Syndróm konskej nohy možno úspešne liečiť, no málo kto o tom vie

Napísal Kristína Chudá 25. júl 2023

Pes equinovarus, čiže konská alebo golfová noha je v súčasnosti najčastejšou vrodenou ortopedickou vadou, a napriek tomu sa o nej medzi rodičmi a verejnosťou vie len veľmi málo. Ak sa na vadu príde ešte pred narodením dieťaťa, je často rodičom odporúčaný potrat, hoci sa tento problém dá úspešne liečiť.

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Laicky povedané, tzv. golfová alebo konská noha znamená, že sa dieťatko narodí s chodidlami (môžu byť postihnuté obe nohy alebo len jedna) vtočenými dovnútra a dozadu. Na prvý pohľad sa novopečenej mamičke môže zdať len ťažko uveriteľné, že jej dieťa sa na nohy vôbec niekedy postaví a bude schopné normálne behať.

A prečo ochorenie vzniká? Rizikové faktory:

-        Rodinná história. V rodine, kde sa táto lekárska anamnéza vôbec nevyskytovala, je výskyt ochorenia skôr náhodný (1 z 1 000). No ak sa v rodine už táto anamnéza vyskytla, šanca na toto vrodené ochorenie je oveľa vyššia.

-        Vrodené podmienky. V niektorých prípadoch môže byť syndróm konskej nohy spojený s inými abnormalitami kostry, ktoré sa vyskytujú pri narodení (vrodené), ako je napríklad spina bifida, vrodená vada, ktorá nastane, keď sa chrbtica a miecha nevyvíjajú alebo nezatvárajú správne.

-        Životné prostredie. Fajčenie počas tehotenstva môže významne zvýšiť riziko tohto ochorenia.

-        Ak počas tehotenstva nie je dostatok plodovej vody. Príliš málo plodovej vody môže zvýšiť riziko klusavky.

Toto ochorenie sa vyskytuje dvakrát častejšie u chlapcov ako u dievčat. Starostlivosť a zvládnutie tohto problému je dlhý proces, ktorý sa začína už vo veku 1 týždňa a v niektorých prípadoch trvá 4 až 5 rokov.

Najefektívnejšiu liečbu ponúka tzv. Ponsetiho metóda

V súčasnosti sa na liečbu Pes equinovarus využíva tzv. Ponsetiho metóda, ktorá je považovaná za jednou z najefektívnejších metód pri liečbe tohto problému. Pri tejto novej metóde zväčša nie je potrebná operácia. Detská nôžka je s týždennými rozostupmi fixovaná do sadry, kedy každý týždeň sa s nôžkou jemne manipuluje (pred každým sadrovaním sa o niečo vyrovná). Sadra je nasadená od prštekov až po stehná. Tento proces sadrovej fixácie umožní natiahnutie šliach a väzov v nohe a dopraje čas kostiam, aby vďaka tlakom rástli do správneho tvaru.

Po sadrovaní zvyčajne nasleduje tzv. Tenotómia, operatívne preťatie Achillovej šľachy. Jedná sa o malý zákrok v celkovej alebo lokálnej anestézii. Achilova šľacha sa pretne malým 5 milimetrov dlhým rezom. Šľacha sa zahojí a je to posledná sadra, ktorú bude mať drobec 3 týždne na nohe.

Vďaka samoliečebnému potenciálu novorodencov a malých detí sa Achillova šľacha úplne uzdraví a zrastie v predĺženej pozícii. V tesnej nadväznosti na tenotómiu nasleduje nosenie špeciálnych dláh. Dlahy sa zo začiatku nosia celodenne, neskôr len v noci. Priemerne nosia deti dlahy 4 roky.


https://www.mayoclinic.org/diseases-conditions/clubfoot/symptoms-causes/syc-20350860

https://www.nationwidechildrens.org/conditions/clubfoot-talipes-equinovarus

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    See Also




    For further reading on performance-enhancing substances,
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    Performance-Enhancing Drug


    Anabolic Steroid


    Stimulant


    Erythropoietin





    References




    (1) World Anti-Doping Agency (WADA). (2019).
    *Prohibited Substances List*. Retrieved from WADA official website



    (2) National Institute on Drug Abuse (NIDA). (2020). *Performance Enhancing Drugs*.
    Retrieved from NIDA official website




    External Links




    (1) World Health Organization - Substance Abuse and Addiction


    (2) National Library of Medicine - Drug Abuse

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