[Surgical treatment of patients with spinal deformities with shortening of the lower limb]. 2013

S V Kolesov, and A N Baklanov, and I A Shavyrin

OBJECTIVE Determination of the optimal diagnostic and treatment strategy in patients with scoliosis and having an anatomic shortening of the lower limb. METHODS Surgical correction of scoliosis held 8 to patients with lower limb shortening caused by congenital dislocation of the hip (n = 3), anatomic shortening of the lower extremities due to the hip (n = 1), the shin bone (n = 4). Shortening before correction and fixation of scoliosis ranged from 6 to 14 cm, after surgery on the spine has been reduced by 2-4 cm achieved reduction or removal of pelvic obliquity. The second stage, after 8-12 months, performed surgery to address shortening of the lower extremity. Osteotomy of the femur with the imposition of a spoke - rod device held 4 tibial osteotomy with the imposition of external fixation device Spoke - and 4 patients and in the subsequent limb lengthening was performed by compression-distraction osteosynthesis. RESULTS After the dorsal stabilization and fixation of the spine scoliosis correction averaged 64% (from 76 to 27 degrees), the value of breast/thoracolumbar kyphosis after surgery failed to bring to the physiological (average 43 degrees). Misalignment of the pelvis is reduced by 67% (from 24 to 8 degrees), which reduced the shortening of the lower limb by an average of 3 cm (compensation relative shortening by reducing or eliminating the distortion of the pelvis). Further compensation shortening held on the second stage of treatment, representing an osteotomy and subsequent elongation of the femur or tibia bones by transosseous compression-distraction osteosynthesis by Ilizarov. CONCLUSIONS Multi-stage treatment reduced the degree of spinal deformity, to normalize the balance of the body, restore the function of distance without the use of orthotic devices and means of support.

UI MeSH Term Description Entries
D007870 Leg Length Inequality A condition in which one of a pair of legs fails to grow as long as the other, which could result from injury or surgery. Inequalities, Leg Length,Inequality, Leg Length,Leg Length Inequalities,Length Inequalities, Leg,Length Inequality, Leg
D008297 Male Males
D010027 Osteotomy The surgical cutting of a bone. (Dorland, 28th ed) Osteotomies
D005260 Female Females
D005269 Femur The longest and largest bone of the skeleton, it is situated between the hip and the knee. Trochanter,Greater Trochanter,Lesser Trochanter,Femurs,Greater Trochanters,Lesser Trochanters,Trochanter, Greater,Trochanter, Lesser,Trochanters,Trochanters, Greater,Trochanters, Lesser
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D012600 Scoliosis An appreciable lateral deviation in the normally straight vertical line of the spine. (Dorland, 27th ed) Scolioses
D013123 Spinal Fusion Operative immobilization or ankylosis of two or more vertebrae by fusion of the vertebral bodies with a short bone graft or often with diskectomy or laminectomy. (From Blauvelt & Nelson, A Manual of Orthopaedic Terminology, 5th ed, p236; Dorland, 28th ed) Spondylodesis,Spondylosyndesis,Fusion, Spinal,Fusions, Spinal,Spinal Fusions,Spondylodeses,Spondylosyndeses

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