Correction of the curvature of the lower extremities
Deformation of the so-called legs crooked legs – is not only a cosmetic defect. In the presence of calf strain load on articular surfaces of the femur in the knee joint is uneven. With age, this leads to the development of degenerative-dystrophic diseases of the knee joint – osteoarthritis, or gonarthrosis. Curvature of the legs cause the development of flatfoot.
The correct form of the legs is such that when a line is drawn through the femoral head, which forms the hip joint, then passes through the middle of the patella and the first interdigital space. Deviation from the foot of this line is accompanied by a breach of the proper biomechanics of the limb.
Curvature of tibia at an angle open outwards is called valgus bending or abstracted shin. Under such a deformation stocked legs resemble the letter X and called the X-shaped. Normally, all people have leg slightly deflected outwards. In men, this angle is from 5 to 7 degrees in women up to 10 degrees. On examination of the patient's tibia show a curvature at an angle outward, a large distance between the ankles when the knees dense.
Deformation of open tibia at an angle into varus bending is reduced, or lower leg. Both legs with such a curvature similar to the letter O, and the deformation is also called the O-shaped curvature of the lower leg. Curvature of the tibia is less common at an angle open anteriorly (rekurvirovannaya tibia), and the curvature of the apex directed backwards, or backward (kifozirovannaya tibia) arc bulge forward.
Valgus, or curvature of the tibia rekurvirovannoe most significantly affect the function of distance. Curvature of the lower leg as reflected in the function of the foot. Curvature of tibia at an angle outward (varus or O-shaped curvature) causes the opposite gates of the foot (valgus) and gradually develops a secondary flat. When the X-shaped legs flat valgus bending develops even more quickly.
Arcuate curvature of the tibia are congenital or are formed in childhood with severe forms of rickets, inflammatory diseases of bone metabolic diseases, endocrine disorders affecting bone strength. In these states, minor congenital deformities can go with an increase in the depth of curvature of the arcs.
In adolescents develop curvature of the lower leg due to a lack in the diet of vitamin D and calcium, inadequate exposure to outdoor sunlight. The reasons for bending legs are also a variety of pathological processes in the articular ends of the femur or the tibia and knee injuries.
In addition to the true strain is found more false legs bending legs, when the defects are not due to the appearance of the bone structure and features of soft tissue. In this case, the distortion correction is conducted at the extremities with physical therapy and special exercises for the legs. In severe cases, the implant is made of soft denture.
Surgical treatment of lower leg strain includes osteotomy – cutting the bone. In varus bending of tibia osteotomy performed valgiziruyuschaya when valgus bending – variziruyuschaya. At the same time from the bones, sawed a wedge, bone is connected and strengthened with a few screws or clamps. In the case of varus or O-shaped curvature of the wedge is sawed from the shin-bone. When the X-shaped or valgus deformity tibia osteotomy is performed (dissection) of the femur and wedge, respectively, sawed out of it.
Reconstructive surgery may be supplemented by chondroplasty aimed at increasing the stability of the knee. After the osteotomy used stable-functional osteosynthesis with the different systems. It is applied to the lower leg or thigh construction by type of Ilizarov apparatus. Term of wearing apparata different. He is from 4 to 8 months or more, depending on whether you are while still lengthening limbs.
Center of Traumatology and ORTHOPAEDICS – Hospital FCS – MOSCOW
Treatment and rehabilitation center for Health Care – Moscow
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REHABILITATION IN ISRAEL – Levinstein rehabilitation center
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