Classification of the cosmetic form of the lower extremities (2)
© M.Yegorov, A.Barinov
A varus deformity of mostly distal region of the skin is characteristic of the sixth variant. In this case a clinical picture corresponds to the roentgenological one. The anatomical axis of the skin derivates from the mechanical axis outside. In patients with a well-developed muscle of a long extensor of the first toe of the foot a deformity may seem bigger than on a X-ray picture.
The seventh variant is characterized by a deformity with the axis of a curvature in the area of a distal region of the hip. A mechanical axis deviates outside or inside from the centre of the knee joint. In the first case the ankle of a curvature is open outside, in the second case, inside. There is a visual similarity with the first and the second variants. The eighth variant {zero variant). A mechanical axis goes through the centres of the hip, knee, ankle joints connecting with the anatomical axis of a shin.
The types of distribution of a muscular mass. The zero type of a distribution of a muscular mass and soft tissues of the lower extremities concerning anatomical axis of the thigh and the shin corresponds to a normal development and a symmetrical distribution of the soft tissue structures. The cases of combinations of a zero variant of a mechanical axis position of the lower extremity and a zero type of muscles and soft tissues distributor! concerning the anatomical axis of the thigh and the skin corresponds to the ideal forms of the legs both anatomically and esthetically.
The first type of distribution of a mass of soft tissue structures corresponding to the anatomical axis of the thigh and the shin is characterized by a feeble development of the shin muscles forming the inner contour of the extremities and by its deviations outside corresponding to the anatomical axis of the shin.
To the second type of the soft tissues distribution corresponding to the anatomical axis of the thigh and the shin belong people having a well-developed external group of shin muscles making the external view of a varus deformity.
The second and the third variants of the axis deviations are characterized by a varus deformity in the region of a knee joint or a proximal metaphysis of a tibia. Hence, the most part of the patients, coming to the hospital needs a correction of a shin axis on the level of a proximal metaphysar region. Predominance of the zero variant of distribution of the soft tissue structures among the patients makes a cosmetic correction easier because only one parameter, the axis, demands a correction. A hard work to change the soft tissues contours is not necessary in this case.
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