ABSTRACT
Objetivo: analizar la corrección de las desviaciones axiales de miembros inferiores, secuelas de raquitismo. Pacientes y metodología: Efectuamos una osteotomía percutánea e inmovilización con yeso y clavos incluidos o fijador externo monolateral, en 134 niños congoleses. Medimos los ángulos antes y después de la corrección, así como el tiempo de consolidación y las complicaciones durante el proceso. Resultados: los valgos femorales y los varos tibiales se corrigieron con mayor facilidad. La calidad de la corrección dependía del número de osteotomías realizadas en cada caso aunque se efectuaron más osteotomías en los casos más graves. Los resultados fueron 80 casos buenos, 45 regulares y sólo 3 defectuosos. No se constató ningún síndrome compartimental y sólo se señalaron algunas infecciones ligeras de los clavos. Conclusión: en nuestro medio las osteotomías percutáneas inmovilizadas con yeso o con fijador externo pueden resolver casos graves con un buen resultado funcional (AU)
Objective: To analyse the correction of axial deviations of the lower extremities as sequels of rickets. Patients and methods: We performed a percutaneous osteotomy and immobilization with cast and embedded nails or monolateral external fixator in 134 Congolese children. We measured the angles before and after the correction as well as the consolidation time and complications during the process. Results: Femoral valgus and tibial varus were corrected more easily. The quality of the correction depended on the number of osteotomies performed in each case, though more osteotomies were performed in the most severe cases. The results were 80 satisfactory cases, 45 fair, and only 3 defective. No compartmental syndrome was recorded and only some mild nail infections were seen. Conclusion: In our setting percutaneous osteotomies immobilised with cast or external fixator can solve severe cases, obtaining a good functional outcome (AU)
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Lower Extremity Deformities, Congenital/surgery , Rickets/surgery , Osteotomy , External Fixators/trends , Rickets/physiopathology , Rickets , Knee/abnormalities , Knee/surgeryABSTRACT
Objetivo: Analizar algunos factores de riesgo en niños raquíticos congoleños con graves deformidades de miembros inferiores y describir las lesiones. Métodos: Los autores analizaron los parámetros obtenidos en una encuesta a dos grupos de niños: un grupo de 194 niños raquíticos con graves deformidades de los miembros y otro grupo control de 107 niños sanos de edades similares. Se describió el tipo de deformaciones y los grados de raquitismo. Resultados: La deformación más frecuente fue el genuvaro (58,2%), seguida del windsept (23,7%) y genuvalgo (13,9%). Entre 2-4 años el genuvaro predominó en las niñas (p=0,0025). Encontramos un raquitismo florido en el 19,1% de los casos, moderado en el 15,5%, mínimo en el 14,2% y solamente deformidades óseas sin raquitismo activo en el 41,2%. De los parámetros analizados, el factor de riesgo más importante fue ser gemelo (OR=25,43 ; 95% CI=3,76-1098,27), seguido de la falta de sol (OR=18,39, 95% CI=6,69-61,55) y tener un hermano raquítico. La alimentación con leche materna fue un factor de protección (OR=0,94, 95% CI=0,90-0,98). La prematuridad y el bajo peso al nacer no influyeron. La edad de la marcha fue de 15,4 meses en los raquíticos y de 12,4 meses en el grupo control (p<0,01). Conclusión: Las deformaciones graves de miembros inferiores secuelas de raquitismo son frecuentes, están asociadas a la gemelaridad, a la falta de sol y al destete precoz (AU)
Background: To analyse risk factors in rachitic Congolese children with serious deformities in their lower members and to describe the lesions. Methods: The authors analysed the parameters obtained in a survey of two groups of children: a group of 194 rachitic children with severe deformities of their members and another control group of 107 healthy children of similar ages. The types of deformity and the degrees of rachitism were described. Results: The most frequent deformity was genu varum (58.2%), followed by windsept (23.7%) and genu valgum (13.9%). Genu varum predominated in girls of between 2-4 years (p=0.0025). We found florid rickets in 19.1% of the cases, moderate in 15.5%, minimal in 14.2% and osseous deformities alone without active rachitism in 41.2%. Of the parameters analysed, the most important risk factor was being a twin (OR=25.43 ; 95% CI=3.76-1098.27), followed by lack of sunlight (OR=18.39, 95% CI=6.69-61.55) and having a rachitic sibling. Maternal feeding was a protective factor (OR=0.94, 95% CI=0.90-0.98). Premature birth and low weight at birth had no influence. Walking age was 15.4 months in the rachitic cases and 12.4 months in the control group (p<0,01). Conclusion: Severe deformities of lower members as a sequel to rickets are frequent; they are associated with being a twin, lack of sunlight and precocious weaning (AU)
Subject(s)
Humans , Male , Female , Child , Lower Extremity Deformities, Congenital/complications , Lower Extremity Deformities, Congenital/diagnosis , Risk Factors , Rickets/complications , Rickets/diagnosis , Logistic Models , Weight by Height/physiology , Infant, Low Birth Weight/physiology , Vitamin D Deficiency/diet therapyABSTRACT
BACKGROUND: To analyse risk factors in rachitic Congolese children with serious deformities in their lower members and to describe the lesions. METHODS: The authors analysed the parameters obtained in a survey of two groups of children: a group of 194 rachitic children with severe deformities of their members and another control group of 107 healthy children of similar ages. The types of deformity and the degrees of rachitism were described. RESULTS: The most frequent deformity was genu varum (58.2%), followed by windsept (23.7%) and genu valgum (13.9%). Genu varum predominated in girls of between 2-4 years (p=0.0025). We found florid rickets in 19.1% of the cases, moderate in 15.5%, minimal in 14.2% and osseous deformities alone without active rachitism in 41.2%. Of the parameters analysed, the most important risk factor was being a twin (OR=25.43 ; 95% CI=3.76-1098.27), followed by lack of sunlight (OR=18.39, 95% CI=6.69-61.55) and having a rachitic sibling. Maternal feeding was a protective factor (OR=0.94, 95% CI=0.90-0.98). Premature birth and low weight at birth had no influence. Walking age was 15.4 months in the rachitic cases and 12.4 months in the control group (p<0,01). CONCLUSION: Severe deformities of lower members as a sequel to rickets are frequent; they are associated with being a twin, lack of sunlight and precocious weaning.
Subject(s)
Joint Deformities, Acquired/epidemiology , Knee Joint , Rickets/epidemiology , Age Factors , Child , Child, Preschool , Congo/epidemiology , Diseases in Twins/epidemiology , Humans , Infant , Male , Radiography , Rickets/complications , Rickets/diagnostic imaging , Risk Factors , Sex Factors , Sunlight , WalkingABSTRACT
Se estudió la huella plantar con los índices de ChippauxSmirak, del arco de Staheli y el ángulo de Clarke, de 1.851 escolares congoleños, 906 chicas y 945 chicos, de área urbana que utilizaban calzado y rural que iban descalzos habitualmente, con edades comprendidas entre 3 y 12 años. Los niños y niñas de menor edad presentaron mayor porcentaje de pies morfológicamente planos. Este porcentaje disminuyó con el crecimiento en ambos sexos. El factor que más influyó en el desarrollo del pie y de la huella plantar fue la edad, después el calzado y, por último, el sexo. Los niños pequeños mostraron una mayor frecuencia de pies morfológicamente planos; las chicas presentaron mayor frecuencia de pies cavos y la población rural descalza estudiada presentó mayor cantidad de pies normales en el grupo de edad más joven (AU)
Subject(s)
Female , Child, Preschool , Male , Child , Humans , Flatfoot/epidemiology , Talipes/epidemiology , Shoes/adverse effects , Dermatoglyphics , Congo/epidemiology , Age Distribution , Sex Distribution , Foot/anatomy & histologyABSTRACT
We studied the cervical spine radiographically of 72 women between 24 and 78 years of age who had carried wood on their head for a mean of 12 (5-41) years and compared the findings with those of 44 women between 21 and 80 years of age who served as controls. The height of the intervertebral discs and the vertebral bodies was statistically lower among woodbearers. Osteophytes were seen infrequently in pre-menopausal women in the study group, and their presence related to age ( P<0.01), short stature ( P<0.01), and the number of years working as a woodbearer ( P<0.05). The medullary canal was narrow in almost half of the post-menopausal woodbearers and narrower in those with degenerative changes ( P<0.01). Listhesis also was more frequent among woodbearers.
