SLOB

By 4 weeks we have lots of bone. We need to toughen this new bone. That is done by weight bearing. Weight bearing begins in ~ 4 weeks if the x-ray looks good.

Bilateral SLOB Upper left inset has both hips uncovered and both Shenton's lines are badly offset. Hips are subluxed (subluxation = ball off center in deformed acetabulum, on their way toward dislocation). SDR & SLOB Selective Dorsal Rhizotomy cuts sensory nerve rootlets to reduce recycling signals. The reduction in spasticity is quite impressive. Yet, the imbalance persists. That imbalance is what damages the hip. If such damage is already present, SDR will not only not treat it, the loss of hip structure accelerates as lower tension allows the ball to ride more lateral with greater ability to do damage and with less medial compression to keep the ball in deep. This is common to many conditions. Low tone asymmetry dislocates more and faster than high tone. If Shenton's Lines are broken, it is wise to not do SDR until that instability has been eliminated and muscular imbalance made better.