Thermo-and-algesthesia condition in patients suffered from vitamin D-resistant rickets with multiplanar deformities of the lower limb bones

Abstract

The literature has not paid adequate attention to the problem of neural structure involvement in the patients suffered from vitamin D-resistant rickets with deformities of the lower limb bones. Purpose. To study the thermo-and-algesthesia condition in the patients suffered from vitamin D-resistant rickets with multiplanar deformities of the lower limb bones. Materials and Methods. The results of examining 15 patients with multiplanar deformities of the lower limb bones due to vitamin D-resistant rickets formed the basis of the work. The authors investigated the thermo-and-algesthesia with an electrical estesiometer in the area of L1–S2 dermatomes. All the patients underwent surgical treatment including transosseous osteosynthesis with the Ilizarov fixator combined with intramedullary osteosynthesis using wires with hydroxyapatite coating. The investigations performed before surgery, in the process of the deformity correction and in the long-term periods after treatment. Results. The authors revealed that before surgical treatment thermo-and-algesthesia disorders observed in the dermatomes from L4 to S2 where thermoesthesia thresholds were increased or there was no thermoesthesia in them at all, algesthesia threshold tended to increase in L5 dermatome. The investigation of the thermo-and-algesthesia during treatment demonstrated that acute deformity correction on the whole didn’t cause significant changes in the thermo-and-algesthesia condition. Conclusion. Thus, the authors observed the moderate disorders of the thermo-and-algesthesia in the dermatomes from L4 to S2 of the patients suffered from vitamin D-resistant rickets with deformities of the lower limb bones. The used technique of correcting multiplanar deformities of the lower limb bones doesn’t result in the failure of the compensatory mechanisms of the thermo-and-algesthesia system both at the stages of treatment and in the long-term periods of postoperative follow-up.