When we enter a room of mirrors at a carnival we laugh at the distorted images we see. For some, however, the image they see of themselves is no laughing matter. Whether it be limbs of disproportionate or unequal length, or simply being of shorter than normal stature, the picture can be a sad one.
Genetic programming, childhood diet, and trauma are some of the causes of a less than desirable physical appearance. Modern orthopedics can address many of these departures from the norm in the human skeletal system. Dr. Dragan has been especially sensitive to those concerned about their short stature.
A Short Height
is as Social-Conditioned Indication
Nowadays there is an uncertainty in a choice of indications to the surgical height correction of healthy people. Absence of direct medical indications to operative intervention in patients of short height who have no disorders of extremities’ functions, makes difficult to treat the diagnosis. Definition of such operations as only cosmetic and carried on the patient initiative, unwarrantedly narrows the understanding of the given problem and infringe on interests of the most part of a society. The task of the given research is an attempt to show on the example of the interrogation of 30 patients, who had the height correction by internal lengthening method, that indications to many surgical operations which change human appearance are socially-caused and demand more detailed discussion and precise definition.
The professor Bliskunov’s limb lengthening method2 appeared in early 80s as a new direction in orthopedics. An opportunity of realization of the tubular bone lengthening by means of the devices (Fig. 1), which are implanted inside the bones and have no external gears, allows carry out the lengthening simultaneously on pair segments of both extremities3. The usage of special conducting devices has made the operations with implanted device not traumatic.
As a result, beside patients with posttraumatic extremities’ shortening the method was claimed by healthy but undersized people. The motivation for the choice of surgical height increasing of such patients has a strongly pronounced social basis, therefore it is necessary to consider the problem, mentioned in this article from two aspects – medicine and sociology.
Scientific regular study of social problems of undersized but healthy people in a modern society started only last years. The first research confirmed with the statistical data had the big resonance in mass media and confirmed an actuality of this problem. The obtained results have allowed to speak even about such not discussed phenomenon, as discrimination on the basis of height size, received the name “heightizm” from an English word “height”.
The size of height is the brightest indication effecting social adaptation of individual in the certain society. Estimating other man – “attractive”/ “not attractive” height is the most important thing especially during momentary situational contact.
The height size is shown brightly at a choice of the sexual partner when appearance of the individual is estimated on the basis of certain standards produced during evolution both a concrete population a human civilization as a whole.
Professor of evolution psychology from English University in Liverpool doctor Robert Dunbar6, on the example of 4419 health men, aged from 25 to 60 proved that taller individuals have better statistical results in questions concerning continue mankind, have better “evolutionary fitness”. “We demonstrate that taller men have more reproductive success than short ones…” .
In the interview Web MD Medical news, doctor Dunbar7 said : “ We know a lot about height, about its psychological perception by people as a proof of social, economical and other success. We showed that this social–economic success is actually understood as evolution success…”
The height size influence the opportunity and quality of getting education, job and career.
The results of the scientist Barry Harper1 from London University, who researched the importance of appearance on the labor market are given below.
Physical Appearance and Annual Income Differences (at 1991 prices)
"Taller workers receive a wage premium, and the disparity in wages is similar in magnitude to the race and gender gaps...”, - is written in the article of Nicola Persico5 and group of scientists from the University of Pennsylvania.
According to the researchers, every additional inch of height is associated with a 1.7 percent increase in wages among British men and among adult males in the US – with a 1.8 percent.
There is given data in the same article about correlation of middle height of American and physical data of the presidents of America, as an example of dependence of the career growth on human height. According to data shown in figure, we can see that majority of men, chosen for the position of president of USA, were taller then the average population.
Certainly nobody tells about prejudice of people with short stature. Mankind history knows many outstanding people of short height: Napoleon Bonapart ( 1m 67cm ), Emmanuel Cant (1m 52cm), William Faulkner (1m 64cm)… We say about social conditions in which individual forms in a modern society, and which worse for the undersized people than for the majority. As a result, people with height discrepancy have problem in self–estimation and social adaptation. At school there often appear conflict situations based on departure from the “norm” of any outward characteristic. “Bigger boys will pick on little ones… Appearance is a factor for the majority of such incidents “, insists doctor Judith Waters4, a professor of psychiatry of the University in Northern New Jersey.
MATERIALS AND METHODS
Below-stated results of interrogation
of patients who had lower extremities lengthening according to the program
by internal limb lengthening method. The patients with constitutional short
height stipulated by family heredity were chosen for the interrogation.
The patients were suggested to answer three questions, choosing the proper
Analysis of answers to the question “2” (93,3% of answers “1”) allows to make an important conclusion that undersized people after height correction do not want to get certain advantages before the majority. Their motive is not to “mark out” and to “compare” to their environment.
According to the above-stated such a concept as “social-comfortable external physical attributes” is important. As to the human height “social-comfortable” means such height value which do not create chronic stressful situation for certain individual in certain public environment as a condition for an inferiority complex and do not influence quality of life negatively.
It is clear that parameters of social- comfortable height will be uniform as statistically verified sized concerning the majority of the Earth population, but they will have deviations concerning certain people, nationalities…. The borders of social-comfortable size of height are on the both side of medium meanings in every considered multitude. Defining parameters of social-comfortable external attributes as an important criterion of estimating is a problem of medicine, sociology and anthropology.
It is often used terms “Cosmetic correction”, “according to the cosmetic indications” defining the indications for the surgical height correction. It is necessary to say that it is proved to speak about cosmetic indications for patients who want to do the correction of their social- comfortable appearance with the purpose of getting certain advantages, for example, in professional sphere (sport, model business...). For the most undersized people medical height correction is the only possible, effective way of solving their social-adaptive problems.
Socialization is a dynamic process of two-side interaction of individual and society, and as a result a human find his certain place in this society.
The higher stage of the society development the more caring of this society is for people who found themselves in social-not comfortable condition, the reasons do not depend on them. Interest of society in free development of maximum quantity of members of the society must concern even health people who have social-not comfortable appearance. If a man especially of a young age can not do for example surgical height correction because of economic condition society must finance such medical programs and provide appearance correction to social-comfortable value. Certainly, everything is in future. Scientific elaboration of criterions for the proper social programs is necessary. Though, nowadays we can affirm with a bigger truth that people who has their height lower than 1m 55cm are in social-not comfortable conditions. A desire of such people to be “equal to” or “not worse” than other members of the society must not be only their private business, it must be supported by this society, a part of social policy.
A short height must be considered as a social-conditioned indication for surgical correction of the length of lower extremities.
It is necessary to continue scientific studying questions concerning problem of social- not comfortable physical appearance of health people for the legal foundation of their medical correction according social indications.
2. Bliskunov A.I. FEMUR LENGTHENING BY INTRAMEDULAR DISTRACTORS. MEDICAL REHABILITATION OF PATIENTS WITH BONE FRACTURES AND ORTHOPEADICAL ILLNESSES. Central Institute of Traumatology and Orthopedics. Journal 26. Moscow 1983. Page 36 – 41.
3. Dragan V.V. ISSUES OF ESTHETIC CORRECTION OF HEIGHT AND FORM OF BOTH FEMURS BY HEIGHT LENGTHENING. Works of Crimean Med. University. Volume 135, part 2. Simpheropol 1999. Page 12 – 19.
4. Jim Moreli. SHORT BOYS GET THE SHORT STROW IN SCHOOL. Web MD Medical News. Atlanta, April 13, 2000.
5. Nicola Persico, Andrew Postlewaite, Dan Silverman. THE EFFECT OF ADOLESCENT EXPERIENCE ON LABOR MARKET OUTCOMES: THE CASE OF HEIGHT. University of Pennsylvania, Department of Economics. October 8, 2001.
6. B. Pawlowski, R.I.M. Dunbar, A. Lipowicz. EVOLUTIONATY FITNESS: TALL MEN HAVE MORE REPRODUCTIVE SUCCESS. Research Center in Economic Learning and Social Evolution, University of Liverpool. Macmillan Publishers Ltd. Journal NATURE 403, 156 (2000), 13 January 2000.
7. Sean Swint. WHAT DO WOMEN WANT? NATURE SERVES UP A TALL ORDER. Wed Atlanta, Jan. 12, 2000.