Limb length discrepancy is a common orthopaedic problem, frequently requiring
surgical intervention. This thesis is concerned with one method of limb
equalisation, leg lengthening surgery. It investigates the effect of leg lengthening
surgery on the muscle function and rehabilitation of patients.
Qualitative research methodologies demonstrated that there is considerable
uncertainty about the best physiotherapy management of patients treated by the
Ilizarov method. There is little evidence-basedre search into the rehabilitation of
patients treated by this method of surgery.
A clinical cohort study was conducted which examined different aspects o f
rehabilitation. These included the effects of leg lengthening surgery on joint range
of motion, muscle strength and on the ability to perform functional activities.
The study of the effect of surgery on joint range of motion highlighted the need
for repeatable measurement techniques. It found that there was a significant loss
of joint range of motion in the latent period prior to distraction of the bones
starting. Factors that influenced loss of joint range in the subjects included in this
study included the rate of lengthening, the age and the diagnosis of the patient. A
mathematical model was developed to assist in predicting the loss of joint range,
at the pre-operative examination.
The ability to perform functional activities and the effect on muscle strength were
investigated and found to recover for up to 2 years following surgery and the
removal of the Ilizarov fixator. Muscle strength recovered to within 5% of the
baseline value by 2 years. This emphasises the need for a prolonged period of
rehabilitation for patients treated by this method of surgery.
Finally a Delphi survey was conducted to produce Clinical Guidelines about the
physiotherapy management of patients treated by the Ilizarov method
