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.

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.

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.

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.

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.

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.

The article presents a case report of surgical treatment of multiple fractures of the femoral neck in 15-year old child.

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.

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.

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.

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.