title: [Orthopaedic Treatment for Patients with Myelomeningocele].
abstract: BACKGROUND
  Due to prenatal diagnostic and folic acid prophylaxis less children with myelomeningocele are now being born. But they become older and need increasingly more orthopaedic care. The orthopaedic care is aimed at the improvement or the preservation of function.
  
  
  METHODS
  In this review the current knowledge from the literature and our approach are presented. This is done in the context of the functional aspects within certain periods of life. Treatment Concept: In the first two years of life, the mobility of MMC children is supported by physiotherapy and orthoses irrespective of the level of the lesion. Afterwards, the optimal orthoses are chosen depending on the muscle power, emerging bone deformities, associated CNS malformation, shunt revisions, obesity and limitations in perception as well as the child's motivation. At school age, it is paramount to encourage independence. Orthotic treatment should be continued as long as the children benefit from it. Orthopaedic operations serve the orthosis fitting and the avoidance of pressure sores. Pathological fractures are common. They should be rapidly recognised in order to avoid further bony deformities.
  
  
  CONCLUSIONS
  The aim of any orthopaedic treatment consists of the avoidance of musculoskeletal deformities in order to support the patient's self employment.
authors.affiliation: CMSC, Kinder- und Neuroorthopädie, Charité - Universitätsmedizin Berlin.
authors.forename: S
authors.initials: S
authors.lastname: Lebek
authors.affiliation: SPZ Neuropädiatrie, Charité - Universitätsmedizin Berlin.
authors.forename: U
authors.initials: U
authors.lastname: Seidel
authors.affiliation: Gottinger Orthopädietechnik, Gottinger Orthopädietechnik, Berlin.
authors.forename: M
authors.initials: M
authors.lastname: Damerau
authors.affiliation: CMSC, Klinik für Orthopädie, Charité - Universitätsmedizin Berlin.
authors.forename: C
authors.initials: C
authors.lastname: Perka
authors.affiliation: CMSC, Kinder- und Neuroorthopädie, Charité - Universitätsmedizin Berlin.
authors.forename: J F
authors.initials: JF
authors.lastname: Funk
mesh_terms: D000293:Adolescent; D000328:Adult; D019090:Case Management / Q000458:organization & administration*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008591:Meningomyelocele / Q000175:diagnosis* / Q000628:therapy*; D019637:Orthopedic Procedures / Q000379:methods*; D009989:Orthotic Devices; D026741:Physical Therapy Modalities; D017755:Prosthesis Fitting / Q000379:methods; D055815:Young Adult