86_piede torto congenito optimized

Upload: com-edizioni

Post on 27-Feb-2018

215 views

Category:

Documents


0 download

TRANSCRIPT

  • 7/25/2019 86_Piede Torto Congenito Optimized

    1/6

    SB@N@ ^KY^K MKHA@HB^K

    MjuidkktTlj`htbhl Nb Mlrjk, Mkstlhtbhl Ylmlhk

    N@DBHBUBKH@

    Bj pb`n` tkrtk mkha`hbtk (S^M) uhl n`dkrobt, ab pr`s`ht` ljjl hlsmbtl,

    nl ljt`rltk svbjuppk okrdkjkabmk n`jj` kssl n`j pb`n`, mg` n`t`robhluhlttbtunbh` vbzbltl p`r mub `ssk hkh pkaabl lj sukjk h`b sukb puhtb

    hkroljb.Mkhsbst` bh uh nbd`ttk lhltkobmk oujtbdlttkrblj`, mkh t`hn`hzl ljjl rbsk-juzbkh` arlzb` ljjutbjbzzk nb trlttlo`htb lpprkprbltb ` t`op`stbvb.Jl oljdkrolzbkh` n`j pb`n` ab pr`s`ht` h`j d`tk l plrtbr` nljjuhnbm`-sbol s`ttbolhl nb vbtl ` h`jjl olaabkr plrt` n`b mlsb `ssl ab vbsbibj`

    ljj`slo` `mkarlmk n`j d`tk nurlht` jl arlvbnlhzl. Jl nblahksb m`rtl,p`r, vb`h` pkstl skjk ljjl hlsmbtl, qulhnk vb`h` mkhstltltl jl n`vblzbkh`hkh mkrr`aabibj` (k plrzbljo`ht` mkrr`aabibj`) olhuljo`ht` n`ajb lssblhltkobmb n`j pb`n` ` n`jjl aloil.@sbstkhk qulttrk arlhnb vlrb`t nb S^M5 `qubhk-vlrk-supbhltk5 73%6 tljk-vljak-prkhltk5

  • 7/25/2019 86_Piede Torto Congenito Optimized

    2/6

    ^@YL^KA@HK5 dr`qu`ht`o`ht` lsskmbltk ln ljtr` n`dkrobt mko` jlspbhl ibnl, bj ob`jko`hbhakm`j`, j` plrljbsb splstbmg`, jlrtrkarbpksb,

    jl ]. nb Ok`ibus. Ylppr`s`htl jldkrol sbhtkoltbml nb S^M.

    SK]^PYLJ@5 nl oljpksbzbkh` ut`rbhl, irbajb` lohbktbmg`, kjbakb-nrlohbks, olmrkskobl, a`o`jjlrbt. ]b trlttl nb uh pb`n` a`h`rltkmkrr`ttlo`ht` ` mg` gl summ`ssbvlo`ht` lmqubsbtk uhl okrdkjkablljt`rltl h`j mkrsk n`jjl a`stlzbkh`. sp`ssk lsskmbltk l jusslzbkh`mkha`hbtl n`jjlhml (JML).

    S`r jl dr`qu`ht` lsskmblzbkh` tlhtk n`jj`dkro` sbhtkoltbmg`qulhtk nbqu`jj` pksturljb mkh ljtr` n`dkrobt mkha`hbt`, bh pr`s`hzl nb S^M

    h`m`sslrbk prltbmlr` sbst`oltbmlo`ht` lmm`rtlo`htb mjbhbmb rlnbkjkabmbn`jj` lrtbmkjlzbkhb mkxk-d`okrljb ` n`jjl mkjkhhl v`rt`irlj`.

    @UBKJKABL

    @mm`ttk jl oljpksbzbkh` ut`rbhl mg` abustbml j`zbkjkabl n`jj`dkro`

    pksturljbnb pb`n` tkrtk jl mlusl n`t`robhlht` jl a`h`sb n`j S^M lh-mkrl bhm`rtl. stltl prkpkstl uh`r`nbtlrb`t nb tbpk oujtbdlttkrblj`, mkhuhbhu`hzl olaabkr` nb uh sbhakjk a`h` lutkskobmk nkobhlht`. Y`m`htb

    stunb ibkptbmb skhk l dlvkr` nb uh`zbkjkabl h`urkousmkjlr`, nbokstrltlnljjlhnlo`htk lhlrmgbmk ` nl sprkpkrzbkhb h`j huo`rk nb obkirbjj`,

    kss`rvltb ljjl ibkpsbl n`b ousmkjb `strbhs`mb n`jjl mlvbajbl.

    DB]BKSL^KJKABL

    Jljt`rltk svbjuppk okrdkjkabmk ljjl ils` n j S^M bht r ssl bj r trkpb`n`

    `n bh plrtbmkjlr` jlstrlaljk mg` h` mkhtrkjjl jl pkrzbkh` bht`rhl ` bjmljmlahk, mg` mkhtrkjjl jl pkrzbkh` st`rhl. Bh mkhnbzbkhb hkroljb, b rbsp`ttbvblssb jkhabtunbhljb n`smrbvkhk uh lhakjk nb nbv`ra`hzl n`j vljkr` nb =3->3.H`j S^M tlj` lhakjk rbnkttk, l s`aubtk n`jjbhstlurlrsb nb5

    l)n`dkrobt kss``l jbv`jjk n`jj` lrtbmkjlzbkhb tbibk-lstrlaljbml, skttk-lstrlaljbml, o`nbktlrsbml ` tlrsk-o`tltlrslj`6

    i)r`trlzbkhb ousmkjk-t`hnbh``-j`alo`htks`prbhmbpljo`ht` l mlrbmkn`b t`hnbhb r`trkoljj`kjlrb bht`rhb, tbiblj` lht`rbkr` `n lmgbjj`k.

    L s`mkhnl n`jjlrtbmkjlzbkh` bht`r`ssltl nljj` n`dkrobt kss``, jltt`a-ablo`htk vbzbltk n`j pb`n` pu lssuo`r` nbv`rsl okrdkjkabl5

    LY^. ^BIBK-L]^YLALJBML @\PBHB]OK5 `ssbkh` pjlhtlr`n`jjlvlopb`n`, mg` pkaabl l t`rrl skjk mkh jl puhtl. Jl mlvbajbl bha`h`r` nbstlht` nlj sukjk ` trl pb`n` ` aloil hkh vb ljmuhl lhakjl-zbkh`. lsskmbltk l r`trlzbkh` n`j t`hnbh` nLmgbjj`.

  • 7/25/2019 86_Piede Torto Congenito Optimized

    3/6

    LY^. ]K^^K-L]^YLALJBML ^LJB]OK5 kppkstk ljj`qubhb-sok. Bj pb`n` p`rn` jlppkaabk pjlhtlr` ` sb trkvl bh `ssbkh` sujjl

    aloil, rbvkjtk v`rsk jljtk.

    LY^. O@NBK-^LY]BMLTLYB]OK5 prkhlzbkh` n`jjl pblhtl n`jpb`n` mkh linuzbkh`, kppkstk lj vljabsok. Bj pb`n` krb`htltk v`rskj`st`rhk, mkh lppkaabk suj ikrnk o`nblj` bht`rhk.

    LY . LY]K-O@^L LY]LJ@TLJAB]OK5 n`vblzbkh` o`nblj`mkh lnnuzbkh` n`jjlvlopb`n` ` lppkaabk suj qubhtk o`tltlrsk.

    MLYL^^@YB]^BMG@ MJBHBMG@

    Jldkrol bnbkpltbmlnb S^M, mg` mkstbtubsm` bj 10% nb tuttb b mlsb, pr`-s`htl tbpbmlo`ht` > prbhmbpljb mkopkh`htb5. bhtrlrktlzbkh` n`jjl aloil.]b lsskmblhk, bhkjtr`, bh arlnk vlrblibj` rbabnbt ` jb`v` ltrkl nb tbibl,

    p`rkh`, kssl n`j pb`n` ` pkjplmmb.Mjbhbmlo`ht` pkssbibj` mjlssbmlr` jldd`zbkh` bh pb arlnb, ilslhnksb

    sujjlhakjk mkopr`sk drl pb`n` ` lss` n`jjl aloil, ` sujjl rbnumbibjbtn`jjl n`dkrolzbkh`. Jl mjlssbdmlzbkh` nb Nbo`ajbk jl pb utbjbzzltl`n bhnbvbnul qulttrk jbv`jjb nb arlvbt n`jjl j`sbkh`5 i`hbahk5 arlnk B, sbobj` ln uh `rrltk ltt`aablo`htk pksturlj`, mkh

    t`hn`hzl lj obajbkrlo`htk h`j t`opk6 okn`rltk5 arlnk BB, rbnumbibj` ol plrzbljo`ht` r`sbst`ht`6s`v`rk5 arlnk BBB, r`sbst`ht` ol plrzbljo`ht` rbnumbibj`6arlv`5 arlnk BT, mkh lhakjk :23 ` brrbnumbibj`.Jl rbnumbibjbtnb uh S^M jl pkssbibjbt nb ktt`h`r` jl mkrr`zbkh` n`jjloljdkrolzbkh` mkh t`rlpbl olhbpkjltbvl k pr`sbnb krtkp`nbmb, pkbmg

    hkh skhk pr`s`htb n`dkrobt kss`` strutturlt` r`trlzbkhb obk-t`hnbh``.Jbrrbnumbibjbt, bhv`m`, mkopkrtl jbhstlurlrsb nb r`trlzbkhb ousmkjk-t`h-nbh`` (r`jltbvl) k n`dkrobt kss`` (lsskjutl) p`r mub hkh sb pu pb t`htlr`uhl mkrr`zbkh` olhulj`5 bh qu`stk mlsk pkssbibj` skjk uhl mkharu`hzllrtbmkjlr` la`hnk mgbrurabmlo`ht` sujj` plrtb okjjb k sujjl strutturl kss`l.

    NBLAHK]B

    Jl nblahksb nb S^M skstlhzbljo`ht` mjbhbml6 bhhlhzbtuttk h`m`sslrbkrbmkhksm`r` h`j h`khltk jlhkoljbl, dlttk hkh nbdmbj` h`jj` dkro` arlvb

  • 7/25/2019 86_Piede Torto Congenito Optimized

    4/6

    nb S^M, ol tljvkjtl suinkjk ` sduaa`ht` h`jj` dkro` obhkrb. nuhqu`bopkrtlht` s`aubr` uh bt`r smrupkjksk mg` mkhs`htl bh ir`v` t`opk nbktt`h`r` uhl nblahksb pr`mkm`.Lhloh`sb kst`trbml lmmurltl5 n`v` rbm`rmlr` `v`htuljb dlttkrbnb rbsmgbk bhtrlut`rbhb, quljb kjbakbnrlohbks, olmrkskobl,a`o`j-jlrbt.

    @slo` mjbhbmk5 vljutlzbkh` a`h`rlj`/ krtkp`nbml/ h`urkjkabml6 kss`rvlzbkh` n`jjl ibjlt`rljbt (s` pr`s`ht`)6

    n`hbzbkh` n`jjl rbnumbibjbt/brrbnumbibjbt.

    ]b rlmmkolhnl jl sboujtlh`l kss`rvlzbkh` nb `htrloib b pb`nbn`j h`khltk.Jl mut`skvrlstlht` jl n`dkrobt nkvr`ii` `ss`r` `slobhltl p`r j`v`h-tulj` rbsmkhtrk nb pjbmg` bhusuljb prknktt` nljjl n`vblzbkh` n`j pb`n`,o`htr` jl mut` n`j jltk kppkstk pu lpplrbr` `mm`ssbvlo`ht` t`sl. Ptbj`lsskmblr` jbsp`zbkh` n`j nbstr`ttk vlsmkjlr` mkh jl stbol n`j r`djj mlpbjjlr`` n`j mkjkrbtk mutlh`k.Ljjbsp`zbkh`, bj pb`n` tkrtk p`nbltrbmk sb pr`s`htl pb pbmmkjk mg` h`jjlhkrol, mkh uh tljjkh` pb okribnk ` `ssbibj` l mlusl n`jjbpkpjlsbl

    mljmlh`lj`. H`j iloibhk pb arlhn`, jltrkl n`j pb`n` ` n`j pkjplmmbk

    pb `vbn`ht` mg` h`j h`khltk, nkv` m`jltl nljjl sbkjkabml bpktk-hbl n`b prbob abkrhb. Bj ikrnk o`nblj` n`j pb`n` mkhmlvk ` pr`s`htluh prkdkhnk skjmk mutlh`k, o`htr` bj ikrnk jlt`rlj` olrmltlo`ht`mkhv`ssk. Bh mlsk nb S^M ibjlt`rlj`, j` pblht` n`b pb`nb skhk rbvkjt`juhl v`rsk jljtrl.Jl vljutlzbkh` krtkp`nbml n`v` mkopr`hn`r` jl okibjbzzlzbkh` nb `h-trloib b pb`nb n`jj` lrtbmkjlzbkhb n`jj` aloi`, kss`rvlhnk5`ssbibjbt,

    rbabnbt,pksbzbkhb bhskjbt`, lsboo`trbl,p`rnbtl nb okibjbt. Nurlht` jlolhkvrl mkhstltltl jl rbabnbt prkhuhmbltl n`j t`hnbh` nLmgbjj`, mkhsmlrsl k lss`ht` nkrsb`ssbkh`.

    Jl vljutlzbkh` h`urkjkabml gl jkib`ttbvk nb bhnbvbnulr` v`htuljb pltk-jkab` h`urkousmkjlrb lsskmblt` lj nbd`ttk nb okrdkjkabl kss`l. Ylnbkarldl trlnbzbkhlj`5 H`jjl vljutlzbkh` n`j S^M v`hakhk utb-

    jbzzlt` prkb`zbkhb L-S, jlt`rljb k duhzbkhljb (sboujlhtb bj mlrbmk), mg`

    p`ro`ttkhk nb obsurlr` jlhakjk nb nbv`ra`hzl lstrlaljk-mljmlh`lr`(v.h.?=3 bh prkb`zbkh` nkrsk-pjlhtlr` >3 bh prkb`zbkh` jlt`rlj`). H`jS^M jl obsurl nb tlj` lhakjk uaulj` l 3, pkbmg ajb lssb jkhabtunbhljbnb lstrlaljk ` mljmlahk skhk plrljj`jb.

    @mkarldl YOH5 vbsuljbzzlhk j` struttur` kst`kmkhnrljb, qu`jj` obk-t`hnbh`` mlpsujk-j`alo`htks`.

    Nblahksb mkarldml pr`hltlj`5 ab pkssbibj` nljjl

  • 7/25/2019 86_Piede Torto Congenito Optimized

    5/6

    ^@YLSBL

    Bj trlttlo`htk n`j S^M n`v` `ss`r` bhbzbltk bj pb t`op`stbvlo`ht`

    pkssbibj`, boo`nbltlo`ht` nkpk jl hlsmbtl. Bj rbtlrnk lhmg` nb pkmgbabkrhb pu mluslr` jbopkssbibjbt nb ktt`h`r` jl mkrr`zbkh` bhmru`htl.

    ^YL^^LO@H^K SL]]BTK

    mkhs`rvltbvk hkh rbmgb`n` jutbjbzzk nb t`mhbmg` mgbrurabmg`. Nl skjk sudmb`ht` l mkrr`aa`r` bj S^M nb B arlnk. T`hakhk `s`aubt`5

    l) olhbpkjlzbkhb mkrr`ttbv` `htrk jl prbol s`ttbolhl nb vbtl, sdruttlhnkjl sbkjkabml bpktkhbl n`b prbob abkrhb. ]b bhbzbl mkh okn`jjlo`htb

    olhuljb (mkh bj pkjjbm` ` jbhnbm` nb uhl olhk) h`j s`hsk mkhtrlrbkn`jj` n`dkrolzbkhb, nl s`aubr` 0-4 vkjt` lj abkrhk. J` olhkvr`, prk-ar`ssbv` olb vbkj`ht`, skhk bhbzbljo`ht` s`aubt` nl uh krtkp`nbmkol summ`ssbvlo`ht` n`vkhk `ss`r` bhs`ahlt` lb a`hbtkrb. Obrlhk lrbnurr` jl n`dkrobt bh vlrbsok ` bh supbhlzbkh`, rbs`rvlhnksb nbmkrr`aa`r` j`qubhbsok bh uh s`mkhnk t`opk.

    i) summ`ssbvl stlibjbzzlzbkh` trlobt` lppjbmlzbkh` nb lpplr`mmgb a`ssltbmkrr`ttbvb d`okrk-pknljbmb mkh abhkmmgbk `ssk l 23, rbhhkvltb kahb7- o`sb uh `slo` rlnbkarldmk n`j pb`n` bh arlnk nb nbr`

    s` jl mkrr`zbkh` ktt`hutl sknnbsdlm`ht`.

    ^YL^^LO@H^K L^^BTK

    Nl lsskmblr` bh uh s`mkhnk t`opk p`r mkrr`aa`r` j`qubhbsok, (bh a`h`r`trl b 4-7 o`sb nb vbtl p`r vbtlr` ajb dd`ttb h`altbvb n`j mlrbmk) k bhtkrhk ljqulrtk o`s` bh mlsk nb bhsumm`ssk n`jjl t`rlpbl mkhs`rvltbvl. dr`qu`ht` jlh`m`ssbt nb rbmkrr`r` ljjljjuhalo`htk n`j t`hnbh` nLmgbjj`, mub sp`ssk

    sb lsskmbl jlp`rturl n`jj` lrtbmkjlzbkhb nb tutt` j` pbmmkj` kssl n`j tlrsk.Jlpprkmmbk mgbrurabmk mg` vb`h` bhv`m` utbjbzzltk p`r mkrr`aa`r` bj vlrb-sok, jl supbhlzbkh` j`qubhbsok jbht`rv`htk nb Mknbvbjjl, mg` pr`v`n`jl jbi`rlzbkh` n`jj` plrtb okjjbs`hzl lprbr` jlrtbmkjlzbkh` skttklstrlaljbml.Mkhs`ht` nb mkrr`aa`r` mkopj`tlo`ht` tutt` j` n`vblzbkhb prkprb` n`j S^Mtrlobt` uh lmm`ssk mgbrurabmk pkst`rk-o`nblj` mub s`au` uh obhkr huo`rknb mkopjbmlhz` pkst-mgbrurabmg` ln `skrnbk h`jjl vbtl lnujtl.Nkpk bj trlttlo`htk n`j S^M, sbl `ssk mru`htk k bhmru`htk, h`m`sslrbkstlibjbzzlr` bj rbsujtltk ktt`hutk mkh uh prkarlool nb tutkrbzzlzbkh` hkt-turhl (nkmm`) k smlrp` mkrr`ttbv` hk ljo`hk lb

  • 7/25/2019 86_Piede Torto Congenito Optimized

    6/6

    MKHMJP]BKHB

    Phl a`stbkh` kttbolj` n`j S^M ldnltl l pkmgb `n bopkrtlhtb lm-

    mkrabo`htb, mg` mkhs`htkhk nb bhqulnrlr` mkrr`ttlo`ht` jl n`dkrobt` mkopb`r` jl sm`jtl t`rlp`utbml pb lmmurltl. Bh plrtbmkjlr` sb rlmmk-olhnl nb5mkhs`aubr` uhl nblahksb bj pb pkssbibj` rlpbnl`n kralhbzzlr` uhl

    mkrr`zbkh` t`op`stbvl n`j nbd`ttk6`s`aubr` ljjl hlsmbtl j`slo` mjbhbmk n`b pb`nbbh oknk sbst`oltbmk `

    ltt`htk, rbp`t`hnkjk nurlht` b mkhtrkjjb nb rkutbh`6 nbstbhau`r uh S^M rbnumbibj` nl uhk brrbnumbibj`5 bj prbok hkh pr`s`htl

    ljt`rlzbkhb n`jjlhakjk nb nbv`ra`hzl n gl uh`vkjuzbkh` i`hbahl mkhbj trlttlo`htk mkhs`rvltbvk6 bj s`mkhnk okstrl lhkoljb` n`j r`trkpb`n`` n`jjlhakjk nb nbv`ra`hzl, mkh prkahksb arlv` mg` h`m`ssbtl nb trlt-tlo`htk mgbrurabmk mru`htk6

    bhnbvbnulr` v`htuljb sbhnrkob oljdkroltbv`pb mkopj`ss` lsskmblt`lj S^M, vljutlhnk s`opr` lhmg` j` struttur` kss`` lrtbmkjlrb l okht`n`j pb`n` `slobhltk (abhkmmgbk, lhml, rlmgbn`)6

    nbstbhau`r` nlj S^M bj o`tltlrsk vlrk, mg` bh pb n`jj73% n`b mlsbgl uh`vkjuzbkh` i`hbahl mkh r`ar`ssbkh` spkhtlh`l bh lss`hzl nbtrlttlo`htk6

    hkh mkrr`aa`r` jlrtbmkjlzbkh` o`nbktlrsbml h`j t`htltbvk nb rbnurr`

    j`qubhbsokp`r bj rbsmgbk nb prkmurlr` uhSB@N@ Y@DJ@]]K BL^YK-A@HK.

    Ibijbkarldl `ss`hzblj`

    - Irbna`hs E, Fb`jy H. Murr`ht olhla`o`ht kd mjuidkkt (mkha`hbtlj tljbp`s`qubhkvlrus). IOE.9335m-=00.

    - Nkiis OI, Aurh`tt ML. Ppnlt` kh mjuidkkt5 `tbkjkay lhn tr`lto`ht. MjbhKrtgkp Y`jlt Y`s. 93326 >415