A veleszületett dongaláb pathogenezisének kutatása

A SE Orthopediai Klinikan 1998 es 2002 kozott 29 műtetre kerult idiopathias es 15 AMC-s dongalabas gyermekből vettunk biopszias ideg es izommintakat. Betegenkent atlag 3 izommintavetel tortent. Osszesen 102 izmot es 34 n. suralist elemeztunk komplex kvalitativ es kvantitativ morfologiai modszerek alkalmazasaval. A dongalabas izmok neuropathologiai eltereseit izomfajtankent kiertekeltuk es az AMC-s izmokban talalt elteresekkel osszehasonlitottuk. Szamitogeppel vezerelt idegmorfometriai elemzest adaptaltuk Magyarorszagra. A dongalabas nervus suralisokat CAMoN szoftverrel analizaltuk. Klinikai es morfologiai osszehasonlito vizsgalatot vegeztunk. Nem talaltunk signifikans osszefuggest az egy vagy tobb labizomban eszlelt patologiai elvaltozas sulyossaga es a lab funkcioja kozott. Megallapitottuk, hogy az irodalmi adatok es a mi adataink kozott nincs jelentős elteres. A kutatas folyaman azonban olyan morfologiai ismeretekhez jutottunk, melyek alapjan a koreredetere vonatkozoan uj elmeletet fogalmaztunk meg. Felmeresunk az első teljes igenyű morfologiai vizsgalatnak tekinthető Magyarorszagon. | Sural and nerve biopsies were obtained from 29 children with congenital clubfoot and 15 children with arthrogryposis multiplex congenita operated in period 1998 and 2002 at the Department of Orthopaedics, Semmelweis University. On average 3 muscle biopsies were taken out of every patients. 102 muscles and 34 sural nerves were studied with complex qualitative and quantitative morphological methods. Neuropathological alterations of all muscles types occured in the patients with idiopathic clubfoot were evaluated and compaired with muscle alterations of the arthrogryposis multiplex congenita. Computer assisted morphometric analysis was adapted in Hungary. Sural nerves of the clubfeet were analysed with CAMoN3 software. Clinical and morphological comparative examination was made. We found no significant correlation between seriousness of the pathological lesion observed in one or more muscles of feet and function of the foot. We found no significant difference between data of the other papers and own data. However in the course of the study we found new morphological infomations on base of those we put forward a new pathogenetic theory. Our survay is the first full exact morphological investigation in Hungary.