This study presents the organizational, clinical, and scientific activities of Henry Turner, the founder of pediatric orthopedics. In 1910, Henry Turner presented a report to the All-Russian Congress about the “Basic principles of care for cripples, which are subject to obligatory care on the part of the state.” He pointed out the deficits in the activities of charitable shelters, where there was neither treatment nor education, and he advocated for main organizational principles for institutions for crippled children. Counseling and medical aid for children in the “Shelter for cripples and paralytics,” organized under the leadership of Henry Turner, facilitated the conversion of the shelter into an “Institute for vocational rehabilitation of physically handicapped children,” with 200 beds, in 1932. In connection with the 50th anniversary of the scientific and medical work of Professor Henry Turner, the Institute was named after him. The plight of pediatric patients was the subject of his constant care and attention; it was his lifework. The Institute’s staff continue Henry Turner’s vision of “orthopedics of the soul,” and not only treat but also teach and nurture children, to help form their personalities and to give them a joy and sense of life.
Резюме. Статья представляет собой дайджест материалов, представленных на X юбилейном съезде травматологов-ортопедов России 16 сентября 2014 г. в Москве директором ФГБУ «НИДОИ им. Г. И Турнера» чл.-корр. РАН Алексеем Георгиевичем Баиндурашвили. Статистические данные о травматизме и заболеваемости костно-мышечной системы детского населения, сведения об организации травматолого-ортопедической помощи детям основаны на данных государственной статистической отчетности Минздрава России. Приведенные данные могут быть полезны организаторам здравоохранения и травматологам-ортопедам в субъектах Российской Федерации.Ключевые слова: травмы, врожденные аномалии и заболевания костно-мышечной системы, специализиро-ванная помощь, дети.В 2013 г. число детей в России по сравнению с предыдущими годами увеличилось до 27 млн, что составило 18,8 % от всего населения стра-ны. При этом доля подростков, родившихся в 90-е годы, уменьшилась на 4,9 %, а доля детей до 14 лет -увеличилась на 2,7 %, что связано со снижением рождаемости в 90-е годы и успеш-ной демографической политикой правительства России.Потребность в медицинской помощи детям по поводу травм и их последствий продолжает оста-ваться высокой. В течение года в медицинские учреждения страны обратилось более 3 миллио-нов детей с повреждениями различной степени тяжести. В их числе 25 тысяч детей первого года жизни, 2,5 млн детей от 1 до 14 лет и 687 ты-сяч подростков. 85 % обратившихся по поводу травм -городские жители, что косвенно свиде-тельствует о лучшей доступности медицинской помощи в городах, в то время как в сельской местности дети обращаются к специалисту только при более тяжелых травмах.В последние годы показатели травматизма у детей до 14 лет стабилизировались, составляя 107-108 случаев на 1000 населения. Травматизм у подростков продолжает оставаться высоким, за 4 года он увеличился с 158 до 168 %. В целом у детей от 0 до 17 лет показатель травматизма со-ставил 116,3 % [5].Структура травм по видам повреждений от-личается определенным постоянством. Обстоя-тельства травмы часто свидетельствуют о безнад-зорности детей. В половине случаев травмы были получены в быту (50,9 %), одну треть составляют уличные травмы (32,2 %). Серьезные повреждения получают дети в стенах школы (6,8 %) и во время занятий организованным спортом (4,7 %). Их чис-ло с годами не уменьшается. Транспортные трав-мы, которые имеют самые тяжелые последствия, составляют 1,1 % [2].В структуре травм по характеру повреждений преобладают поверхностные травмы (39 %), далее регистрируются раны (16,1 %), вывихи и растя-жения (14,2 %), переломы костей верхней (13,2 %) и нижней (5,6 %) конечностей. Во всех возраст-ных группах все виды травм у мальчиков бывают в 1,5 раза чаще, чем у девочек [2].Показатели смертности детей от воздействия внешних причин свидетельствуют, что основной причиной гибели являются несчастные случаи, связанные с транспортом (5,8 на 100 000 детей от 0 до 17 лет). Дорожно-транспортные травмы
Background. Among all cranial nerves, the facial nerve is the most exposed to birth injuries. Difficulties with medical assistance during the first months of life for children with a facial nerve birth injury is known and debated. According to the literature data, the scope of diagnostic and treatment activities varies, and these treatments have not always demonstrated effectiveness. Aim. We discuss the protocol of medical assistance for newborns and children during the first months of life with a facial nerve birth trauma. Materials and methods. We analyzed domestic and foreign literature dedicated to facial nerve birth trauma. Results. The results showed the necessity of a multidisciplinary approach for patients with facial nerve birth trauma involving neurologists, ophthalmologists, otolaryngologists, audiologists, maxillofacial surgeons, geneticists, doctors for rehabilitation medicine, and microsurgeons. Key directions of medical assistance during the first months of life include the prevention of the development of ophthalmologic complications; topical and etiological differential diagnosis; and dynamic observation to timely resolve whether surgical treatment is necessary. Conclusion. The integration of developed protocols in clinical practice is essential for understanding the etiology, pathogenesis, natural history, differential diagnostics, and prior treatment by medical doctors of different specialties to improve the quantity of medical assistance.
Background. The use of transpedicular screws as support elements from the standpoint of biomechanics is preferable as compared to that of laminar fixation, albeit the former carries the risk of various complications (such as malposition screws, damage to the Dura mater, spinal cord, and major blood vessels) caused by structural changes in the vertebrae under the background of their defects, with small size of roots arcs vertebrae in young children. Thus, the issue of ensuring safe and correct installation of transpedicular screws in the surgical treatment of children with congenital scoliosis remains relevant. Aim. We aimed to evaluate the correctness of the position of the transpedicular screws installed in the vertebral bodies in preschool children with congenital scoliosis of thoracic and lumbar localization using guide templates (SHN). Materials and methods. We conducted a prospective analysis of the outcomes of surgical treatment of 30 patients with congenital scoliosis against the background of impaired formation of the vertebrae of the thoracic and lumbar spine. The patients included 12 boys and 18 girls of age: 1 year 8 months to 6 years 5 months (average: 3 years 4 months). Based on the computed tomography of the spine, performed postoperatively, the correctness of the position of the installed elements of the corrective multi-support metal structure was evaluated. The correctness of the position of the installed transpedicular support elements was evaluated based on the scale described by S.D. Gertzbein and co-authors (1990). Results. The total number of implanted transpedicular screws sets was 96 (100% of the planned transpedicular screws set), and 48 SHN were used for transpedicular screws installation. The correct position of installed screws by degree of displacement revealed Grade 0 93.7% (90 screws), Grade I 4.2% (4 screws), Grade II 2.1% (2 screws), Grade III 0%. The number of screws with a Grade 0 + Grade I offset was 94 (97.9%). Conclusion. The results obtained with the use of SHN among preschool children with congenital scoliosis of thoracic and lumbar localization revealed high accuracy and correctness of transpedicular screws installation (93.7%) with the use of this type of navigation in clinical practice. The use of SHN for installing transpedicular screws in the surgical treatment of congenital spinal deformities in young patients allows for the selection of the optimal size and correct position of the transpedicular support elements in the vertebrae to be instrumented.
Various options for medical treatment of children with compression fractures of the thoracic and lumbar spine include unloading of damaged segments by simultaneous or gradual reclination (e.g., functional traction and reclination of the spine); measures aimed at building and strengthening the muscular “corset” of the back; and the use of orthotic devices of various designs (e.g., fixating-discharging, fixating-correcting corsets, orthoses on a modular basis). Questions regarding the early and late use of orthotics in patients with compression fractures of the vertebral bodies are discussed. Literature analysis, considering different methods used in the treatment of these patients in terms of their effectiveness to restore the height and shape of the damaged spinal segment revealed the absence of a differentiated approach for choosing treatment and selection criteria for orthopedic management.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.