Poliomyelitis: Orthopedic High-Yield
Neuromuscular Orthopedics & Infectious Disease
1. Pathophysiology
Caused by the Poliovirus (Enterovirus), it targets the Anterior Horn Cells of the spinal cord, leading to lower motor neuron (LMN) damage and subsequent flaccid paralysis.
2. Clinical Phases
| Phase | Characteristics |
|---|---|
| Acute | Febrile illness; asymmetrical flaccid paralysis. |
| Convalescent | Gradual recovery of muscle function (up to 2 years). |
| Residual | Permanent paralysis, muscle atrophy, and limb length discrepancy. |
3. NEET High-Yield Pearls
- Key Findings: Flaccid paralysis, decreased muscle tone, absent deep tendon reflexes (DTRs), and sensory sparing.
- Deformities: Often result in equinus foot, scoliosis, and flexion contractures of the hip or knee due to muscle imbalance.
- Vaccination: India is declared polio-free; OPV (Oral Polio Vaccine) vs. IPV (Inactivated Polio Vaccine) considerations remain a common exam topic (VAPP risk with OPV).
- Post-Polio Syndrome: A condition occurring decades later, characterized by new weakness, fatigue, and pain in survivors.
- Orthopedic Management: Focused on bracing (AFOs), tendon transfers to balance the limb, and corrective osteotomies for long-standing deformities.