Research of effective treatment methods in patients with pseudoarthrosis and lower extremities long bones defects remains today very relevant. In the structure of traumatological patients general disability it takes up to 33.1% of cases. Surgical techniques are used, such as: intramedullary osteosynthesis, method of open reposition and bone fragments fixation by metal structures, method of transcutaneous osteosynthesis. They are recognized as effective treatment methods in patients with pseudoarthrosis and lower extremities long bones defects, that greatly improves treatment outcomes. Unfortunately, when they are used as single intervention, unsatisfactory therapy results occur in up to half of the cases. Concomitant structural and functional changes of the limb - such as regional blood circulation insufficiency, presence of extensive cicatrical soft tissues defects, changes in bone segment length, joints contractures, etc. - interferes bone consolidation and requires an application of additional treatment methods. Thus, the generally accepted treatment approach in patients with pseudoarthrosis and lower extremities long bones defects is a combination of surgery, pharmacotherapy, methods of physical therapy and physiotherapy in order to optimize the processes of osteoregeneration in non-union area.
In 40 patients with patellofemoral pain syndrome, before and after the course of treatment, the strength indices of the hip muscles were studied by isokinetic dynamometry, as well as the severity of the pain syndrome in the knee joint and the lumbosacral spine according to the visual analogue scale. The patients of the main group (n = 20) used the technique of complex correction of the pelvic region and lower limb, which was mainly aimed at stabilizing the lumbosacral spine. Patients of the control group (n = 20) performed therapeutic gymnastics aimed at training the muscles of only the interested lower limb. The treatment was performed on an outpatient basis daily for 21 days. After the course of treatment in patients of the main group, the strengths of the quadriceps femoris were significantly higher (p < 0.05), and the degree of pain in the knee joint and lumbar spine was significantly lower (p < 0.05). The obtained data confirm the necessity and expediency of including exercises for stabilization of the lumbosacral spine in the rehabilitation program for patients with patellofemoral pain syndrome.
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