Developmental dysplasia of the hip (DDH) is a vital and most frequently diagnosed disorder in pediatricrequiring developement and implementation of new diagnostic methods because of failure in detection of early dysplastic changes. Limitation in applying the diagnostic instrumental methods in infants and lack of uniform standards of clinical practice and management results in the increase in treatment cost and duration of rehabilitation. The purpose of this study was the search for new sensitive methods of diagnostics and treatment of DDH and profound study of pathogenic mechanisms. Despite the great attention of international pediatric specialists to the problem of DDH in children, the methods for early diagnostics, prevention of severe forms and complications are not still developed. The current study identifies the molecular mechanisms of DDH pathology and analyses the opportunities of instrumental and non-instrumental methods for its diagnosis. The authors presented the promising biomarkers and cytokines for the diagnosis and prediction of DDH.
A group of degenerative hip disorders in children is discussed in the current review. The key pathogenic focus of these disturbances is an initial hyaline cartilage alteration or subchondral bone, which provokes damage of the epiphyseal hip zone. Eventually, such events lead to a local inflammatory reaction in the hip joint, cytokine cascade with hypoxia and ischemia, and apoptosis and necrosis in the hip. Developmental hip dysplasia, Legg-Calvé-Perthes disease, and slipped capital femoral epiphysis are analyzed in this review as the spreading forms of degenerative hip disorders in children. The key points of etiology, pathogenesis, diagnostics, and treatment of each disease are characterized. A group of degenerative hip joint diseases remains under the close supervision of pediatric orthopedists and traumatologists because of their high prevalence, severity of clinical manifestations, damage of life quality, and development of complications in the form of arthritis. In addition, the lack of unified approaches to the application of treatment methods for degenerative hip joint diseases is the subject of discussion among surgeons and often causes a decrease in the quality of care in terms of time and volume.
We analyzed foot functions in the late postoperative period in 41 patients with post-traumatic arthrosis of their ankle joints. The study involved clinical and surgical techniques as well as the Foot Function Index (FFI) measuring and statistical methods. No significant differences in FFI scores were revealed in 6 months after ankle arthrodesis surgeries with plates or intramedullary nails. However, in 3 months after their surgeries the patients with intramedullary nails featured lower FFI scores suggesting earlier satisfactory outcomes in this cohort.