Study of the peculiarities of the osteopathic status in patients with planovalgus deformity of the feet in combination with a history of placement torticollis and without such a combination

Abstract

Introduction. The relevance of the feet planovalgus deformity problem is caused by its prevalence and tendency to progression, insufficient knowledge of a number of aspects, and the complexity of treatment. Another urgent pediatric orthopedics problem is the placement torticollis in infants, and the possible relationship of this problem with feet planovalgus deformity. Among the least studied aspects of these diseases categories it is necessary to highlight the problem of the peculiarities of the osteopathic status in children with feet planovalgus deformity with a history of placement torticollis, and the dynamics of clinical manifestations during their osteopathic correction.The aim of the research was to study the features of the osteopathic status in patients with planovalgus deformity of the feet in combination with a history of placement torticollis and without such a combination, and to evaluate the clinical efficacy of complex therapy, including osteopathic correction.Materials and methods. The study involved 60 patients aged 7–14 years with planovalgus deformity of the feet. The study participants were divided into two groups. The first group included 30 patients with planovalgus deformity of the feet and a history of placement torticollis. The second group included 30 patients with planovalgus deformity of the feet, who did not have a history of torticollis. All study participants received complex therapy (orthopedic treatment and osteopathic correction). At the beginning and at the end of the course of osteopathic correction, the condition of the arch of the foot (the severity of fl at feet) and osteopathic status were assessed in all study participants.Results. In the first group there were prevailed somatic dysfunctions (SD) of the head region, the detection rate was 86%, the pelvic region (somatic component — C), 76 %, and the neck region (C), 13 %. Among the second group participants there were prevailed SD of the pelvic region (C) — the detection rate was 100 %, the lower extremities, 43 %, and the lumbar region (C), 13 %. The SD in the pelvic region was the most typical; however, more often (p<0,05) this dysfunction was detected in the second group. The number of regional SD in general was statistically significant (p<0,05) more in the first group. The participants in both groups were most characterized by local SD of the vertebrae (76 and 100 %) and fibula (20 and 56 %). There was a statistically significant (p<0,05) difference between patients in terms of the detection frequency of these musculoskeletal system dysfunctions. Among the local SD of the craniosacral system and organs of the head, intraosseous SD (90 and 17 %) and SD of the dura mater (40 and 23 %) prevailed. SD of the temporomandibular joint was detected only in the first group (23 %). There was a statistically significant (p<0,05) difference between the groups in terms of the detection rates of temporomandibular joint dysfunctions and intraosseous dysfunctions. According to the results of treatment, the incidence of SD in the head region and the pelvic region decreased significantly (p<0,05) in patients from the first group, and in the SD of the pelvic region and the region of the lower extremities — in patients from the second group. The severity of flat feet of the study participants was not statistically significantly different before treatment. At the end of the complex treatment, the patients of the both categories showed a statistically significant (p<0,05) improvement in the state of the foot arch.Conclusion. The revealed differences between the participants of the groups in the prevalence and number of regional dysfunctions and the prevalence of local SD could, presumably, reflect the relationship between the placement torticollis and planovalgus deformity of the feet. Based on the absence of differences in the degree of severity of flat feet between the participants of the groups, it can be assumed that the history of the placement torticollis is not associated by itself with the aggravation of the severity of feet planovalgus deformity.