Abstract
Objective. To study topographical features of the trunk posture and spinal deformities in patients with unilateral shortening of the lower limb. Material and Methods. Seventy-eight patients at the age of 5 to 22 years with unilateral shortening of the lower limb were examined: Group 1 included 59 patients with anatomical shortening of the lower limb of 2.0 to 17.0 cm; Group 2 included 19 patients with functional shortening of the lower limb of 1.0 to 1.5 cm. Efficacy of the spinal correction was assessed by computer optical topography. Results. Posture disorders and spine deformities observed in lower limb length discrepancy are mainly the manifestations of the locomotor system adaptation to biomechanically off-normal conditions for function. Adaptive responses of the locomotor system such as posture disorders, postural asymmetries, and spine deformities were preserved in 39 % of cases. Depending on the side of shortening and the amount of limb length discrepancy the spinal adaptive deformities have different rates of resistance to the performed corrective manipulations: conservative therapy for deformity, surgical elimination of lower limb length discrepancy, and compensation for a short limb with supports. Conclusion. Adaptive deformities of the spine in patients with small discrepancy between the length of lower limbs turned out to be more resistant to correction, than those in patients with large anatomical shortening of the lower limb.
Highlights
Topographic Control of Spinal Deformity Correction in Patients with Unilateral Shortening of the Lower Limb D.V
Posture disorders and spine deformities observed in lower limb length discrepancy are mainly the manifestations of the locomotor system adaptation to biomechanically off-normal conditions for function
Adaptive responses of the locomotor system such as posture disorders, postural asymmetries, and spine deformities were preserved in 39 % of cases
Summary
Изучение топографических характеристик осанки туловища и деформаций позвоночника у пациентов с односторонним укорочением нижней конечности. Наблюдаемые при разновысокости ног нарушения осанки и деформации позвоночника являются преимущественно адаптационными проявлениями опорно-двигательной системы к биомеханически аномальным условиям функционирования. В 39 % случаев приспособительные ответы опорно-двигательной системы сохраняются в виде нарушений осанки, постуральных асимметрий и деформаций позвоночника. В зависимости от стороны укорочения и величины разновысокости ног приспособительные деформации позвоночника имеют разную степень резистентности к применявшимся корригирующим воздействиям: консервативная терапия деформаций, оперативное устранение разновысокости ног, компенсация укороченной конечности подставками. Приспособительные деформации позвоночника у пациентов с малой разновысокостью ног оказались более резистентными к коррекции, чем у пациентов с большим врожденным анатомическим укорочением конечности. Ключевые слова: деформация позвоночника, коррекция искривлений, оптическая топография, одностороннее укорочение нижней конечности.
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