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Classification of the cosmetic form of the lower extremities (1)

© M.Yegorov, A.Barinov

The analysis of great number of different signs of cosmetic defects of the lower extremities revealed the most frequently occurring variations of their signs. Taking into consideration the dependence of results of the lower extremities cosmetic corrections upon their original form the decision was made to systematize the data present and to develop their classification.

Classification of a cosmetic form of the lower extremities developed by M. F. Yegorov did not consider the aetiological factors. The main factors for a classification development were simplicity, visibility, practical convenience. The systematisation was made by 2 signs: a position of the mechanical axis of the lower extremity in a frontal plane and a distribution of the muscular mass and soft tissues concerning anatomical axis of the hip and shin.

8 variants of a mechanical axis curvatures of the lower extremity and 3 types of soft tissues structures distributions have been evolved. The present classification has been developed for one type of the correction of the lower extremity axis: proximal metaepiphysis of tibia.

The first variant is characterised by a declination of the lower extremity mechanical axis externally from the centre of the knee joint. The level of the curvature apex is a projection of the joint fissure. In case of a muscular mass predominance a cosmetic defect aggravates along the medial line of the shin.

The second variant. A mechanical axis is curved inside from the centre of the knee joint. Not abruptly expressed varus deformity of the knee joint with the apex of a curvature along the line of the knee joint is clinically observed. In case of a well-developed and competiting external group of the calf muscles and a lateral head of the calf muscle the cosmetic defects is more expressed.

The third variant of a curvature of a mechanical axis of the extremity is characteristic of people having varus deformity due to the tibia curvature in a proximal metaepiphysar area. A clinical picture is a little different from the second variant of an axis deviations. The single difference is seen in a leg "shortening" at a visual comprehension concerning the length of the thighs. As in the second variant a cosmetic defect is smoothed out or aggravated depending upon the mass and development of the shin muscles situated along the external contour.

The forth variant is characterised by a varus shin deformity formation due to a curvature of both proximal and distal metaphysar regions of tibia. The anatomical axis is projected outside from the shin mechanical axis. Roentgenologically and clinically the levels of the shin deformity are mostly expressed in the regions of both metaphyses.