Evaluation of the Resources tibialis anterior muscle of the shin in Patients with Achondroplasia during Lengthening (Ultrasound Examination)

Abstract

The purpose of the study was the determination of echo signs of the resourcesof tibialis anterior muscle of the shin in patients (6-18 years old) with achondroplasia. The patients were examined before treatment and in the process of shin lengthening ondays 10, 20, 30, 60 and 90 after distraction initiation with Ilizarov apparatus. Mean lengthening made up 9±2cm. Ultrasound examination was performed on VOLUSON-730PRO (Austria) and AVISUS Hitachi (Japan) systems. Echo signs indicative of the reduction of the resources of tibialis anterior muscle of the shin during lengthening, i.e. violation of typical muscular striation, change in the direction of muscular fibers bands, thinningof intermuscular septum, decrease in contractile muscular response by 90±5% and increase in acoustic density by 45% as compared with the initial level, were identified. At the exhaustion of reserve potential of tibialis anterior muscle of the shin the effect of “frosted glass” was visualized, with the exception of patients with achondroplasia aged 6-1- years in whom marked destructive changes in tibialis anterior muscle of the shin during the first months of distraction were associated not only with tissue alteration but with insufficient physiological maturity of the organism.