Present day explanation of the clinical signs in the biomechanical aetiology of the so-called idiopathic scoliosis (1995-2011). The relationship between the "model of hips movement" and the character of scoliosis; three groups and four types. The causative role of "gait" and "standing "at ease" on the right leg".

The observations from 1985-1995 and till 2012 clarify that the development of so-called idiopathic scoliosis is connected with "gait" and habitual permanent "standing at ease" on the right leg. The scoliosis is "a result" of asymmetry of "function" - "changed" loading during gait and asymmetry in time during 'at ease' standing, more prevalent on the right leg. Every types of scoliosis is connected with the adequate "model of hips movements" [MHM] (Karski et al., 2006 [1]). This new classification clarifies the therapeutic approach to each types of scoliosis and provides the possibility to introduce causative prophylaxis.

"Syndrome of contractures" (according to Mau) with the abduction contracture of the right hip as causative factor for development of the so-called idiopathic scoliosis.

The article provides basic explanation of "syndrome of contractures" (Mau) at newborns and babies and it's conjunction with biomechanical etiology of the so-called idiopathic scoliosis (Karski 1995-2006). The authors analyzed children with "syndrome of contractures" and noted its relevance to some clinical symptoms at children with scoliosis. Newborns and babies with clinical signs of "syndrome of contractures" require further spine examination already at age of 3-4 in order to detect "danger of oncoming scoliosis" and to introduce neo-prophylaxis. The research based on "syndrome of contractures" can explain predominance of female gender of patients with scoliosis, sides of curves, side of rib hump, progression and sensibility to new rehabilitation exercises.

Recent observations in the biomechanical etiology of so-called idiopathic scoliosis. New classification of spinal deformity--I-st, II-nd and III-rd etiopathological groups.

The article examines the biomechanical etiology of so-called idiopathic scoliosis (AIS). It describes I-st, II-nd and III-rd etiopathological groups (epg) of spine deformity which were developed during the years 2001/2004/2005. All children with so-called idiopathic scoliosis had an abduction contracture of the right hip, often connected with a flexion and external rotation contracture. In other cases we found only limited range of adduction of the right hip in comparison to the left hip. We maintain that children with this real abduction contracture of the right hip constitute the first etiopathological group of the development of scoliosis (I-st epg). This group has an "S" double shaped scoliosis with the rib hump on the right. Other patients, with only limited adduction of right hip in comparison to the left hip, constitute the second etiopathological group of development of scoliosis (II-nd epg). This group has a "C" shaped lumbar, sacro-lumbar or lumbo-thoracic left convex scoliosis. The third etiopathological group (III-rd epg) shows either no or a minimal curve on X-ray with either no rib hump or a very minor one but have a "stiffness of spine". Such patients have problems with sporting activities and, as adults, the spinal stiffness leads to considerable "back pain". The right hip structural abduction contracture, or the differences in adduction, is connected with the "syndrome of contractures" in neonates and babies described by many authors and in depth by Mau. How does scoliosis develop? Our explanation is as follows. Asymmetry of movement of the hips during gait provokes asymmetry of loading and asymmetry of growth of both sides - left and right - and the gradual development of scoliosis. In I-st epg, the scoliosis is a secondary compensation for deformities in the pelvis and spine. The II-nd epg is linked to a permanent standing posture maintained on a free right leg during the first years of life. The III-rd epg comprises of patients from the boarder groups of I-st and II-nd epg. This classification establishes a clear therapeutic approach to every etiopathological group of scoliosis and allows for the possibility of introduction of causative prophylaxis.

In-vitro mechanical impacts on calves' proximal femurs: significance of mechanical weakening of the femoral head in the etiology of Perthes disease in children.

Experimental research was conducted to determine the effects of mechanical forces on the hip joint in the etiology of Perthes disease in children. The authors aimed to identify areas of lower resistance to mechanical forces in a growing femoral head. Calves' femurs, used as experimental models, were repeatedly subjected to mechanical impacts. The results showed that the areas most susceptible to trauma were the layers of immature bone located underneath the epiphyseal growth zone and underneath the growth plate. The authors conclude that blood vessels in these areas are highly vulnerable to mechanical damage, and the resulting impairment of blood flow to the femoral head leads to the development of Perthes disease in children.

"Contracture syndrome" in newborns and infants according to Prof. Hans Mau as an explanation of the "geography" and certain clinical features of idiopathic scoliosis.

Background. Many malformations and dysfunctions of the skeletal system are connected with the "contracture syndrome" described by Prof. Hans Mau. The clinical features include plagiocephaly, torticollis, infantile scoliosis, pelvic deformity, foot deformity, adductor contracture mostly of the left hip, abductor contracture mostly of the right hip. Material and methods. The authors analyzed 300 histories of children aged from 3 weeks to 12 months treated in the years 1999-2001, and 100 histories of children with idiopathic scoliosis. Conclusions. Newborns and babies with clinical features of "contracture syndrome" require further spinal examination at age 3-4 in order to detect the risk of incipient scoliosis and to introduce appropriate preventive measures.

New conservative treatment of idiopathic scoliosis: effectiveness of therapy.

Background. This article provides basic information concerning a new conservative treatment for idiopathic scoliosis, with appropriate asymmetric flexion-rotation exercises and special redressing positions. Material and method. The analysis was based on 288 children with scoliosis and a control group of 268 children. The authors describe the most important exercises and provide a statistical analysis of treatment outcome in children with idiopathic scoliosis. Results and Conclusions. Early detection of the risk of scoliosis and correct therapy through new conservative treatment based on exercises make it possible not only to limit the progression of spinal deformity (61%), but also, in some cases of incipient scoliosis, to reduce the curvature (32%).

Biomechanical factors in the etiology of idiopathic scoliosis: two etiopathological groups of spinal deformities.

Background. The paper constitutes a study of the biomechanical etiology of so-called idiopathic scoliosis. Material and methods. This research involved clinical material from 434 children with scoliosis, examined and treated in the years 1995-2002. Computer-assisted gait analysis was also added to the examination. Results. In idiopathic scoliosis, there is a real abduction contracture of the right hip, often connected with flexion and outward-rotation contracture of the right hip, or only a limited range of adduction. The right hip abduction contracture, structural or functional, is connected with the "contracture syndrome", Prof. Mau's "Siebenerkontrakturen Syndrom". Children with real abduction contracture of the right hip or adduction of 00 constitute the first etiopathological group of scoliosis, a double S-shaped scoliosis. There is initial rotation deformity with spinal stiffness; deformity, connected with gait, starts at age 3-4. Patients with only a difference in the adduction of both hips (15-250 adduction of the right hip, 35-500 adduction of the teft hip) constitute the second etiopathological group of scoliosis, C-shaped lumbar, lumbo-sacral, or lumbo-thoracic left convex scoliosis, usually diagnosed after age 10. Conclusion. In accordance with the respective biomechanical etiology of scoliosis, children with scoliosis and endangered with scoliosis should be given exercises to restore the flexibility of the spine. The paper underlines the importance of asymmetric rotational flexion-extension exercises. The understanding of the biomechanical etiology of idiopathic scoliosis enables prevention of the causes of this spinal deformity.

Capital femoral epiphysis and growth plate of the asymptomatic hip joint in unilateral Perthes disease.

Radiograms of 173 children with unilateral Perthes disease were reviewed with particular reference to the presence of flattening and irregularity of the 'unaffected' epiphyses. The slope and shape of the growth plate were also evaluated. About 35% of children with Perthes disease showed changes of the unaffected proximal femur in the first radiograms of the hip joints. These consisted of small epiphysis, flattening of the epiphysis, contour irregularities (20%), and changes in the growth plate (15%). The radiographic abnormalities were not accompanied by any clinical symptoms of the asymptomatic hip joint and they receded with age during treatment.

Etiology of the so-called "idiopathic scoliosis". Biomechanical explanation of spine deformity. Two groups of development of scoliosis. New rehabilitation treatment; possibility of prophylactics.

INTRODUCTION: Between various etiological factors of idiopathic scoliosis we also studied the biomechanical causes connected with the hip and pelvic regions. At all children with idiopathic scoliosis there is a real or functional abduction contracture of the right hip (sometimes plus flexions- and out-rotation contracture). The right hip abduction contracture is connected with "syndrome of contractures" at newborns and babies. MATERIAL: 629 children treated in University Pediatric Orthopaedic Department, Lublin/Poland were divided into two groups: *I group of development of scoliosis- 220 children aged from 4 to 10. Real abduction contracture of the right hip 4-6-8 degree, adduction of the left hip 35-40-45 degree. Rotation deformity, both scoliosis (Lumbar L and thoracic Th) at the same time. Progression. **II group of development of scoliosis - 409 children aged from 10-12 to 14. Adduction of the right hip 10-15 even 20 degrees, adduction of the left hip 35-40-45 degree. Lumbar left convex scoliosis, no rotation deformity or small, no thoracic scoliosis, or small, no progression or small. INFORMATION ABOUT "SYNDROME OF CONTRACTURES": Clinical symptoms of _syndrome of contractures" were described exactly by Mau and others. At scoliotic patients we see in the region of right hip the following tissues contracted and shortened: *tractus iliotibialis, *fascia lata, * fascias of m.gluteus medius and minimus, *m. sartorius, *m. rectus, *capsules of right hip joint. CLINICAL RESEARCH: Since 1980s we added the tests for the adduction of both hips in straight position of the joint to the standard examination of scoliotic patient. Depending on the value of adduction movements of both hips we divided all patients into two above mentioned groups (I and II). EVALUATION OF PRESENT REHABILITATION TREATMENT IN OUR MATERIAL:Children were divided into three groups depending on range of scoliosis: A. Scoliosis L 5 degrees - 10 degrees, Th 5 degrees - 10 degrees. These children did not perform (wrong!) extension exercises 10% B. Scoliosis L 15 degrees - 25 degrees, Th 15 degrees - 25 degrees. These children performed (wrong!) extension exercises 30% C. Scoliosis L 25 degrees - 35 degrees or more, Th 25 degrees - 35 degrees or more. Older children. Extension (wrong!) exercises long time (1-2-3 years!) 60% CONCLUSIONS: 1 . The so-called idiopathic scoliosis are connected with the right hip real or functional abduction contracture (sometimes plus flexion and out-rotation contracture). 2. There are two groups of development of idiopathic scoliosis. The first group - small children, early rotation deformity, both scoliosis (L and Th), progression. The second group is connected only with the habit of permanent standing "at ease" on the right leg. Older children. L scoliosis, sometimes Th scoliosis. 3. X-ray pictures of spine with pelvis are necessary for proper diagnosis.4. Abduction contracture of the right hip is connected with "syndrome of contractures" of new-borns and babies.5. We see necessity to introduce new stretching-flexion asymmetric exercises and a special sports program for the children endangered with scoliosis. 6. We proved that the "new prophylactics" through "new clinical test" and "new rehabilitation treatment" at school children (5-6-7-8 years old) gives positives results.