EUROMEDICA  Hanover 23-24  Mai 2011	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover

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Purpose: To improve long-term results of operative treatment of patients with chronic venous insufficiency of lower extremities by use of biomechanical methods of functional diagnostic.

Methods: With the aim of complex functional diagnostic of venous and musculoskeletal system conditions were used: Dopplerography and Doppler mapping, podometry, goniometry, plantography, X-ray and optical projecting competer investigation of bearing, functional electromyography.

452 pathients were examined at the age of 18 to 85 (middle age - 51,5 12,5 years) with chronic venous insufficiency C3-C6 class of CEAR. 164 of them (37%) are men and 288(63%) are women. Most of them are ill more then 5 years. The life quality of patients in long term postoperation period was analyzed with the help of questionnaire “SF36 Health Status Survey”.

Results: The results of examination of patients (C3-C6) showed that 56% have scoliosis, 28% -osteohondrosis, 89% - dysfunction of foot configuration, 45% - osteoarthritis. The most evident pathology of musculoskeletal system have patients with active trophic changes of soft tissues of lower extremities. Were noted pathological changes of internal temporary structure of step cycle and lowering locomotion, especially in ankle joint. There is a physiological reaction of unloading of affected extremity with pathological displacement of gravity (C3- C4a) projection centre. In C4b-C6 - there is an overwork of affected extremity.

In early term postoperation period was noted the increase of life quality coefficient. Were also increased physical functioning and role-physical functioning, general health and vitality. But 6,24% patients remained with pain which was before operation, and also convulsive syndrome. In long term period the amount of patients with pain syndrome was decreased, and was only 2,3%. The sense of heaviness, which appears during heavy physical activity, had 3,85% patients. Edema of distant part of lower extremities had 2,8% of patients, and 4,9% kept convulsive syndrome. In long term postoperation period index of life quality is but staying rather low in comparison with health people.

From our point of view, the appearance of complaints and low life quality coefficient of part patients in long term postoperative period thought to be because of concomitant pathology musculoskeletal system. An absence of adequate treatment is the main reason of life quality decrease.

Conclusion: Rehabilitation programs before and after operation should be used to stimulate muscle system of lower extremities, recovery amplitude locomotion, liquidation of pathological walk and work on feedback principle.