Vol 3, No 3 (2015)

Articles
Rehabilitation of children with lesions of the proximal humeral metaepiphysis using transosseous distraction osteosynthesis technique
Garkavenko Y.E., Lamerdonov A.A., Dolgiev B.K.
Abstract
We present an analysis of the treatment of 39 children with a shortening of the humerus after sustained osteomyelitis. Variants of lesions of the proximal humerus metaepiphysis are highlighted, and the differentiated approach to therapeutic measures depending on the identified changes resulted in a positive outcome.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(3):5-9
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Analysis of the surgical treatment of stenotic ligamentitis of fingers in children
Govorov A.V., Zavarukhin V.I.
Abstract
Purpose of the study. Clinical analysis of the surgical treatment of stenotic ligamentitis of fingers in children. Materials and methods. A retrospective analysis of data examining 140 children and surgical treatment of 105 children with the diagnosis of "constrictive ligamentitis of fingers" was performed in the G. I. Turner Research Institute for Children’s Orthopedics in the period from 2011 to 2013. We considered gender and age of patients, the symptoms of the disease and patient complaints, and nature of the preferential affection of one or both hands and fingers as well as the family history. Results. Regarding gender, the patients were evenly distributed: 54 girls (51%) and 51 boys (49%). The largest number of children in need of surgical treatment (89) belonged to the age group of 1-4 years (85%). The prevalence of pre-emptive affection of fingers of one of the limbs has not been noted. The disease was mostly diagnosed on the first finger (131 cases). Recurrence of deformity in the long term was not noted. Conclusion. Conservative treatment may contribute to the progression of deformity. The applied surgical treatments permitted the maximum functional and cosmetic result.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(3):10-14
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Surgical treatment of children with idiopathic thoracolumbar scoliosis using transpedicular spinal systems
Vissarionov S.V., Nadirov N.N., Belyanchikov S.M., Kokushin D.N., Murashko V.V., Kartavenko K.A.
Abstract

Purpose of the study. Evaluation of the surgical treatment of children with idiopathic scoliosis of thoracolumbar localization. Materials and methods. Surgery was performed on 33 patients aged from 13 to 17 years with a curve approximating 42°-123°, according to Cobb. Surgical correction of the deformity was performed using three tactical options with the use of a transpedicular multi-basic metallic device. Results. In idiopathic thoracolumbar scoliosis, the surgical correction ranged from 74% to 100%. Loss of correction in the follow-up period from 2 to 5 years was 2°-4°. Conclusion. Surgical treatment of children with idiopathic thoracolumbar scoliosis depends on the degree of the main curve, spinal mobility, and the patient's age. Application of a multi-basic transpedicular metallic device allows significant correction of the angle of the curve, a true de-rotation of vertebral bodies at the apex of the curve to be performed, and the frontal and sagittal profile of the spine to be restored while maintaining the results achieved in the late postoperative period.

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(3):15-20
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Analysis of complicated outcomes in burns in children
Afonichev K.A., Filippova O.V.
Abstract
This article analyzed the long-term results of the treatment of children who have undergone thermal injury and explored the main reasons for the unsatisfactory results of the treatment, which resulted in significant functional limitations that led to medical help for re-treatment. The investigation indicates the most important principles of surgical and conservative treatment and attempts to understand which factors led to the appearance, progression, or recurrence of a deformity.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(3):21-25
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Computer plantography as a diagnostic method for congenital clubfoot in children
Nikityuk I.E., Klychkova I.Y.
Abstract
Examination of the anatomical and functional states of feet in children with congenital clubfoot is an urgent priority that has significant theoretical and practical value. The purpose of the study was to investigate the morphological and functional parameters of the foot to evaluate the degree of affection of its support function in congenital clubfoot using the technique of computer plantography. Plantographic characteristics of the feet were determined in 65 children with this disorder, aged from 4 to 16 years. The mathematical processing of plantographic characteristics of the feet was performed using the following; the calcaneo-axial and the calcaneo-metatarsal angles and the angle between the outer tangents on the basis of what were defined border values of angles, depending on the severity of foot deformities. The proposed method of analysis of the foot plantogram is statistically significant for the classification of congenital clubfoot with different degrees of severity: mild, moderate, and severe. This technique is an addition to the clinical and X-ray methods and allows the evaluation of functional support for the feet.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(3):26-31
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Progressive non-infectious anterior vertebral fusion in a baby with Saethre-Chotzen-acrocephalosyndactyly type III syndrome
Al Kaissi A., Grill F., Ganger R.
Abstract
We report on a 3-months old baby of Austrian origin and product of non-consanguineous parents. Abnormal craniofacial contour was the main deformity. The overall clinico-radiographic features were consistent with Saether-Chotzen-acrocephalosyndactyly type III syndrome. Bi-directional sequencing of the exon 8 and of the FGFR3-genes, exons 7 of FGFR3 (Fibroblast growth factor receptor3) genes, the exon 5 of the FGFR1 gene, revealed no mutations. Sagittal MRI imaging of the spine showed anterior vertebral fusion along the thoraco-lumbar vertebrae compatible with the non-infectious type.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(3):32-35
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Chondromyxoid fibroma of the femur in a child aged 9 years (Clinical case)
Pozdeev A.P., Chigvariya N.G., Krasnogorskiy I.N.
Abstract
The article reflects the experience in the diagnosis and surgical treatment of chondromyxoid fibroma in the proximal metadiaphysis of a large femoral bone in a child in the first decade of life. We presented the family and medical history of the child complaints, orthopedic/local status, and the results of radiological methods and emphasized difficulties of nosologic identification and differential diagnosis of the bone destructive process at the stage before biopsy and surgery. Macroscopic findings during surgery were identified, and the amount of resection of the affected bone was determined. A detailed description of the results of pathological and morphological (macro- and microscopic) studies is given, which could confirm the tumor process. Late results with the absence of oncological re-occurrence (7 years) and good anatomical and functional results from orthopedic surgery are shown.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(3):36-43
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Bruck syndrome: a case report
Buklaev D.S., Kostik M.M., Agranovich O.E., Trofimova S.I.
Abstract
The article describes the clinical case of an infant with Bruck syndrome. The clinical and radiological analyses showed the presence of systemic osteoporosis with pathological fractures; contractures of the elbow, knee, and ankle joints; delay of physical and motor development; and signs of hypoplasia in some of the muscle groups. There was also a right-sided congenital muscular torticollis. X-ray analysis revealed a moderate antecurvation deformity of the lower legs and femurs, with cortical thinning. Laboratory data detected an abnormal beta-cross lap increase.Treatment of osteoporosis by inhibitors of osteoclastic resorption (pamidronate) had a positive effect, and the elimination of flexion contractures at the elbow using plaster bandages with the distraction device also resulted in a positive effect.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(3):44-47
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Kyphosis in patients with cerebral palsy: causes of its development and correctional possibilities (literature review)
Umnov V.V.
Abstract
In this article, the literature pertaining to the treatment of kyphosis in patients with cerebral palsy was reviewed. Among the most common causes of kyphosis is the connection with pathological reflexes of newborns and infants with cerebral palsy, the presence of a hamstring syndrome, as well as weaknesses of the extensor muscles of the trunk. Attention is paid to a fundamental decrease in the quality of life of patients if they have pronounced kyphosis. Among the treatments, different variants of corsets are used, but the effectiveness of this method of treatment is low. It is notable that in some adolescent patients, they develop a fixed deformity that was successfully corrected and stabilized with spinal surgery. Therefore, a variety of techniques and devices for fixation have been used
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(3):48-51
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Dysfunction in the hip joints in children with Charcot-Marie-Tooth syndrome (literature review)
Pozdnikin I.Y.
Abstract
A review of the literature on the treatment of children with dysfunction in the hip joints in motor-sensory neuropathy Charcot-Marie-Tooth is presented. Peculiarities of disease diagnosis and the approach used in the treatment of patients are described. The Charcot-Marie-Tooth syndrome is a hereditary neuromuscular disease characterized by progressive atrophy of the distal muscle group of the lower limbs. According to international authors, the incidence of hip joint dysfunction in this condition is at least 10%, ranking second only to foot deformities. In the Russian literature, the problem has not been adequately interpreted. Early diagnosis of dysfunction in the hip joints during Charcot-Marie-Tooth syndrome is complicated by the child's age and is characterized by progression. Conflicting clinical signs and trivial symptoms of the disease also confuse diagnosis, until it becomes clearer in adolescence or the second or third decade of life. Surgical reconstructive operations on the hip joint often occur too late, and they are accompanied by a greater frequency of neurological complications. Practitioner awareness coupled with an early diagnosis of hip subluxation and decentration and complex orthopedic and neurological examinations of children with the disease of Charcot-Marie-Tooth should result in more favorable outcomes.
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(3):52-56
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