Scoliose idiopathique de l’adolescent : effet de la décompensation coronale sur les paramètres biomécaniques des membres inférieurs
| Autor: | Ádám Tibor Schlégl, Bálint Niklai, Péter Than, Miklós Tunyogi-Csapó, Kristóf József, Máté Burkus, István Márkus |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Orthodontics
030222 orthopedics Cobb angle business.industry Scoliosis Knee Joint medicine.disease 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Coronal plane Bone maturation medicine Orthopedics and Sports Medicine Surgery Decompensation business 030217 neurology & neurosurgery Pelvis Balance (ability) |
| Zdroj: | Revue de Chirurgie Orthopédique et Traumatologique. 104:441 |
| ISSN: | 1877-0517 |
| DOI: | 10.1016/j.rcot.2018.06.018 |
| Popis: | Study hypothesis We hypothesized that altered coronal balance in adolescent scoliosis leads to asymmetric stress on the lower limbs, with subsequent effects on bone maturation and later morphology. We aimed to assess the correlation between the biomechanical parameters of the lower limbs and coronal balance in idiopathic scoliosis. Materials and methods In this study, EOS images of 280 patients and 56 controls were randomly selected from our clinics’ database. The average age of AIS patients was 14.5 years and average Cobb angle 33.48°. Three D reconstructions of the pelvis and lower limbs were performed and coronal balance assessed. Reliability of measurements was ensured by intra- and inter-observer agreement. During statistical analysis the Kolmogorov–Smirnov test, t-test and linear regression analysis were performed. A p value Results Of the 15 examined lower limb parameters, a significant difference between sides was found in those with AIS for femur length, total length, collodiaphyseal angle, angle between the femoral mechanical and anatomical axis and tibial torsion. In addition, the tibial length and the mechanical tibiofemoral angle were significantly higher than those of the controls. The coronal balance was found to be the strongest predictive factor showing a significant correlation with all of the previous parameters, except tibial torsion. With patients grouped based on coronal balance (compensated, right and left decompensated) the paired t-test also supported these findings. Conclusion The biomechanical parameters of the lower limbs are affected in cases of scoliosis with an altered coronal balance. It was thought that a shift in balance in the coronal plane accounted for the small but significant changes seen in our study, with the lower limb on the side of decompensation becoming shorter in comparison to its counterpart, with a lower collodiaphyseal angle and increased varus at the knee joint. Level of evidence III, case-control study. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|