BACKGROUND: Questionnaires are standard tools used for examination of patients. Obtained data provide information about knee function disturbance and level of the quality of life. Young patients with various knee injuries also needed examination questionnaires. In worldwide practice, the Pediatric International Knee Documentation Committee (Pedi-IKDC) is more often used by doctors. However, if the doctor wants to use foreign questionnaire in his/her practice, the questionnaire should be validated and culturally adaptable. AIM: This study aimed to enable the validation and cultural adaptation of the Russian version of the Pedi-IKDC questionnaire based on the English version for children and adolescent. MATERIALS AND METHODS: This questionnaire was translated from English by professional medical translator and by orthopedic surgeon. The Lysholm questionnaire was also used to control the adequacy of Pedi-IKDC results. Statistical analysis was performed to process data. RESULTS: Cronbachs alpha was 0.902, which means that questions have high level of consistency. The high correlation of results between the Lysholm and Pedi-IKDC questionnaire also proves the adequateness and objectiveness of the results. CONCLUSIONS: The proposed Russian version of the Pedi-IKDС questionnaire gives effective, objective, and adequate results. It is a good tool for knee assessment in children.
Background. Patellar instability is a common problem in pediatric patients. Up to 2%–3% of all knee injuries are associated with acute patellar dislocation. According to the data in the literature, patients aged 10–17 years are at the highest risk of patellar dislocation and subsequent instability. These patients must be evaluated according to the proposed algorithm to select the optimal treatment method. Aim. To diagnose patellar instability in children and subsequently select the optimal treatment method based on acquired data. Materials and methods. The study is based on data acquired through the examination and treatment of 147 patients at the 9th Department of Pediatric Traumatology and Orthopedics. Great emphasis was put on computed tomography (CT) data, its essential parameters, which require the most thorough analysis, and assessment methods. These parameters include patellar tilt, dysplasia of the distal metaepiphysis of the femur, the tibial tubercle–trochlear groove index, and the rotational relation of the femur and tibia. Results. A novel algorithm for patient examination using CT is proposed. Data obtained by multislice CT (MSCT) had a significant influence on the selection of the surgical method for treating patients with patellar instability. Conclusion. The examination of patients with patellar instability using MSCT in adherence to the proposed diagnostic algorithm allows the selection of the optimal treatment method, which will increase the likelihood of rapid recovery of patients and their return to the level of activity similar to that before injury.
Treatment results of 1353 children and adolescents with acute elbow injuries were performed. The main difficulties for diagnosis and treatment of those injuries were shown. Using stored experience the methods of diagnosis and treatment for all types of injuries were optimized. Potential complications and mistakes were described; the ways of their prevention were presented. Tactics of postoperative management of patients was elaborated. Differentiated approach to the treatment of every type of injuries enabled to obtain good and excellent results in 93.2% of patients.
Experience in treatment of 76 children with K^ig's desease during the period from 1992 to 2011 is presented. Examination plan included roentgenography, CT, US, MRT and arthroscopy. In 41 children 1 st and 2 nd stages of the disease was diagnosed, in 9 and 26 patients 3 rd and 4 th stages, respectively. Defect size averaged 3.17 sq. cm with 6.8 mm depth. In 1 st and 2 nd stages of the disease osteoperforation was performed, in 3 rd and 4 th stages — intrafocal osteoperforation of the defect bottom and cartilaginous defect plasty with Chondro Gide collagen membrane was applied. All interventions were performed arthroscopically. Excellent results were achieved in 69 (90.7%) patients, good in 5 (6.5%) and satisfactory in 2 (2.6%) patients.
Введение. Несмотря на то что нестабильность надколенника является частой патологией в структуре заболеваний и травм коленного сустава в детском возрасте, в настоящее время отсутствуют полноценные сведения, на основании которых можно было бы судить об эффективности и предпочтительности того или иного метода ее лечения. Цель исследования: оценить эффективность методов оперативного лечения детей с посттравматической нестабильностью надколенника. Пациенты и методы. Исследование выполнено на основании данных обследования и лечения 127 пациентов в возрасте от 8 до 17 лет с посттравматической нестабильностью надколенника. Артроскопическая стабилизация по методике Ямамото в модификации отделения была проведена 49 пациентам, стабилизация с транспозицией бугристости большеберцовой кости-67, с пластикой медиальной пателлофеморальной связки аутотрансплантатом-9, корригирующая остеотомия-2. Эффективность лечения выявляли с использованием шкал оценки коленного сустава AKPS и 2000 IKDC. Анкетирование проводили при обращении, через 1, 2-4 года и 4-7 лет после операции. Результаты. В ближайшие сроки после операции (до 2 лет) в группе детей после стабилизации надколенника по методике Ямамото в модификации отделения хорошие и отличные результаты были констатированы в 77,8% случаев, после транспозиции бугристости большеберцовой кости-в 73,3%, после стабилизации надколенника с пластикой медиальной пателлофеморальной связки-в 88,9%, в отдаленном периоде (в сроки 5-7 лет)-в 90,9 и 86,5% случаев в 1-й и 2-й группах соответственно. Заключение. Предложенный алгоритм обследования и лечения позволяет максимально эффективно проводить лечение детей с посттравматической нестабильностью надколенника и получать хорошие и отличные результаты в большинстве наблюдений. К л ю ч е в ы е с л о в а: оперативное лечение, надколенник, нестабильность, травма, дети К о н ф л и к т и н т е р е с о в: не заявлен И с т о ч н и к ф и н а н с и р о в а н и я: исследование проведено без спонсорской поддержки
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