Special aspects of the support function of lower limbs in children with the consequences of unilateral lesion of the proximal femur with acute hematogenous osteomyelitis

Abstract

Background. Acute hematogenous osteomyelitis in the lesion of the proximal femur causes hypofunction or destruction of the metaepiphyseal growth zone of the femur. Theoretically, this leads to the formation of orthopedic consequences, including shortening of the lower limb. Aim. The study aimed to examine the plantographic characteristics of the feet in children with a lesion of the proximal femur and analyze the influence of the regularities of plantar pressure distribution in the asymmetry of the load on the lower limbs. Material and methods. Total 15 pediatric patients aged 6–16 years with consequences of acute hematogenous osteomyelitis of the proximal femur and shortening of the affected lower limb by 1.0–6.0 cm were examined. In addition, 15 healthy children belonging to the same age were examined for comparison. Stabilometry and plantography methods were used, and the statistical study included correlation and regression analysis. Results. When we conducted tests with a double-support load on the feet, in comparison to healthy children, pediatric patients exhibited a significant decrease in the value of the anterior index of the support t in both the affected and unaffected sides. The parameters of other support indices (namely, m, s, and l) of the contralateral feet in patients were within the normal range, indicating the functional consistency of the corresponding arches of the feet, providing static and dynamic limb support ability. However, the correlation and regression analysis showed that, in comparison with the norm, the foot support ability in pediatric patients is implemented due to the strengthening of the functional relationship between the inner and the medial longitudinal arches of the foot on the intact side and the inversion of the interaction of the longitudinal arches with the transverse arch on the side of the lesion. Conclusion. In children with consequences of acute hematogenous osteomyelitis of the proximal femur, the parameters of the plantographic characteristics indicate a change in the activity and consistency of the muscles that form all the feet arches on both the affected and intact lower limbs.