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MYOTENOFASCIOTOMY TREATMENT
FOR DISEASES OF THE LOCOMOTOR APPARATUS
BY DR. IGOR NAZAROV
MAY 2002
The treatment that I have practiced and developed over the last 10 years in Russia (since 1992) and that I currently continue to practice can be defined as selective and closed myotenofasciotomy. It can be used to treat the muscular problems of patients with cerebral palsy and also of those patients who suffer from symptoms that are similar to those related to cerebral palsy. In addition, patients with foot deformities (club feet, talipes equinus, etc.), hand deformities, neck deformities (congenital torticollis) and other deformities can be treated. The main problem with these pathologies are the contractures that can form on practically all motor segments of the human body. There are contractures:
- of the soft tissue (muscular contractures) and
- of the joints (joint contractures).
The problem with muscle contractures is considerable in these patients. They are the main reason for the difficulties that these patients suffer, particularly the contractures in the muscles, the fasciae, the aponeuroses, the ligaments and the tendons.
In the first stage of the evolution of this disease – in the prenatal phase or after birth – the motor centres of the central nervous system are negatively affected by hypoxia, asphyxia, trauma or by other processes such as the auto-immune process (I cannot be specific, given that I have not researched this matter in depth), which processes in turn give rise to spasticity in the muscles of the locomotor apparatus. Moreover, hypoxia can have a direct and negative influence on the muscles, given that it affects all tissues of the human body. The result of spasticity is that the muscles suffer from hypoxia for a long time, given that they are contracted, and this causes the development of the degenerative process of dystrophy in the soft tissue structures.
After a period of time, and with the efforts of physicians (neonatologists, paediatric neurologists and physiotherapists) and with the defences of the child’s body itself, spasticity in muscles is successfully reduced or eliminated, and thus there is recovery of the blood supply and of the nutrition of the muscles and other soft tissues, and the tissue cells thereof begin to recover from the degenerative process of dystrophy. However, not all the affected cells recover. In the cellular groups that had suffered extensively and that had deficient blood circulation, a part of the cells cannot recover. This part goes to a very low energy level, and the cells are devitalised forever, which leads to the formation of contractures in the soft tissues.
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