PATHOGENETIC APPROACH TO DIAGNOSIS AND TREATMENT OF CHILDREN WITH CLINICOFUNCTIONAL ORTHOPEDIC DISORDERS

Aim. To study the clinicofunctional peculiarities of children with deformed pelvis and slight asymmetry of the lower extremities length, to develop the program of differentiated treatment. Materials and methods. 140 children aged 3 to 15 years with distorted pelvis and slight asymmetry of the lower extremities length of primary (idiopathic) genesis and pathology of locomotor system of the known etiology (secondary) were examined. There were 78 girls (55,7%) and 62 boys (44,3%). Orthopedic disorders, topographic and electromyographic changes, pain syndrome and vegetative dysfunction peculiarities were studied. Efficiency of conservative orthopedic treatment was assessed in 100 children. Results. Different degrees of severity of clinicofunctional disorders were determined. Impairment of bearing was increasing in process of child growing. In case of organic orthopedic pathology, vertebral column deformity was growing progressively worse against the background of marked pelvic distortion. Neuromuscular dysfunction was detected in all the examined patients. Rehabilitation program was worked out individually taking into account the degree of manifestation of vegetative and muscular dysfunction, orthopedic and somatic pathology. Conclusion. 1. Functional orthopedic disorders are progressing while child growing and lead to the secondary changes in pelvis and vertebral column. 2. Vegetative dysfunction and asymmetry of bioelectric paravertebral muscles activity are additional means for an early diagnosis of the degree of severity and compensation state.

Pelvic deformity, lower extremities length asymmetry, impairment of bearing, vertebral column deformity, neuromuscular disorders, conservative treatment