Vol 3, No 2 (2015)

Cover Page

Articles

Malformations of the internal organs and systems in children with asymptomatic spinal dysraphism

Vissarionov S.V., Kokushin D.N., Bogatyrev T.B.

Abstract

The purpose of research is to determine the prevalence of associated malformations in children with latent forms of spinal dysraphism.

Materials and methods.

The study involved 64 patients aged from 9 months to 17 years old. Clinical and radiological examination including MRI scan of spine and spinal canal were performed to evaluate the orthopaedic and neurological status of the patients.

Results.

Malformations of the spine were observed in 100 % of children, associated malformations of the organs and systems are found in 33 (52 %) patients. Herewith the malformations of the genitourinary system were revealed - in 52 % of patients, the musculoskeletal system - in 45 % of children, the cardiovascular system - in 39 %, the digestive system - 12 %, otolaryngology - 9 % and bronchopulmonary system - in 3 % of patients.

Conclusion.

Pediatric patients with latent forms of spinal dysraphism require detailed examination both on the part of the spine and the spinal canal and the internal organs and systems. The most prevalent malformations included those of genitourinary, musculoskeletal (appendicular skeleton) and cardiovascular systems.

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(2):5-9
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Сomparative study of computer-assistance ortho-suv external fixation and conventional hybrid external fixation in adolescent with genu recurvatum

Bukharev E.V., Pozdeev A.P., Zubairov T.F.

Abstract

The aim of the study: to compare the results with the use of computer-assisted Ortho-SUV ExFix and conventional hybrid external fixator.

Materials and methods.

A retrospective analysis of examination and treatment of 13 patients aged 13 to 17 years with genu recurvatum of different etiology in combination with crus shortening. Ortho-SUV Frame was used in 5 patient, conventional hybrid external fixation was used in 5 patients.

Results.

Average time correction of deformity using Ortho-SUV ExFix (group A) was 23 ± 3,8 days, and using hybrid external fixator - 31 ± 4,5 days (group B). Fixation index (FI) for group A was 49,8 days/cm and 72,7 days/cm for group B. Posterior proximal tibia angle (aPPTA) reference value is 81° (77-84°). aPPTA after the final correction was 81,8 ± 1,6° for group A and 85,2 ± 4,1° for group B.

Conclusions.

Ortho-SUV frame allow for correction time reduction of 8 days and FI decrease of 22,9 days/cm. Genu recurvatum correction accuracy by Ortho-SUV frame is superior to the correction accuracy when using a hybrid wire-rod device.

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(2):10-14
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Malformations of the first ray of the foot in children: diagnosis, clinical picture, treatment

Konyukhov M.P., Klychkova I.Y., Kovalenko-Klychkova N.A., Nikityuk I.E.

Abstract

Malformations of the first ray of the foot vary widely and are divided into simple and complex. Complex malformations include abnormality of development of the first metatarsal or the main phalanx and refer to atypical adducted foot deformity. They are also characterized by varus location of the first ray of varying severity. The cause of deformation is a damage of longitudinal epiphyseal growth plate area of the first metatarsal - “longitudinal epiphyseal bracket” or the so-called delta phalanx. Over the past five years, we treated 37 patients (53 feet) aged from 6 months to 17 years old with developmental disabilities of the first ray of the foot. The spectrum of pathology is very diverse. In the majority of cases surgical treatment was multi-staged. It was revealed that the removal of deformity at the first stage of treatment should be complete, with maximum use of the bone to restore the length and shape of the affected bone. In treating combined deformities the good effect is guaranteed only with the removal of all the elements, including excision of the fibrous bridle along the inner surface of the first ray.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(2):15-24
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Surgical treatment of thumb adduction contracture in children with infantile cerebral palsy

Novikov V.A., Umnov V.V.

Abstract

The purpose of the work is to evaluate the effectiveness of different methods of surgical treatment of thumb adduction contracture in children with infantile cerebral palsy.

Materials and methods.

The present study is based on diagnostic results of children with infantile cerebral palsy with affected upper limb. The main criterion for selection of patients was the presence of thumb adduction contracture, the absence of significant positive outcome in a patient after conservative treatment, the impossibility of active thumb abduction more than 30° and the instability of the first metacarpophalangeal joint. Total we examined and treated 9 patients with spastic types of cerebral palsy.

Results and conclusions.

We evaluated the results of the following types of surgical treatment: release of adductor pollisis muscle, release of adductor pollisis muscle and tendon shortening of m.abductor pollicis longus, release of adductor pollisis muscle and tendon transfer of m.extensor indicis in the tendon m. abductor pollicis longus, the fixation of the first metacarpophalangeal joint with extramedullary plate. Based on these data, we were able to confirm the effectiveness of surgical treatment of thumb adduction contracture.

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(2):25-31
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Radiological diagnosis of hip joint abnormalities in children

Kamosko M.M., Poznovich M.S.

Abstract

Abnormalities of the hip joint in children covers a wide range of diseases, including both congenital and acquired ones. Hip dysplasia, Legg-Calve-Perthes disease and juvenile slipped capital femoral epiphysis account for up to 25 % of all diseases of the musculoskeletal system in pediatric patients. Early diagnosis of these disorders and timely treatment are of paramount importance in the prevention of childhood disability.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(2):32-41
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Femoroacetabular impingement: literature review

Husainov N.O.

Abstract

Aim.

To review the concept of the femoroacetabular impingement, its causes, pathogenesis, diagnosis and methods of treatment to increase the awareness among the practicing physicians.

Materials and methods.

literature data available from the medical data-bases was analyzed.

Results.

English-languaged literature was reviewed, key-points important to know were identified.

Conclusion.

Femoroacetabular impingement is a condition with quite non-specific clinic. At the moment x-ray features of this condition are well-known, algorithms of diagnosis and methods of treatment are established.

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(2):42-47
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Repeated fracture of the femoral neck. Tactics of treatment. Clinical observation

Bortulev P.I., Proshchenko Y.N., Ovsyankin A.V., Drozdetskiy A.P., Bortuleva O.V.

Abstract

The article presents a case report of surgical treatment of multiple fractures of the femoral neck in 15-year old child.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(2):48-51
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Treatment of post-burn secondary foot deformity

Afonichev K.A., Nikitin M.S., Kuptsova O.A.

Abstract

A case of simultaneous correction of severe post-burn deformity with limited movement in the ankle joint, subluxation and contractures in the metatarsophalangeal joints in a 3-year old child is presented. Excision of scar tissues, tendinous plasty, capsulotomy of involved joints were performed. To close the defect, a full-thickness skin graft was used. In two years, no signs of recurrence were observed.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(2):52-55
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Giant congenital melanocytic nevus of the face. A clinical case report

Tsyplakova M.S., Usoltseva A.S., Stepanova Y.V.

Abstract

This article describes a rare case of congenital anomalies: giant melanocytic nevus of the face. Errors in the choice of treatment strategy of children with this disease and their complications can lead to poor aesthetic and functional results. When choosing a method of plastic eliminate defects formed after removal of nevi, it is necessary to take into account anatomical features of the maxillofacial region. The department developed the scheme of complex treatment of these patients. Surgical treatment in combination with massage and myogymnastics, regular medical observation, provides a good aesthetic results. Integrated approach in the treatment of children with giant nevi of the face allows for an early medico-social rehabilitation of children with this pathology.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(2):56-60
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Embryonic development and the structure of the growth plate

Zavarukhin V.I., Morenko E.S., Sviridov M.K., Govorov A.V.

Abstract

This article presents modern data on embryonic development and zonal structure of the meta-epiphyseal growth plate in which dysfunction has an important role in the formation of skeletal deformities in children.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(2):61-65
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Features rehabilitation of infants with congenital hip dislocation on the stages of conservative treatment

Voloshin S.Y., Belousova E.A.

Abstract

Congenital dislocation of the hip is one of the most common diseases in children leading to disability, which is difficult to diagnose in the first days of life. In the structure of congenital orthopedic diseases congenital dislocation of the hip holds one of the first places. This determines the importance and urgency of the problem, as the most complete restoration of anatomical structures and functions of the hip joint in children occurs in the early diagnosis and comprehensive, timely begun treatment. Rehabilitation of children in the first year of life should be early, systematic, comprehensive and differentiated. Technique of rehabilitation stages conservative treatment includes: wearing functional tires, gymnastics, massage, physiotherapy, therapeutic swimming. This prevents the progression of the disease, the development of early and late complications, does not violate the static-dynamic functions without delay verticalization.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(2):66-70
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The first professor N.D. Kazantseva research work. In regards to the 70th anniversary of great victory

Gorbunova Z.I.

Abstract

Из военных страниц истории Уральского научно-исследовательского института травматологии и ортопедии им. В. Д. Чаклина известно, что практические врачи и научные сотрудники института были или мобилизованы на фронт, или работали в эвакуационных госпиталях Свердловска, Дальнего Востока. Врачебные кадры института пополнялись за счет эвакуированных из западных областей, выпускников Свердловского государственного медицинского института, освобожденных от прохождения военной службы. Приходилось вновь обучать врачей основам практической и научной работы.

Несмотря на тяжелейшие условия жизни и работы, отсутствие большинства опытных сотрудников института, продолжалась научная работа, выходили сборники научных статей, защищались диссертации. Так, с 1941 по 1944 г. были подготовлены и защищены 7 диссертаций, из них 3 — докторские (М. В. Мухин, З. В. Базилевская, А. М. Наравцевич). Были изданы 2 монографии И. Я. Штернберга (1941, 1942) о реконструкции культей верхних и нижних конечностей. Сотрудники института также публиковали научные статьи в сборниках санитарного отдела Уральского военного округа [1, 2].

В архивном фонде института находятся документальные материалы о выполнении научно-исследовательских работ (НИР) сотрудниками в 1944 г. Сведения о выполнении НИР представлены амбарной книгой, в которой указаныфамилия, имя, отчество сотрудника, название темы НИР, срок выполнения и выделены следующие разделы — истекший срок, что сделано, подпись исполнителя, замечания профессора (рис. 1). Интересно, что текст документа рукописный и заполнялся каждым научным сотрудником. Приводим данные о выполнении НИР в 1944 г. врачом Н. Д. Казанцевой (рис. 2).

Казанцева Н. Д. Тема: «Репаративные изменения в суставах после огнестрельных переломов крупных суставов». Срок исполнения — 15.12.1944.

28.09.44 г. просмотрены по каталогам все имеющиеся гистологические препараты, начиная с 1932 г. до настоящего времени. Отобрано 4 случая с огнестрельными ранениями суставов. Два из них просмотрены под микроскопом и проработаны. Проработана докторская диссертация проф. Богданова о внутрисуставных переломах и гистологических изменениях в них. Журнальные статьи из журнала «Хирургия» № 1 о гистологических изменениях в суставах при огнестрельных переломах. Разработано 65 историй болезней из клиники восстановительной хирургии с огнестрельными ранениями суставов. 13 человек вызваны для повторной консультации и наблюдения. Из них прибыли только 3 человека, остальные не явились. Намечено подытожить все данные о разобранных историях болезней клиники восстановительной хирургии. Заняться теоретической частью вопроса об огнестрельных внутрисуставных переломах. Сделать выборки по историям болезни с гистологическими препаратами и проработать все имеющиеся переломы до конца.

Комментарии: Студентка Нина Давыдовна Казанцева была эвакуирована из Ленинграда и продолжила учебу в Свердловском медицинском институте, который окончила в 1943 г. и была направлена в институт, где работала врачом-травматологом. Согласно заявлению она была «освобождена от работы 22.09.1945 г. ввиду реэвакуации по месту жительства» (приказ по Свердловскому институту ВОСХИТО № 78 от 27.09.1945 г. § 6) 
и уехала в Ленинград. Нина Давыдовна всегда с большим удовольствием и радостью вспоминала годы работы в институте под руководством профессора В. Д. Чаклина, которые оказали на нее большое влияние. Н. Д. Казанцева стала пластическим хирургом, работала в научно-исследовательском детском ортопедическом институте им. Г. И. Турнера; была учителем член-корреспондента РАН, доктора медицинских наук, профессора А. Г. Баиндурашвили.

Таким образом, настоящая публикация позволяет представить выполнение научно-исследовательских работ в институте в период Великой Отечественной войны и участие в них молодых врачей, что имеет не только исторический, но и медицинский интерес.

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(2):71-72
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