Aim - to evaluate the effectiveness of surgical correction of shortening and axial deformities of the lower extremities in children by temporary blocking of the growth zones. Materials and methods. The article presents five-year experience (2011-2016) in the treatment of 45 children (59 knees) with deformities of the lower extremities of different etiology. These cases included such congenital and acquired deformities as post-traumatic deformities, Blount's disease, metaphyseal dysplasia, after-effects of osteomyelitis, exostotic chondrodysplasia. Shortening or elongation of the limbs were found in 13 patients, the angular deformity - in 29 patients, combined deformity - in 3 patients. Results. In our practice, the timing of the correction of deformity ranged from 10 to 32 months. The degree and time of correction of the deformation directly depend on its severity and age of patients. The analysis of the results of the treatment of children with the use of this methodology showed the following results: good outcomes were observed in 37 patients (82.2%), satisfactory - in 8 patients (17.8%), unsatisfactory outcomes were not observed. Complications occurred in 3 patients (6.6%). Irreversible complications were not observed. Conclusions. Method of temporary blocking of the growth zones of long bones (method of controlled growth, temporary epiphysiodesis) is a good alternative to corrective osteotomies due to sufficient efficacy, minimal invasiveness, and little risk of complications.
The aim of the study was the analysis of domestic and foreign medical literature of different time periods, which describes the basic methods of surgical and conservative treatment of congenital or habitual dislocation of patella, as well as statistical analysis of the results of treatment. Due to the existence of a large number of options of surgical treatment for this pathology (more than 150 methods were developed) and high variability of its manifestations, it is necessary to know the basic methods and their results for planning tactics of treatment with individual approach to each patient. Based on this review, analysis was performed for the results of using different options for invasive treatment of congenital or habitual dislocation of patella. Also, the paper contains the indications and efficacy of conservative therapy for this disease. A comparative analysis was made on the results of surgical and conservative methods of treatment of patellar dislocation, which were used in different time periods, from the initial description of the first results of treatment of this pathology to modern surgical techniques that are currently used. It is shown that all methods of surgical treatment of the pathology are divided into three main groups: myofascioplastic surgeries, osteoplastic and combined surgical interventions. It is underlined that the diseases requires individual approach to the choice of correction method in each certain case to achieve positive outcomes.
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