Introduction. Pes calcaneus deformity is a rare pathology in children, which is due to the defect of long flexors of the foot caused by various neurological diseases. The treatment choice is based on the patient’s age, parameters of neuromuscular disorders, and degree of foot deformation. Aim. This study aimed to analyze the results of operative correction of рes calcaneus deformities in children. Material and methods. This analysis of surgical treatment involved 13 patients (21 feet) aged 1.5 to 15 years with рes calcaneus deformities. The different approaches and methods of surgical treatment were described. Children up to 12 years old were released joints of the foot with the elimination of deformation and tendon-muscle transposition with the transfer of functionally preserved muscles in the position of fallen muscle antagonists. Children over 12 years old underwent surgery on the bone apparatus of foot: three-articular arthrodesis or corrective osteotomy of the calcaneus, some cases were supplemented with tendon-muscle transpositions. Results. Treatment results were evaluated based on the radiometric parameters on the system of AOFAS. All treated patients showed improvement in foot stability with reduced deformation; АОFAS at an average of 91.14 points was observed. Conclusion. A record of all causes and strain components with a graded approach eliminates the pes calcaneus deformity in the long-term, despite persistent violation of neuromuscular conduction.
The development of secondary deforming coxarthrosis in childhood and adolescence, as a rule, is accompanied by the formation of a pronounced deformity of the hip joint, up to ankylosis, which significantly limits the function of the lower limb and leads to early disability. In most patients, hip ankylosis develops in a vicious position with the resulting flexion-intracavity installation of the lower limb. If such a condition is encountered in childhood and adolescence, treatment currently remains debatable. Various methods are used, ranging from arthroplastic organ-preserving interventions and corrective osteotomies to joint replacement. In this report, we present a clinical case of children treated with post-infectious secondary deforming coxarthrosis with fibrous ankylosis of the hip joint in a vicious position. We applied a coherent combination of modern treatment methods: distraction in the apparatus, arthroscopy, intra-articular injections, physiotherapy, and other rehabilitation. The treatment results were evaluated over a two-year period. In this case, the rational use of a consistent set of remedial measures helped to improve joint function, socialize the patient, and postpone surgery for joint replacement for at least 2 years.
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