Vol 2, No 3 (2014)

Articles
CURRENT TRENDS IN TREATMENT OF UPPER AND LOWER LIMB DEFORMITIES IN INFANTS WITH ARTHROGRYPOSIS
Baindurashvili A.G., Agranovich O.E., Konyukhov M.P.
Abstract
The paper describes the treatment of arthrogryposis, which is a severe congenital pathology. It provides an overview of the natural history and etiology, as well as the development of a system for assisting patients with arthrogryposis in the Institute n. a. G. I. Turner. We described in detail the variants of upper and lower limb deformities, as well as methods of complex treatment in infants, depending on the nature and degree of severity.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(3):3-13
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RESULTS OF TREATMENT OF JUVENILE FEMORAL HEAD EPIPHYSIOLYSIS
Baskov V.E.
Abstract
Juvenile femoral head epiphysiolysis (JFHE) is a relatively rare and not fully understood endocrine and orthopedic disease. For decades, the approach and techniques of surgical treatment have undergone significant changes and still continue to be improved. This paper presents a 36 year old follow-up results of treatment effects of JFHE according to one of the previously used surgical techniques.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(3):14-17
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ARTHROSCOPIC KNEE SURGERY IN CHILDREN
Brianskaia A.I., Baindurashvili A.G., Arkhipova A.A., Sergeeva P.P., Potemin V.S.
Abstract
Knee joint injuries account for 10-25 % of all injuries of the musculoskeletal system in children. Some intra-articular defects, and primarily of a traumatic origin, are reasonable to correct by arthroscopy. Among these are injuries of meniscus and cruciate ligaments, the presence of osteochondral defects, traumatic patellar dislocation, accurate diagnosis of uncertain symptoms and signs. Performing knee surgery in children, one should always focus on a more “gentle” structure of the developing body, and, consequently, all the actions of the surgeon should be very careful to avoid possible further injury.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(3):18-23
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SURGICAL TREATMENT OF L5-SPONDYLOLISTHESIS VERTEBRAE IN CHILDREN. BENEFITS OF POSTERIOR APPROACH
Vissarionov S.V., Murashko V.V., Belyanchikov S.M., Kokushin D.N., Solokhina I.Y., Guseva I.A., Murashko T.V., Pavlova M.S.
Abstract
Objective to develop current options of surgical treatment of L5-spondylolisthesis in children. Materials and methods: 48 patients were observed and underwent surgical treatment at age of 10-17 years. In 9 patients spondylolisthesis of L5 was grade 2, in 14 - grade 3, in 12 - grade 4. 9 patients had spondyloptosis of the body of L5-vertebra. The article presents different options of surgical treatment of spondylolisthesis in children depending on the degree of vertebrae body shift and the main clinical manifestations. During surgery the anatomy of the vertebral canal and the normal interposition in the pathological segment were reconstructed. It resulted in normalization of the body balance and regression of neurological symptoms. Results: in spondylolisthesis grade 2 and 3 full reduction was achieved. In patients with grade 4 spondylolisthesis deformity was reduced to grade 2-3. Pain and radicular syndromes regressed in 2-3 days after surgery. In patients with monoparesis and contractures regression of neurological deficit took 1-1,5 months. Conclusions: The method of surgical treatment in patients with spondylolisthesis of L5 vertebrae depends on the degree of vertebrae shifting presence of segmental instability and neurological sighns.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(3):24-33
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ANEURYSMAL BONE CYST OF THE CLAVICLE IN CHILDREN (CLINICAL CASES AND TREATMENT)
Zubairov T.F., Bukharev E.V., Zakharyan E.A.
Abstract
The purpose. To examine the results of the treatment of children with aneurysmal cyst of the clavicle. Material and methods. The results of examination and treatment of patients aged 16 and 17 years with a diagnosis of aneurysmal cyst of the clavicle. All patients underwent surgical treatment with the ABC stage delimitation. We used a surgical technique, which consists in open removement of the abnormal tissue with replacement of the bone defect with bone-plastic material or autogenous bone from the iliac crest. Conclusions. The method of treatment of aneurysmal bone cyst of the clavicle must be individualized depending on the location, aggressiveness and extent of the lesion. The use bone-plastic material or autogenous bone from the iliac crest restore the structural integrity of a compromised clavicle gives good results in the observation period of up to 2 years.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(3):34-39
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ТREATMENT STRATEGY OF FLEXION CONTRACTURE OF THE WRIST JOINT IN CHILDREN WITH CEREBRAL PALSY
Novikov V.A., Umnov V.V., Zvozil A.V.
Abstract
Objectives. The objective of study was to assess the effectiveness of transplantation of m. flexor carpi ulnaris tendon on the place of m. extensor carpi radialis brevis / longus (Green operation) to eliminate the deficit of active wrist joint extension in children with cerebral palsy. Materials and methods. The present study is based on a survey of children with cerebral palsy with affected upper limb. The main criterion for selection of patients was the presence of active extension deficit in the wrist joint, both isolated and in combination with other contractures of the upper limb joints. Total 22 patients with spastic forms of cerebral palsy were examined. Results and conclusions. Green operation is a good method of surgical treatment of active extension deficit in the wrist joint in patients with cerebral palsy. In the presence of moderately severe contractures in the wrist joint, serial casting can eliminate them completely. Presence of a fixed pronation contracture of the forearm is a factor that reduces the effectiveness of FCU transplantation. Pronation contracture should be corrected before or during Green surgery. FCU transplantation is effective for children of any age, but its effectiveness is reduced from 12 years old.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(3):40-46
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POSTTRAUMATIC SHOULDER INSTABILITY IN CHILDREN: CLINICAL PRESENTATION, DIAGNOSIS AND TREATMENT
Proshchenko Y.N., Shumkov P.S., Ovsyankin A.V., Bortulev P.I., Drozdetskiy A.P., Bortuleva O.V.
Abstract
The article presents an analysis of the treatment of 15 patients with posttraumatic shoulder instability aged 11-17 years, as a result of primary traumatic dislocation and chronic instability. We identified the following causes of chronic shoulder instability: Bankart injury, SLAP-injury; Hill-Sachs defect; fracture of the glenoid, type 3 humeral head-glenoid relation, and retroversion of the humeral head, as well as defects in the treatment of primary shoulder dislocation. Surgical treatment is performed in 7 patients with chronic instability (7 joints). Unsatisfactory result was detected in 1 patient (1 joints), which is caused by a type 3 humeral head-glenoid relation.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(3):47-52
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CONGENITAL CLUBFOOT. CLASSIFICATION, ETIOLOGY, PATHOGENESIS, THE EVOLUTION OF TREATMENTS (LITERATURE REVIEW)
Klychkova I.Y., Konyukhov M.P., Lapkin Y.A.
Abstract
Congenital clubfoot deformity takes the 2 nd place among the malformations of the muskuloskeletal system and is observed in 4-5 ‰ of newborn. More often the deformity is bilateral, in 20 % of cases it is associated with other developmental disorders and is frequently seen in different syndromes. Clubfoot classifications are variable and are constantly improved according to the practical needs. It is generally assumed that clubfoot is a polyetiological disease. The main theories of its development are congenital (genetic), mechanical and neuromuscular. The majority of specialists consider that clubfoot formation is due to dysplastic process with the predominant foot and shin lesion. Bone, neuromuscular or vascular system hypoplasia predominate depending on the severity of the deformity. Evolution of the clubfoot treatment methods occurs in a spiral-form fashion from the conservative management to total releases and bone reconstructions, from low-invasive to excessively radical surgery. At present the spiral turn has stopped at the consisting of many stages low-invasive method of clubfoot correction developed by I. Ponseti which is considered now to be the golden standard of treatment.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(3):53-63
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A RARE CASE OF CONGENITAL ABNORMALITIES OF THE MAXILLOFACIAL REGION
Stepanova Y.V., Tsyplakova M.S.
Abstract
This article describes a rare case of congenital abnormality: a median facial cleft in combination with congenital complete bilateral cleft lip and palate. An integrated approach to the treatment of children with severe pathology of the maxillofacial area provides a good aesthetic and functional result. Surgical treatment in combination with orthodontic treatment, massage, myogymnastics, dynamic observation of the child contributes to the normal development of the maxillofacial area in a child with a rare congenital facial cleft.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(3):64-67
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ULTRASONOGRAPHY OF THE HIP JOINT EXAMINATION HIP JOINT IN THE ASSESSMENT OF THE EFFECTIVENESS OF TREATMENT IN CHILDREN WITH LEGG-CALVE-PERTHES DISEASE AND HIP OSTEOARTHRITIS
Tikhonenko T.I., Vybornov D.Y., Gurevich A.I., Lozovaya Y.I.
Abstract
We performed dynamic hip doppler ultrasonography in children with Legg-Calve-Perthes disease (LCPD) in order to determine the effectiveness of the conservative and surgical treatment. The study included children aged from 3 to 7 years old with LCPD who had pain in the hip joints during admission. We assessed the structural changes in the head of the femur and the hip joint (B-mode), when the Doppler study analyzed diameter of enveloping hip vessels, blood velocity and resistance index. The study found that severe pain and contracture of the hip during admission appeared as a manifestation of concomitant hip osteoarthritis. On admission all patients had signs of arterial spasm and venous stasis in the hip joints, which determined the administration of a comprehensive arthrologic, osteogenesis stimulating and angioprotective therapy, according to the data of dynamic ultrasound.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(3):68-75
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Sabyrbek Artisbekovich Dzhumabekov
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Abstract
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(3):76-77
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