully aware of the chances, that the disabled child actually has with regard to integration in life, and of what can be done in this respect. Besides the neurological, paediatric and urological care, it is the task of the orthopaedist to preserve or even to improve verticalization and mobility in paraplegic patients. In this manner he exercises an influence on the quality of life of the disabled children and on their social integration. Improvement and further development of physiological orthoses for walking enable even children suffering from a thoracic level of paralysis to walk independently and to achieve integration into society. Orthopaedic aspects of integration must be part of the information given to the parents by the obstetrician, so that they may be able to assess in what way their disabled children can participate in the future at various levels of everyday life.
authors.affiliation: Abteilung für Orthopädie im Kindesalter, Orthopädische Universitätsklinik, Heidelberg.
authors.forename: M
authors.initials: M
authors.lastname: Schiltenwolf
authors.forename: C
authors.initials: C
authors.lastname: Carstens
authors.forename: L
authors.initials: L
authors.lastname: Bernd
mesh_terms: D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008591:Meningomyelocele / Q000534:rehabilitation*; D009460:Neurologic Examination; D009989:Orthotic Devices; D010264:Paraplegia / Q000534:rehabilitation; D010348:Patient Care Team