Victoria – an11y.o. girl
The Donetsk region.A Girl Victoria, 11 y.o., are trying to bear a little sister from the fire and gets blind comminuted penetrating mine and explosive wounds of lumbosacral region and pelvis, unstable damage 4th and 5th lumbar vertebra and the sacrum with damage (total break) roots of the cauda equina of the spinal cord at the level of 5 lumbar vertebrae. In a state of traumatic hemorrhagic shock of the3-d degree, with paralysis of the lower limbs and dysfunction of the pelvic organs, the girl was taken to the surgical ward of the local hospital, where the primary debridement, plastic closure of the defect of the dura mater were made and vertebrae and bone fragments, compressing the spinal cord were removed, restored vital functions. After that, the girl was brought to the Moscow Research Institute of Emergency Children's Surgery and Traumatology, in serious condition caused by spinal cord injury, paralysis of the lower limbs and severe pain in her legs. Immediately rehabilitation measures have been initiated as part of preoperative preparation: the treatment of expressed neuropathic pain, the tight chest-lumbar corset was made, the mechanotherapy was made, learning breathing exercises, massage of the chest, the lower limbs and lumbar region, physiotherapy with analgesic, antiedematous, regenerating, goals , consultations and sessions with a clinical psychologist. After this preconditioning, the next stage of surgical treatment was made, for fixing the broken vertebrae and the sacrum. After surgery, rehabilitation measures were continued, but their implementation was limited with the severe neuropathic pain that is poorly cropped, despite the intense antipain therapy. In 3 weeks, it was held the next stage of neurosurgical treatment is to release from scarring, adhesions, and the remaining bone fragments roots - level 4 and 5 lumbar vertebrae to the right and locking the front 5th lumbar vertebrae. As a result of neurosurgical treatment, the pain in her legs was stopped, the mood of the child was improved, there was a motivation to recovery and rehabilitation activities were continued with the gradual expansion mode and motor load.
Throughout the 78 days of treatment in the Research Institute of Emergency Children's Surgery and Traumatology there were an intensive medical and psychological rehabilitation for the girl. For her, there was developed a special set of individual exercises to strengthen muscle corset in the initial supine position, abdomen, flanks, in the initial position on all fours, a set of exercises to strengthen the shoulder girdle in a starting position lying on the back with the weights (dumbbells ) in hands. From the first day in the hospital, a clinical psychologist was working with a child, helping to cope with post-traumatic stress, building an internal picture of the disease. As a result of treatment and rehabilitation, the expressed neuropathic pain in the lower extremities stoped, the exercise tolerance significantly increased. There was a sensitivity and motor function below the level of injury. The girl began to sit on her own, to keep the balance in the initial sitting position without additional support, seat herself in a wheelchair and back, stand in support.The child was transferred to a periodic aseptic catheterization,a thoraco-lumbar corset of the rigid fixation of carbon was made, special devices to hold the foot (dynamic feet holders) were selected as well as the rehabilitation equipment: a wheelchair of active type, a back-supporting walker with a seat and fixation of the pelvis, trunk support, holders shins. The girl broughtto the vertical position , trained how to walk in the back-supporting walker, in the chest-lumbar corset of the rigid fixation and dynamic foot holders.
Conducting rehabilitation and acquisition of the dynamic feet holders and back-supporting walkers have been paid for the Victoria by the Charity Foundation of providing medical and social rehabilitation and care for children with severe trauma and its consequences (The Foundation of Children's Dr. Roshal).