Global postural re-education in the postoperative physiotherapeutic approach to distraction osteogenesis

Abstract

We present the case of a 16-year-old female patient, a native of La Paz, Bolivia, who underwent osteogenesis due to bilateral tibio-fibular distraction with the aim of correcting genu valgus and promoting a planned increase in height. Two months after surgery, the patient manifested severe pain in both lower limbs (VAS 9/10), marked muscle retractions, paresthesia’s in the feet and a significant functional limitation, without clinical improvement despite having received 15 sessions of conventional physiotherapy based on local heat, massage therapy and electroanalgesia with transcutaneous electrical nerve stimulation. Given the poor evolution, an approach based on global postural re-education was implemented, according to Philippe Souchard, aimed at making retracted muscle chains more flexible, restoring postural control and normalizing gait. The program included 20 sessions (three per week, for 2 months), with progressive postures of global postural reeducation treatment adapted to pain tolerance. The patient showed a favorable evolution, with decreased pain (VAS 9 to 2), improvement of joint range, recovery of independent gait, postural correction, normalization of distal sensation and increased functional independence. This case shows the effectiveness of the physiotherapy approach through global postural re-education in the postoperative rehabilitation process of bone lengthening, highlighting its positive impact on the patient's comprehensive recovery.