The concept of postural pattern formation in patients with posttraumatic diaphyseal deformities of the long bones of lower extremities
DOI:
https://doi.org/10.15674/0030-59872021310-17Keywords:
Postural pattern, lower extremity, posttraumatic deformity, secondary changes, adaptive changesAbstract
Objective. To invent the concept of new postural pattern formation in the consequence of severe injury of lower extremities associated with the development of «syndrome of posttraumatic diaphyseal deformities of lower extremities». Methods. The classic model of the development of transformation «health–disease», that was initially worked out in 1960th years, has been used to build up a concept of the returning of patient from trauma to relative health. The idea of this approach was to make analogy of regulatory process under the conditions of disease with emergency control in
sophisticated technical systems of automatic control. The results of instrumental investigation of patients and mathematic modelling was used. Results. In the case of the development of «syndrome of posttraumatic diaphyseal deformities of lower extremities» in addition to decreased muscular strength, joints stiffness and limb lengthening the complex of following complications occurs: anatomical disarrangements in adjusted joints and muscular imbalance. If the deformity development is accompanied by the saved weightbearing function of the limb a compensatory mechanism in length of time and in a process of walking capacity restitution creates new «body scheme» and stereotypes of walking and standing. Inherent program of movement substitutes with acquired one. If the deformity occurs just on one lower extremity the anatomical disarrangements of the whole skeletal system take place: the tilt
of pelvis and spine, hip abduction/adduction contracture, varus/valgus deformity in knee joint, the disturbance of weightbearing capacity of feet with different derangements in ankle and subtalar joints (including varus/valgus deformities). The severity of these secondary changes depends upon the value of deformity, general and psychological status of patient. Outcomes. Invented concept of new postural pattern formation in consequence of severe injury
of lower extremities associated with the development of «syndrome of posttraumatic diaphyseal deformities of lower extremities» allows to assess and understand a locomotor behavior of patient and take it into consideration in treatment planning.
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