3+4+Supplementum/2012 - Společnost pro pojivové tkáně

aBSTRakT
BiOMeCHaniCal eTiOlOGY
Of SO-Called idiOPaTHiC
SCOliOSiS. COnneCTiOn wiTH
THe MOdel Of HiPS MOVeMenTS
and a CHild’S MOTORiC. new
ClaSSifiCaTiOn.
Karski, T. University of Vincent Pol in Lublin
introduction
The biomechanical etiology of so-called
idiopathic scoliosis was presented for the
first time in 1995 in Szeged as a part of
Hungarian Orthopedic Convention. Since
then, it was also presented during many
Meetings worldwide, including SICOT
(Cairo – 2003, Havana – 2004, Istanbul –
2005, Marrakech – 2007, Prague – 2011).
Methods and material
Material of 1950 children aged 3 to 18
is divided basing on the new classification.
The knowledge about the biomechanical
etiology of scoliosis presented for the first
time in 1995 was enlarged in the years
2001 – 2007. Present knowledge deals not
only the new classification (epg) of scoliosis,
but also new tests for screening and
provides rules for the new therapy and
causal prophylaxis.
Short information about the
„models of development of
scoliosis” independent from the
type of deformity
a. Asymmetry of movements between
right and left hip (connection with
“Syndrome of Contractures” – Hans Mau),
B. “asymmetry of movement in hips, in pel-
332 14 th Prague-Sydney-Lublin
vis and spine during gait”, C. asymmetry in
“length of time” during stand position “at
ease” - left versus right leg. The standing
mostly or only on the right leg (deciding
cumulative time), in result d. asymmetry
of growth and slowly development of scoliosis
in region of pelvis and of spine. Here
I would like to draw the attention to the
fact that every type of scoliosis starts to
develop in age of 2 years, when the children
start to “stand” and start to “walk”.
Groups of scoliosis in connection
with model of hips movements
„S” double scoliosis (i epg).
Model of hips movements: abduction
contracture in right hip (often also
external rotation contracture and flexion
contracture) and large movement of left
hip. Both curves develop at same time.
Biomechanics: gait and permanent standing
position on the right leg. This type is
connected with stiffness of spine, curves
and rib prominence. Some cases “lordoscoliosis”.
Progress.
„C” one curve scoliosis (ii/a epg).
Model of hips movements: in the right
hip the adduction is limited; in left hip the
movement is full. Biomechanics: permanent
standing “at ease” on right leg. Firstly,
physiological deviation and later “C” scoliosis
appear. In older patients “degenerative
scoliosis” occurs. Without progression.
“S” double scoliosis (ii/B epg).
The same model of hips movements
like II/A epg. Additionally influences: laxity
and wrong / harmful exercises in previous
therapy. Thoracic curve as secondary. No