Issue №2-90, 2019

Study of the structural and functional condition of the hips muscle in patients with secondary coxarthrosis after the injury of the acetabuli mensura

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1 Menshchikov I.N., 1 Menshchikova T.I., 1 Dolganova T.I., 1 Dolganov D.V., 1 Chegurov O.K., 1 Mal’tseva L.V.

1 «Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics» Kurgan, Russia


ABSTRACT

Purpose. To evaluate the structural and functional condition of femoral muscles in patients with Stage III posttraumaticcoxarthrosis (CA).Material and Method. Patients with Stage III posttraumatic coxarthrosis and the history of transacetabular fracture andpelvic osteosynthesis with the Ilizarov fixator were examined (n=12, age: 40–72 years). Ultrasound examination (USE) wasperformed using Voluson –730 PRO (Austria) and Hitachi (Japan) devices. Static and dynamometric parameters of supportfeet responses were evaluated using DiaSled-Scan computer-assisted diagnostic complex. The developed stand was used fordynamometry. All the patients underwent roentgenography to verify coxarthrosis stage. N.S. Kosinskaya classification wasused in the work.Results and discussion. When USE scanning, m. gluteus medius on the side of involvement had an uneven contour withthin, short bundles of muscle fibers, the acoustic density of the muscle was 75% gained due to the increase of connectivetissue amount, the thickness was 25% reduced comparing with the contralateral segment. The least structural changes wererevealed in the area of m. rectus and m. iliopsoas: 12.3%– and 18.3%-increase of the acoustic density, 25%– and 20%-decreaseof the muscle thickness, respectively. The preservation of the contours of the muscles, the bundles of the muscle fibers intheir structure, the maintenance of intermuscular septa differentiation in the muscles studied evidenced of the preservationof the muscle reserve potential for subsequent rehabilitation. Dynamometric studies demonstrated the reduction in themuscle strength of the involved femur up to 50% relative to the values of the intact limb. It was found by podography data,that when walking the damper fall was smoothed in 80% of observations, an additional wave was registered in its structure,and the back push was reduced in 64% of observations.Conclusions. Complex structural and functional evaluation of the femoral muscle condition in patients with CA adequatelyreflects pathological and morphological condition of the involved joint.


KEYWORDS: Posttraumatic coxarthrosis (CA), ultrasound examination, muscle structure, podography, dynamometry.



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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.