Vol 6, No 2 (1999)

From 1996 to 1998 twenty four patients, aged 12.5- 24.5, with idiopathic scoliosis underwent Cotrel-Dubousset instrumentation. Significant correction of all multiplane spine deformities was achieved: scoliosis - by 50.8%, thoracic hypokyphosis - by 8.1-22.5, torsion - by 24.5%. Lumbar lordosis was preserved. Mean follow up was 10.7 months. Only in 5 patients the loss of the correction was observed and it was equal to 7-8°.

Basing on literature data and personal investigations the authors summarize current concepts regarding etiology and pathogenesis of Scheuermann’s disease. The types of clinical course of the disease are considered depending on its localization and peculiarities of structural changes in spine segments are considered. Further perspective study of spine osteochondropathy is planned.

In 17 male patients, aged 18-26 years with L5 transverse processes neoarthroses clinical manifestations and X-ray data were studied. In 12 patients transverse-sacral neoarthroses were diagnosed, in 4 patients transverse-iliac neoarthroses and in 1 patient transverse-transverse neoarthroses were detected. Syndromic pattern of lumbar transverse processes neoarthroses including complaints, clinical manifestations and X-ray data was typical for spondyloartralgia. However unlike lumbar spondyarthralgia neoarthroses spondylartralgia was characterized by prevalence of monoarticular lesion symptoms with strictly local pain in neoathrosis zone at palpation, unilateral localization of painful sense and unilateral muscle tension; recurrence and increase of pain were provoked not as much by extension as by rotatory motions and inclination towards the «aching» side. Prevailing method of treatment of patients with transverse-sacral, transverseiliac as well as transverse-transverse neoarthroses is a conservative one with obligatory intra-articular corticosteroid blocades.

Seventy eight patients with sequelae of interphalangeal finger joint injuries ( long-standing dislocations, fracture-dislocations, peri- and intracapsular fractures, contractures) were treated by modified hinge-distraction devices. In 1-3 years follow up outcomes were evaluated in 71 patients. Good results were achieved in 68 cases (95.8%). Use of our hinge-distraction devices excluded the superfluous mobility, provided the main axis of articular ends motion, volume constancy of the articular split as well as the possibility of active and passive movements that gave adequate conditions for the restoration of osteoarticular structures as well as surrounding soft tissues.

Forty four female patients with degenerative-dystrophic hip diseases were subjected to clinical and psychological examination. Psychological method included Minnesota Multiphasic Personal Inventory test and «Hand» test. It was shown that patients with marked disorders of static-dynamic function, bilateral hip joint pathology accompanied spine osteochondrosis as well as the patients with relatively early stage of the disease and with high level of pain sense were the most disadaptied. These data may be used for the elaboration of the complex rehabilitation program.

The case of preoperative diagnosis of peripheric primitive neuroectodermal tumor (pPNET) of the chest with damage of body sternum in 21-year-old patient is presented in Native literature for the first time. CT and echography data as well as serum tumor-markers level are given. The detection of tissue-markers and electronic microscopy data are the most reliable diagnostic methods. However clinical and routine morphologic examinations are important as well. Our patient received neoadjuvant chemotherapy followed by chest resection and plasty by osseous-musculocutaneous flap on vascular pedicle. Efficacy of polychemotherapy with vincristine, cyclophosphan, farmorubicin and platidiam is proved. Nine months after operation no tumor relapse and metastasis were observe. In spite of relatively low sensitivity of pPNET to cytostatic drugs, combined treatment with neoadjuvant is the most justified. Original method for the plasty of chest defect with no application of artificial materials provides favourable conditions for wound healing with good and satisfactory cosmetic outcomes.

Use of autoblood preliminary stored by different preservation method can decrease the risk of posttraumatic complications but not in all cases. In 18 patients who underwent orthopaedic surgery autotransfusion with Cell Saver apparatus was performed that allowed to compensate 1.2-3.2 1 blood loss without additional use of donor blood. Use of electronic apparatus confirms its high efficacy for intraoperative blood reinfusion.

Acrocephalosyndactyly (type III), or Saethre-Chotzen syndrome, according to the International Nomenclature of Hereditary Skeletal Diseases, belongs to the group of dysostoses, manifested by deformities of individual bones or their combinations, and is included in the subgroup of dysostoses with a primary lesion of the face and skull. The type of inheritance is autosomal dominant.

At the end of 1998, the publishing house "Hippocrates" published the book "Plastic, Reconstructive and Aesthetic Surgery" under the general editorship of a well-known surgeon, Director General of the Center for Plastic and Reconstructive Surgery (St. Petersburg), laureate of the State Prize Professor A.E. Belousov. This is a joyful and welcome event, especially for those specialists who studied and improved in the field of reconstructive microsurgery according to the previous book by A.E. Belousov, written in collaboration with prof. S.S. Tkachenko, "Microsurgery in traumatology" (L., "Medicine", 1988).