Актуальность. Асептический некроз головки бедренной кости -тяжелое дегенеративно-дистрофическое заболевание. У взрослых больных 30-40 % артрозов тазобедренных суставов являются следствием недолеченных в детском возрасте таких заболеваний как врожденный вывих бедра и болезнь Пертеса. Цель. Улучшение исходов оперативного лечения асептического некроза головки бедренной кости у детей. Материалы и методы. Исследование проведено на основании данных 28 детей и подростков с асептическим некрозом головки бедренной кости, пролеченных оперативно в отделении детской ортопедии НИИТО МЗ РУз с 2013 по 2014 г. Всем больным выполнена операция -туннелизация и костная пластика на питающей мышечной ножке. Результаты. Через год после операции при рентгенологических исследованиях отмечалось значительное увеличение высоты головки, однородность ее структуры, исчезновение фрагментации. Клинически отмечалось отсутствие хромоты, симптом Тренделенбурга был отрицателен с обеих сторон. Заключение. Восстановление микроциркуляции в области тазобедренного сустава, достигнутое путем туннелизации, и костная пластика на питающей мышечной ножке обусловливают возможность раннего восстановления функции опоры конечности. Ключевые слова: дети, асептический некроз головки бедра, болезнь Пертеса, рентгенография, диагностика, хирургическое лечение.Relevance. Aseptic necrosis of the femoral head is a serious degenerative-and-dystrophic disease. 30-40% of the hip arthroses in adult patients appear to be a consequence of the diseases not completely treated in childhood such as congenital dislocation of the hip and Perthes disease. Purpose. To improve the outcomes of surgical treatment of the femoral head aseptic necrosis in children. Materials and Methods. We performed the study based on the data from 28 children and adolescents with the femoral head aseptic necrosis who were treated in the Department of Pediatric Orthopaedics of SRITO of the Ministry of Health of the Republic of Uzbekistan within the period from 2013 to 2014. All the patients underwent surgical tunneling and muscle-pedicle osteoplasty. Results. A year after the surgery X-rays revealed the significant increase in the head height, homogeneity of the head structure, fragmentation disappearance. Clinically limping was absent, the Trendelenburg symptom was negative at both sides. Conclusion. Microcirculation restoration in the hip zone achieved by tunnelization, as well as muscle-pedicle osteoplasty provide the possibility of early recovery of limb weight-bearing function.
Introduction Fibular hemimelia is a rare congenital malformation of lower limbs with associated deformities of the knee and ankle joints. There is no consensus among the authors regarding the choice of treatment method, appropriate timing of surgery, strategy and postoperative rehabilitation. Objective To explore clinical manifestations of the deformities and review outcomes of pediatric surgical treatment of fibular hemimelia. Material and methods Surgical treatment was performed for 11 children with fibular hemimelia at the Department of Pediatric Orthopedics, RSSPMCTO RUz between 2014 and 2019. Clinical and instrumentation studies were produced for all patients. Results Outcomes of surgical treatment were evaluated using functional characteristics with 7 rated as good and 4 as fair. Conclusion External fixation offers an effective treatment option in the pediatric surgical management of fibular hemimelia.
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