[A strategy of rehabilitation in children with proximal femoral focal deficiency treated with modyfied Van Nes rotationplasty].

We present a strategy of a complex rehabilitation in children with pffd before and after Van Nes rotationplasty. The rehabilitation proces is divided into tree stages: preoperative, in which general exercises, swimming etc. are used to improve patient's general phisical condition with special care to improve ankle range of motion and to strenghten the muscles: gastrocnemius, quadriceps femoris and glutei on the afected side. Second stage begines whith the cast removal. Gentle ankle manipulations, passive and in about a 0 days after the cast removal, active ankle movements are excercised. The last stage begins when individual prosthesis is made and the patient begins to learn how to stand and to walk with proper active "knee" flexion and extension and with proper foot progression angle, initialy with cruthes on flat surface, and finnally, about 3 months after the surgery without cruthes, also on stairs. A good cooperation with the child's parents and with the child itself is necessary to have a success in the rehabilitation process.