Introduction. Bone cysts are one of the most common tumor-like bone diseases of childhood, most often occurring in the 1st and 2nd decade of life. According to the world medical literature, there is still no consensus on the best methods of treating bone cysts.Aim – to evaluate the effectiveness of surgical treatment of aneurysmal bone cysts (ABC) in children with the use of allografts of biological (animal and human) origin.Materials and methods. This study included 56 pediatric patients with ABC treated at The National Medical Research Center for Children’s Health, Russia, Moscow. 37 patients with aneurysmal bone cysts (29 active ABC, 8 inactive ABC) underwent surgical treatment. Our follow-up period ranged from 12 months to 80 months. In the postoperative period, the examination was carried out at a period of 3, 6, 12, 18, 24 months and then once a year, while assessing: the presence/absence of the recurrence (radiologically), the timing of functional recovery of the operated segment, the timing of X-ray reconstruction of the graft, the assessment of physical and emotional components of the patients’ quality of life were evaluated using the PedsQL questionnaire at admission and within 12 months from the date of surgery.Results and discussion. In 37 cases of surgical treatment of ABC with the use of allografts of biological origin, the recurrence presented in 7 patients (19%) – these patients, who had an active ABC, required repeated surgical interventions. The average time of complete bone repair in the lesion site ranged from 9 months to 22 months (14 months on average). Functional recovery of the operated segments was on average 10 months for the upper extremities and 12 months for the lower extremities.Conclusion. The use of allografts of biological origin is effective in the case of inactive aneurysmal bone cysts. In case of active ABC the effectiveness of bone grafting with allografts of biological origin is reduced.
ФГАУ «Научный центр здоровья детей» Минздрава России, МоскваВведение. По литературным данным, частота переломов надколенника составляет примерно от 0,5 до 1,5 % от всех повреждений скелета. По характеру перелома можно выделить авульзивные, поперечные, оскольчатые и продольные. При смещении фрагментов более 2-3 мм и повреждении сухожильного растяжения четырехгла-вой мышцы предпочтительна открытая репозиция с восстановлением конгруэнтности суставной поверхности и стабильным остеосинтезом. В случаях продольных переломов артроскопия может рассматриваться как вы-сокоэффективный метод хирургического лечения. Материалы и методы. С применением артроскопии нами были прооперированы 4 пациента с продольным переломом надколенника. Возрастной диапазон пострадавших варьировал от 14 до 17 лет. Из них 3 мальчика и 1 девочка. Все больные получили травму во время занятий спортом. Поскольку при продольных переломах надколенника боковой разгибательный аппарат четырехглавой мышцы бедра оставался неповрежденным, объем оперативного вмешательства в этих случаях заключался в артроскопически ассистированной закрытой репозиции фрагментов и чрескожной диафиксации спи-цами без наложения проволочного шва. Результаты и обсуждение. Малоинвазивность, возможность визуального контроля за качеством восстанов-ления геометрии суставной поверхности надколенника и надежностью фиксации фрагментов, существенное сокращение сроков последующей реабилитации делают артроскопию высокоэффективным методом хирурги-ческого лечения переломов надколенника.Ключевые слова: коленный сустав, перелом, надколенник, артроскопия, подростки. ARTHROSCOPIC TREATEMENT OF PATELLA FRACTURES IN CHILDREN © I.V. Timofeev, E.Y. Dyakonova, A.A. Gusev, E.A. Romanova, P.V. KhrolenkoScientific Centre of Children Health, Moscow, RussiaIntroduction. The frequency of patellar fractures is approximately 0.5% to 1.5% of all skeletal injuries. The following types of fractures can be distinguished: avulsive, transverse, longitudinal, and comminuted. In cases of displacement of more than 2-3 mm and quadriceps tendon injuries open reduction and internal fixation with the restoration of the articular surface is more preferable. In cases of longitudinal fractures, arthroscopy is regarded as a highly effective method of surgical treatment. Materials and methods. Using arthroscopy, we have operated on 4 patients with longitudinal fracture of the patella. The average age of the injured persons was 15.4 years (14-17). These were 3 males and 1 female. All patients had sport-related injuries. Because of the longitudinal fracture of the patella, the lateral knee extensor mechanism remained intact, and arthrosopy-assisted surgical intervention with closed reposition of fragments and transcutaneous wire fixation was performed without wire suturing. Results and discussion. Minimal invasiveness, the possibility of visual control over the recovery quality of patellar surface, the reliability of fragment fixation, and a significant reduction in the subsequent rehabilitation make arthroscopy a highly effective ...
Osteogenesis imperfecta (OI) is a heterogeneous group of diseases with different types of inheritance, characterized by frequent fractures and deformities of the bone skeleton. Conservative and surgical treatment of children with this pathology is an integral part of a multidisciplinary approach. In the surgical treatment of bone deformities in children with OI, the method of choice is corrective osteotomies, and an effective method of fixation is intramedullary osteosynthesis. Surgical treatment of children with OI is aimed at reducing the number of fractures, correcting deformities and increasing motor activity. Aim of the study to determine the indications for intramedullary osteosynthesis of long tubular bones in children with the disease. To review the studies concerning treatment of children with OI. Consider the different types of metal fixers, their advantages and disadvantages. Today the technique of intramedullary fixation is the "gold" standard in the surgical treatment of children with OI. There is a clear advantage of telescopic rods in terms of the frequency of reoperations, but their use does not exclude the presence of postoperative complications.
Objective of the study: to evaluate the effectiveness of layered alloplasty in the surgical treatment of active aneurysmal bone cysts (ABCs) in children. Materials and methods of research: from 2007 to 2020 56 patients with ABCs were treated in the Neuroortopedic Department with orthopedics of the National Medical Research Center for Children’s Health (Moscow, Russia). All patients have underwent a comprehensive clinical and radiological examination, including the determination of intraosseous pressure (IOP) to determine the activity of the pathological process. Surgical treatment of 19 patients with ABCs was performed through layered alloplastic method of the cyst cavity with the enhancing of the bone growth zone with alloimplants based on sea coral. Results: the results of treatment were evaluated on the basis of an analysis of the radiographic picture of reconstruction of bone implants and restoration of bone tissue structure, as well as analysis of the quality of life of patients in the 1st and 2nd module of the PedsQL Generic Core scale questionnaire before and after surgical treatment. Conclusion: the use of layered plasticity of a bone defect in the surgical treatment of ABCs can be considered as effective method for preventing recurrence of the disease.
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