Disorder of the longitudinal limb growth and muscular contractility

Abstract

Background: The reduction of the muscular contractility in the patients after operative lengthening of the limb with delayed growth is the main factor limiting the volume of orthopaedic treatment. Objective: Our aim was to study the dependence of the muscular contractility of the femur and tibia on their longitudinal sizes in healthy individuals and patients of various age and in the patients with different variants of natural growth disorders of one of the lower limb before and after its operative lengthening according to Ilizarov. Methods: Maximal torque of various groups of the femoral and tibial muscles was evaluated in 78 patients aged from 4 to 40 years with delayed longitudinal growth from 3 to 12 cm of one of the lower limbs using original dynamometers. Control group included 424 healthy children aged from 7 to 15 years and 36 persons aged from 18 to 35 years. Results: The dependence of maximal torque of various groups of the femoral and tibial muscles on their longitudinal sizes in healthy individuals and patients of various ages and gender as well as in the patients with growth disorders before and after their operative lengthening was presented. The affected limb muscular strength and the same of the intact one reduced every cm of the longitudinal growth delay (for instance, the posterior tibial muscle for 3.2 and 1.7 Nm correspondingly). Conclusion: Compensatory increase of the muscular strength in the contralateral femur was found only in significant reduction of the muscular contractility of the affected tibia. In equal amount of the tibial shortening its muscular strength reduced relatively more in the patients with congenital disease and consequences of the osteomyelitis and less in trauma cases.