Vol 1, No 1 (2013)

Articles
Ot glavnogo redaktora
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Abstract
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):3-3
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Children's injuries and special care service for children of St. Petersburg
Baindurashvili A.G., Solovyova K.S., Zaletina A.V., Dolzhenko N.V., Lapkin Y.A.
Abstract
The most important indicators of children's health are the rates of children’s traumas and children’s disability due to injuries. According to these indicators one can estimate the availability and the quality of medical care as well as the effectiveness of preventive measures. The objective of the study was to analyze the statistics on children’s injuries in St. Petersburg in 2011 and a comparison of injury rates and condition of trauma care to children with similar average indicators across Russia and the North-Western Federal District. For the analysis we used statistical data of public health institution "Medical information analysis center" of the Health Care Committee of St. Petersburg and the data of the state statistical reporting of the Health Ministry of Russia. For better clearness, not absolute but relative data is used in the article as a percentage of the total number or in terms of the corresponding for 1000 by sex and age of the children’s population. We also used our own data of analysis of special care to children with injuries in health care facilities and work of pediatric medical social expert commission of the city.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):4-9
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SURGICAL TREATMENT OF CONGENITAL DEFORMATION OF THORACOLUMBAR SPINE IN CHILDREN
Vissarionov S.V., Kokushin D.N., Belyanchikov S.M., Murashko V.V., Kartavenko K.A.
Abstract
The analysis of the results of surgical treatment of 32 patients with congenital spinal de formity against lateral and posterolateral hemivertebrae in the area of the thoracolumbar junction was carried out. The patients' ages ranged from 1.2 to 4 years old, 11 boys and 21 girls. Terms of postoperative follow-up were from 2 to 10 years. The angle of scoliosis before surgery was from 26 to 52, kyphosis - from 12 to 56. Surgical intervention was performed with the combined approach in the amount of extirpation of abnormal vertebrae with surrounding disks, deformity correction with dorsal metalwork, corporodesis and posterior fusion with local bone autograft. Metal structure was removed in 1.5-2 years after surgery. Correction of scoliosis was 94-100 %, kyphotic - 82-90 %. The progression of deformation, neurological complications and joining of the dysplastic process were not observed. In assessing of the long-term results, scoliosis curve ranged from 0 to 8 (average - 4.2), kyphotic from 0 to 10 (average - 5.1). The progression of the spinal deformity with hemivertebrae in the area of the thoracolumbar transition requires early surgical elimination of the defect with a full radical correction of congenital deformation, restoration of the anatomy of the spinal canal and the physiological curves of the spine at the level of deformation with fixation of a minimum number of spinal motion segments with metal construction and bone plastic stabilization (front and posterior spinal fusion).
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):10-15
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ORTHOPEDIC AID TO CHILDREN WITH SEQUELAE OF HEMATOGENOUS OSTEOMYELITIS OF LONG BONES IN THE TURNER ORTHOPEDIC INSTITUTE
Garkavenko Y.E., Pozdeev A.P.
Abstract
The article presents achievements of the Turner Orthopedic Institute in solution of the problem of treatment in children with sequelae of hematogenous osteomyelitis of the long bones.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):16-20
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ALGORITHM OF TREATMENT OF CONGENITAL CLUBFOOT IN CHILDREN OF YOUNGER AGE GROUP
Klychkova I.Y., Kenis V.M., Stepanova Y.A., Sapogovskiy A.V., Kovalenko-Klychkova N.A., Ivanov S.V.
Abstract
Congenital clubfoot requires complete correction before the period of verticalization. Conservative methods are priority in treatment. The most effective method is Ponseti method that allows correcting all the deformations even in severe clubfoot. However, if clubfoot is accompanied with abnormal anatomy of foot or significant changes in functional ability of muscles, operative treatment is inevitable. The extent of surgical intervention depends on the severity of detected abnormalities and is determined individually. The use of ultasound, radiographic, and CT investigations, according to indications, contributes to the diagnostics. The indication for surgery is the lack of effect of conservative treatment after 10-12 cast correction in children over the age of 4 months. Diagnostic criteria for deciding in favor of surgery are: availability of fibrous coalition, the deformation of the talar or the sphenoid bone, the anomaly in the point of attachment of the tendon of the tibialis anterior muscle, lack of the repositioning of navicular bone on the talar head. Orthosis supply and rehabilitation treatment depend on the extent of surgical intervention.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):21-25
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THE SYSTEM OF TREATMENT OF HIP DYSPLASIA IN CHILDREN (CONCEPTION OF SRICO N.A. H.I. TURNER)
Kamosko M.M., Krasnov A.I., Baskov V.E., Voloshin S.Y., Pozdnikin I.Y., Barsukov D.B., Baskaeva T.V., Lyapina O.V.
Abstract
The system of treatment of hip dysplasia that is developed, applied and perfected at FSBI "Scientific and Research Institute for Children's Orthopedics n.a. H. Turner" involves the early entirely functional treatment (Lorenz method, other methods are similar in gist, providing immobilization with a cast or other devices, are not applied). The operative therapy is performed in primary patients with intrauterine or teratogenic dislocations of the hip. Technology of operative treatment is extremely gentle, sparing. Operations on deepening of socket, iatrogenic affection on cartilage cover, capsular arthroplasty are excluded from the arsenal of surgeons. Anatomy of a children’s dysplastic of hip joints (not subjected to inappropriate conservative or surgical treatment) has several fairly standard options. For each option, there is a combination of classical operational techniques (tenomyotomy of lumbar-iliac muscle, capsulotomy, detorsion, varization, shortening, medialization, changes in the spatial orientation of the arch or of the whole acetabulum), which have proven on the vast clinical material to be very effective with the right technical performance.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):26-35
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THE MAIN DIRECTIONS IN THE COMPLEX REHABILITATION OF CHILDREN WITH CLEFT LIP AND PALATE
Stepanova Y.V., Tsyplakova M.S.
Abstract
Complex treatment of children with cleft lip and palate is complicated and multi-step. Treatment is conducted by high-skilled specialists. The organization and execution of this complex are possible only at the large specialized center. Coordinator of this work is the maxillofacial surgeon. The performance of rehabilitation circuits includes preoperative orthodontic and orthopedic treatment, operative intervention (reconstructive and plastic surgery), orthodontic and orthopedic treatment after operation. Post-operative conservative treatment prevents the development of secondary deformities of the nose and upper lip. Professional psychological help and long supervision promote the achievement of good social adaptation of patients with congenital cleft lip and palate, improvement of their health.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):36-43
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ROBOTIC MECHANOTHERAPY IN REHABILITATION OF CHILDREN WITH CEREBRAL PALSY AFTER COMBINED ORTHOPEDIC SURGERY
Ikoeva G.A., Kivoenko O.I.
Abstract
The article represents a clinical research of 20 patients with infantile cerebral paralysis, who had got an early motor rehabilitation after complex orthopedic and neurosurgical treatment. The comparative analysis of results after traditional exercise therapy and mechanotherapy was carried out with the use of robotic system “Lokomat”. It was set up that early use of robotized mechanotherapy during postoperative period reduces significantly the time of motor rehabilitation in comparison with traditional exercise therapy.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):44-47
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FEATURES OF THE X-RAY ANATOMICAL CONDITIONS OF THE FOOT AND ANKLE IN CHILDREN WITH FIBULAR APLASIA
Buklaev D.S.
Abstract
The article contains the results of the analysis of radiographs of the foot and ankle in 84 children with malformations of the fibula. We found that infants’ relation to the ankle joint is often normal, as in the sagittal and frontal planes. With increasing age the number of posterior subluxation increases as well as anteriorly, laterally. Also dislocations of the foot were presented. The most significant relationships were violations of the subtalar joint. There were pronation, supinatsion, positions of calcaneus bone and its lateroposition, which was the most frequent cause of valgus deformity. Also we found a violation of the form of the talus such as a flattening of the block, smoothing of the neck. In rare cases of the varus deformity of the foot abnormalities of the tarsal bones were observed.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):48-52
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THE OCCURRENCE OF THE RADIAL CLUB HAND IN CHILDREN WITH DIFFERENT SYNDROMES
Golyana S.I., Avdeychik N.V., Safonov A.V., Prokopovych V.S.
Abstract
Radial club hand is a developmental anomaly of the upper extremity, being characterized as a longitudinal underdevelopment of a forearm and a hand on the radial surface, consisting in a hypo-/ aplazy radial bone and the thumb of various degree of expressiveness. Characteristic symptoms of this developmental anomaly are: shortening and bow-shaped curvature of a forearm, palmar and radial deviation of a hand, underdevelopment of the thumb from its proximal departments and structures, anomaly of development of three-phalanx fingers of a hand (is more often than the 2-4th), violation of a cosmetic condition and functionality of the affected segment. From 2000 for 2012 in FSI SRICO n.a. H.Turner examination and treatment of 23 children with various syndromes at which the radial club hand was revealed are conducted. The main syndromes at which it is revealed radial club hand - Holt-Orama syndrome, TAR- syndrome and VACTERL syndrome. Tactics and techniques of surgical treatment of a radial club hand it various syndromes most often don’t differ from treatment of other types of a radial club hand though demand an individual approach depending on severity and a type of deformation of the upper extremity.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):53-60
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IDIOPATHIC SCOLIOSIS. /LECTURE, PART I. «PARADOXES»/
Dudin M.G., Pinchuk D.Y.
Abstract
In the paper we discussed and analyzed the issues that confront practicing orthopedists with the most mysterious and at the same time the most studied vertebral column lesion in children and adolescents - idiopathic scoliosis. Nowadays a great amount of information on its various aspects has been already accumulated, but a practical output in the form of a system of effective treatment has not been yet found and (we can’t even speak about) there is no speech at all about the prevention (prophylactic) of the disease (scoliosis). On the basis of the own many year’s experience with this category of patients and the results of a comprehensive multi-faceted survey, the authors acquired the right to form their own point of view on the etiology and pathogenesis of the three-plane deformation in orthograde human (homo erectus). In this paper, the authors present their reflections on the history of the study of scoliosis, the terminology, statistical indicators and the existing views on its origins. Concerning argumentation on the own findings (conclusions) and views on the disease the authors plan to tell in the following sections.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):61-65
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STABILOMETRICAL ESTIMATING METHOD OF FUNCTIONAL RESULTS OF TREATMENT IN CHILDREN WITH CONGENITAL CLUBFOOT
Nikityuk I.E., Klychkova I.Y.
Abstract
Stabilometrical study was performed in 58 patients with congenital clubfoot aged from 5 to 16 years old not only before the conservative and surgical treatment, but also in the long-term period after correction of foot deformities - from 2 to 10 years. Among them 39 patients had both affected feet, 8 - only the right foot and 11 - only the left one. The most significant imbalance of the body was observed in patients with unilateral lesions of the feet, while the correlation patterns of deviation of body pressure center were detected in the frontal plane: the dislocation to the left - in right-side clubfoot and to the right - in left-side clubfoot. The functional state of musculoskeletal system of patients with unilateral clubfoot depends on the affected side; herewith statokinetic abnormalities are more marked in right-side clubfoot. As a result of the treatment of patients with different forms of clubfoot, a clearly positive dynamics of biomechanical changes was observed, e.g. increased functional activity of the operated feet and lower limbs as a whole.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):66-71
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THE HISTORY OF THE METHOD OF DISTRACTION OSTEOSYNTHESIS IN HAND SURGERY, ITS DEVELOPMENT AND CURRENT STATE
Zavarukhin V.I., Golyana S.I., Govorov A.V.
Abstract
This article is a brief historical review of distraction osteogenesis development in hand surgery. It describes the key steps in the evolution of methods beginning with immobilization and external fixation up to the distraction method in orthopaedics and its introduction in hand surgery.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):72-76
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Nauchno-prakticheskaya konferentsiya «Aktual'nye voprosy diagnostiki i lecheniya vrozhdennogo vyvikha bedra i priobretennoy patologii tazobedrennogo sustava», posvyashchennaya pamyati professora Egora Seliverstovicha Tikhonenkova
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Abstract
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):77-80
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Pravila dlya avtorov
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Abstract
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2013;1(1):81-83
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