The Use of Robotic Motor Rehabilitation in Complex Treatment of Subluxation and Dislocation of the Hip in Children With Sequelae of Spina Bifida

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

2021

Introduction. Spina bifida is a severe malformation of the spine and spinal cord. Pathology of the hip joint in children with spina bifida has always been one of the most challenging pediatric orthopedic problems. Purpose of the study. The aim of this study is to perform a comparative analysis of the duration of operations and hematological indicators of blood loss after performing osteotomy of the ilium and acetabuloplasty to treat children with herniated disc consequences in the presence of hip subluxation and dislocation. It also seeks to determine the safest surgical intervention. Materials and methods. We observed and treated 60 patients aged 38 years with spina bifida with subluxation and dislocation of the hip. Patients were subdivided into two groups of 30 patients each, differing in the technique of performing the intervention on the pelvic component of the joint. The first group is represented by patients who underwent osteotomy of the ilium (52 joints) aimed to stabilize the hip joint. The second group comprised children who underwent acetabuloplasty (55 joints), another variant of intervention on the pelvic component of the joint. Results. As our study shows, performing osteotomy of the ilium required significantly more time than acetabuloplasty (p = 0.0088 (p 0.05)). In addition, performing osteotomy of the ilium was accompanied by a more pronounced decrease in the level of both hemoglobin and the number of blood erythrocytes than when performing acetabuloplasty. Conclusion. Our study demonstrates that osteotomy of the ilium requires more time for its implementation. It is accompanied by a more pronounced decrease in hemoglobin and blood erythrocytes than acetabuloplasty. Therefore, we can conclude that acetabuloplasty is preferable in cases where the expected clinical result and the required degree of correction are comparable.

Section: Introductionunclassified

Comparative analysis of the dynamics of the duration of the surgery and hematological indicators of blood loss after osteotomy of the ilium and acetabuloplasty in treatment of children with spina bifida

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

2021

“…Спинномозговая грыжа -порок развития позвоночника, представляющий собой неполное закрытие нервной трубки в не полностью сформированном спинномозговом канале, сопровождающийся разнообразными ортопедическими нарушениями со стороны позвоночника и нижних конечностей. В процессе лечения деформаций нижних конечностей, вызванных в основном мышечным дисбалансом из-за нейротрофических нарушений, статико-динамических изменений, нередко возникают переломы длинных трубчатых костей [1][2][3]. За последние десятилетия интерес к изучению остеопороза у детей значительно повысился [4].…”

Section: Introductionunclassified

Fractures of lower limbs in children with spina bifida

Вячеславович²,

Pediatr Traum Orthop Reconstr Surg

et al. 2018

Background. Spina bifida is a serious defect in the development of the spine and spinal cord. It is accompanied by several orthopedic disorders of the spine and lower limbs, including fractures of long tubular bones. In spina bifida, osteoporosis plays an important role in the pathogenesis of motor disorders. Aim. The objective was to determine the patterns of occurrence and the clinical and radiological features of fractures of the long tubular bones of the lower limbs in children with sequelae of spina bifida. Materials and methods. From 2006 to 2017, 544 patients with spina bifida were examined and treated at the Turner Research Institute for Children’s Orthopedics. Clinical-neurological and radiographic methods were used. The neurosegmental level of spinal cord involvement was determined using the Sharrard classification, and the motor level was assessed according to the method proposed by Melbourne Medical University. Results. The clinical picture of a fracture of a long tubular bone in a child with spina bifida has many characteristics. There was no abnormal mobility in the fracture site in 56% of cases, edema was absent in 88% of children, and pain in the fracture region was observed in only 19% of cases. The radiographic features of the atypical fracture of long tubular bones in children with sequelae of spina bifida included lack of a fracture line, presence of a hypertrophic periosteal reaction, and sclerosis areas at the fracture site. Conclusion. The frequency and localization of fractures of the lower limbs in children with sequelae of spina bifida are determined according to the neurosegmental level. The clinical picture of fracture often differs from usual fractures by the absence of pain syndrome, edema in the fracture region, and displacement of bone fragments, which must be considered for diagnosis. The peculiarities of the clinical and radiological picture are associated with the presence of osteoporosis in this pathology due to a decrease in the motor activity level of the patients.

Surgical treatment of hip subluxation and luxation in children with spinal hernia consequences

Баиндурашвили

Khir. Z. im. N.I. Pirogova

2017