Aleksandra N. Filippova, Dmitriy N. Kokushin, Nikita O. Khusainov
BACKGROUND: Flexiondistraction injuries of the spine result from high-energy trauma (traffic accidents and falls from a height). This type of injury is commonly found in the thoracolumbar junction. Among combined injuries in the presence of flexiondistraction fractures of the vertebral column, injuries of the chest or abdominal organs are often observed, which are crucial for patient survival, and their diagnostic measure is complex because of the severe and unstable conditions of the patients.
AIM: To analyze a cohort of pediatric patients who underwent surgery for flexiondistraction injury of the spine.
MATERIALS AND METHODS: We analyzed the data of clinical and instrumental studies and surgical outcomes of 28 pediatric patients (aged 217 years) with flexiondistraction injuries of the spine. The standard preoperative examination included clinical and laboratory studies, spondylography, multislice spiral computed tomography and magnetic resonance imaging of the damaged area, electrocardiography, and ultrasonography of the abdominal organs and kidneys. All patients underwent surgery for the correction and stabilization of traumatic spinal deformity with a multisupport metal structure and posterior local fusion. The analysis included an assessment of the mechanism of injury, concomitant injuries, time elapsed after the injury before admission to the hospital, level of the damaged segment, and treatment. Data were processed statistically using an online calculator. The nonparametric MannWhitney method was used.
RESULTS: Catatrauma was the leading cause of injury in 50% of the patients, compared with traffic accidents in 36%. In 80% of the patients, spinal injury was localized at the thoracolumbar junction and lumbar spine. Moreover, 71% of the patients were transferred to the National Research Center for Childrens Orthopedics and Trauma Surgery for surgical treatment on the spine in the early stages after injury (up to 7 days), and 8 children (19%) were admitted within 1045 days (average 16 days). In 19 (68%) patients, in addition to spinal injury, concomitant injuries occurred, with skeletal trauma and injuries of the abdominal cavity organs as the most frequent. All patients achieved complete correction of the deformity at the level of the damaged segment.
CONCLUSIONS: Flexiondistraction fractures of the spine in children are characterized by a high incidence of concomitant injuries, which dictates the need for a full examination to identify them and correctly interpret the data. The elimination of mechanical instability in the early stages in this type of injury can reduce the extent of fixation and contribute to the restoration of the physiological profile and disk apparatus of the spinal column.
{"title":"Flexion–distraction injuries of the spine: Features of diagnostics, clinical picture, and results of surgical treatment of children","authors":"Aleksandra N. Filippova, Dmitriy N. Kokushin, Nikita O. Khusainov","doi":"10.17816/ptors464680","DOIUrl":"https://doi.org/10.17816/ptors464680","url":null,"abstract":"BACKGROUND: Flexiondistraction injuries of the spine result from high-energy trauma (traffic accidents and falls from a height). This type of injury is commonly found in the thoracolumbar junction. Among combined injuries in the presence of flexiondistraction fractures of the vertebral column, injuries of the chest or abdominal organs are often observed, which are crucial for patient survival, and their diagnostic measure is complex because of the severe and unstable conditions of the patients.
 AIM: To analyze a cohort of pediatric patients who underwent surgery for flexiondistraction injury of the spine.
 MATERIALS AND METHODS: We analyzed the data of clinical and instrumental studies and surgical outcomes of 28 pediatric patients (aged 217 years) with flexiondistraction injuries of the spine. The standard preoperative examination included clinical and laboratory studies, spondylography, multislice spiral computed tomography and magnetic resonance imaging of the damaged area, electrocardiography, and ultrasonography of the abdominal organs and kidneys. All patients underwent surgery for the correction and stabilization of traumatic spinal deformity with a multisupport metal structure and posterior local fusion. The analysis included an assessment of the mechanism of injury, concomitant injuries, time elapsed after the injury before admission to the hospital, level of the damaged segment, and treatment. Data were processed statistically using an online calculator. The nonparametric MannWhitney method was used.
 RESULTS: Catatrauma was the leading cause of injury in 50% of the patients, compared with traffic accidents in 36%. In 80% of the patients, spinal injury was localized at the thoracolumbar junction and lumbar spine. Moreover, 71% of the patients were transferred to the National Research Center for Childrens Orthopedics and Trauma Surgery for surgical treatment on the spine in the early stages after injury (up to 7 days), and 8 children (19%) were admitted within 1045 days (average 16 days). In 19 (68%) patients, in addition to spinal injury, concomitant injuries occurred, with skeletal trauma and injuries of the abdominal cavity organs as the most frequent. All patients achieved complete correction of the deformity at the level of the damaged segment.
 CONCLUSIONS: Flexiondistraction fractures of the spine in children are characterized by a high incidence of concomitant injuries, which dictates the need for a full examination to identify them and correctly interpret the data. The elimination of mechanical instability in the early stages in this type of injury can reduce the extent of fixation and contribute to the restoration of the physiological profile and disk apparatus of the spinal column.","PeriodicalId":37631,"journal":{"name":"Pediatric Traumatology, Orthopaedics and Reconstructive Surgery","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135198782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aleksei N. Kozhevnikov, Dmitrii B. Barsukov, Aigul R. Gubaeva
BACKGROUND: Aseptic necrosis of the femoral head in children remains a subject of great interest among specialists, despite its long history of study. The LeggCalvPerthes disease is the most common form of aseptic necrosis of the femoral head in children. The necrotic lesion in the femoral head results from the blockage of the arterial blood supply to the epiphysis, leading to its infarction. Some children experience a more aggressive disease course, with signs of osteoarthritis, which can result in the early development of coxarthrosis. Numerous publications have demonstrated the successful use of bisphosphonates in adult patients with aseptic necrosis of the femoral head.
AIM: To generalize data on the use of bisphosphonates in children with the LeggCalvPerthes disease presenting with signs of osteoarthritis through the analysis of contemporary global literature.
MATERIALS AND METHODS: A literature search was conducted in the open databases of PubMed, Science Direct, and Google Scholar, and the analysis depth spanned 20 years. The search terms used included LeggCalvPerthes disease, aseptic (avascular) necrosis of the femoral head, and bisphosphonates. The review encompassed the literature on bisphosphonates, their biological action, effectiveness of their use in patients with aseptic necrosis of the femoral head, and results of our research.
RESULTS: Studies on the efficacy of bisphosphonates in children with LeggCalvPerthes disease are limited. Currently, the effect of bisphosphonates on disease course and outcome is unknown. Despite this, mechanisms of chronic inflammation are increasingly mentioned in the literature, which may directly or indirectly influence the clinical course and outcome of the disease. The key is the hyperactivity of osteoclasts in osteonecrosis. The experience of using bisphosphonates in adult patients with aseptic necrosis of the femoral head had positive results in preventing the progression of the deformity of femoral head deformity.
CONCLUSIONS: Bisphosphonates are specific inhibitors of osteoclast activity, which has been used in many diseases. The results and inferences of using bisphosphonates in children with LeggCalvPerthes disease will lead to the formulation of a new treatment algorithm.
{"title":"Legg–Calvé–Perthes disease presenting with osteoarthritis: Mechanisms of the development and prospects of conservative therapy using bisphosphonates","authors":"Aleksei N. Kozhevnikov, Dmitrii B. Barsukov, Aigul R. Gubaeva","doi":"10.17816/ptors456498","DOIUrl":"https://doi.org/10.17816/ptors456498","url":null,"abstract":"BACKGROUND: Aseptic necrosis of the femoral head in children remains a subject of great interest among specialists, despite its long history of study. The LeggCalvPerthes disease is the most common form of aseptic necrosis of the femoral head in children. The necrotic lesion in the femoral head results from the blockage of the arterial blood supply to the epiphysis, leading to its infarction. Some children experience a more aggressive disease course, with signs of osteoarthritis, which can result in the early development of coxarthrosis. Numerous publications have demonstrated the successful use of bisphosphonates in adult patients with aseptic necrosis of the femoral head.
 AIM: To generalize data on the use of bisphosphonates in children with the LeggCalvPerthes disease presenting with signs of osteoarthritis through the analysis of contemporary global literature.
 MATERIALS AND METHODS: A literature search was conducted in the open databases of PubMed, Science Direct, and Google Scholar, and the analysis depth spanned 20 years. The search terms used included LeggCalvPerthes disease, aseptic (avascular) necrosis of the femoral head, and bisphosphonates. The review encompassed the literature on bisphosphonates, their biological action, effectiveness of their use in patients with aseptic necrosis of the femoral head, and results of our research.
 RESULTS: Studies on the efficacy of bisphosphonates in children with LeggCalvPerthes disease are limited. Currently, the effect of bisphosphonates on disease course and outcome is unknown. Despite this, mechanisms of chronic inflammation are increasingly mentioned in the literature, which may directly or indirectly influence the clinical course and outcome of the disease. The key is the hyperactivity of osteoclasts in osteonecrosis. The experience of using bisphosphonates in adult patients with aseptic necrosis of the femoral head had positive results in preventing the progression of the deformity of femoral head deformity.
 CONCLUSIONS: Bisphosphonates are specific inhibitors of osteoclast activity, which has been used in many diseases. The results and inferences of using bisphosphonates in children with LeggCalvPerthes disease will lead to the formulation of a new treatment algorithm.","PeriodicalId":37631,"journal":{"name":"Pediatric Traumatology, Orthopaedics and Reconstructive Surgery","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135198214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Advances in pediatric orthopedics and traumatology have certain patterns that originate in fundamental research and continue in the latest technologies. This article presents the views of the authors on the development of the most promising strategic trends in pediatric orthopedics and labels the main directions, starting from classical pediatric orthopedics and continuing with the latest achievements in pediatric neuroorthopedics and genetics. It also describes some of the advances in the treatment of genetic diseases and points to new challenges that pediatric orthopedists face in connection with the invention of life-changing methods of targeted therapy. Without claiming to be complete, the article outlines the trends for the possible joining of the efforts of scientists, practitioners, and researchers of related specialties, which will accelerate the introduction of the best practice for the current generation of pediatric traumatologists and orthopedists.
{"title":"Pediatric orthopedics and traumatology: The future begins today","authors":"Alexey G. Baindurashvili, Vladimir M. Kenis","doi":"10.17816/ptors568869","DOIUrl":"https://doi.org/10.17816/ptors568869","url":null,"abstract":"Advances in pediatric orthopedics and traumatology have certain patterns that originate in fundamental research and continue in the latest technologies. This article presents the views of the authors on the development of the most promising strategic trends in pediatric orthopedics and labels the main directions, starting from classical pediatric orthopedics and continuing with the latest achievements in pediatric neuroorthopedics and genetics. It also describes some of the advances in the treatment of genetic diseases and points to new challenges that pediatric orthopedists face in connection with the invention of life-changing methods of targeted therapy. Without claiming to be complete, the article outlines the trends for the possible joining of the efforts of scientists, practitioners, and researchers of related specialties, which will accelerate the introduction of the best practice for the current generation of pediatric traumatologists and orthopedists.","PeriodicalId":37631,"journal":{"name":"Pediatric Traumatology, Orthopaedics and Reconstructive Surgery","volume":"2016 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135198453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alina M. Khodorovskaya, Vladimir A. Novikov, Valery V. Umnov, Alexey V. Zvozil, Evgenii V. Melchenko, Dmitriy V. Umnov, Dmitriy S. Zharkov, Olga V. Barlova, Elizaveta A. Krasulnikova, Fedor A. Zakharov
BACKGROUND: Heterotopic ossification is the formation of bone tissues in the soft tissues of the body. A distinct form of heterotopic ossification is neurogenic, that is, resulting from severe injury to the brain or spinal cord of different genesis. Neurogenic heterotopic ossification is a complex multifactorial process of differentiated bone formation in the paraarticular soft tissues of large joints. Heterotopic ossification leads to the formation of persistent contractures and ankylosis, which cause severe disability and complicate rehabilitation.
AIM: To analyze publications dealing with various aspects of neurogenic heterotopic ossification.
MATERIALS AND METHODS: In the first part of our review, we present the results of the literature analysis on the epidemiology, risk factors, pathogenesis, and clinic and laboratory diagnosis of neurogenic heterotopic ossification. Scientific literature databases PubMed, Google Scholar, Cochrane Library, Crossref, and eLibrary were searched for without language limitations.
RESULTS: Current literature data on heterotopic ossification in patients with central nervous system pathologies are presented. Topical questions of etiology, risk factors, pathogenesis, and clinic and laboratory diagnostics of this pathological process are highlighted.
CONCLUSIONS: Understanding the risk factors of heterotopic ossification development and their prevention in the context of the modern knowledge of heterotopic ossification pathogenesis may help reduce the incidence of heterotopic ossification in patients with severe central nervous system injury.
{"title":"Neurogenic heterotopic ossification: A review. Part 1","authors":"Alina M. Khodorovskaya, Vladimir A. Novikov, Valery V. Umnov, Alexey V. Zvozil, Evgenii V. Melchenko, Dmitriy V. Umnov, Dmitriy S. Zharkov, Olga V. Barlova, Elizaveta A. Krasulnikova, Fedor A. Zakharov","doi":"10.17816/ptors453731","DOIUrl":"https://doi.org/10.17816/ptors453731","url":null,"abstract":"BACKGROUND: Heterotopic ossification is the formation of bone tissues in the soft tissues of the body. A distinct form of heterotopic ossification is neurogenic, that is, resulting from severe injury to the brain or spinal cord of different genesis. Neurogenic heterotopic ossification is a complex multifactorial process of differentiated bone formation in the paraarticular soft tissues of large joints. Heterotopic ossification leads to the formation of persistent contractures and ankylosis, which cause severe disability and complicate rehabilitation.
 AIM: To analyze publications dealing with various aspects of neurogenic heterotopic ossification.
 MATERIALS AND METHODS: In the first part of our review, we present the results of the literature analysis on the epidemiology, risk factors, pathogenesis, and clinic and laboratory diagnosis of neurogenic heterotopic ossification. Scientific literature databases PubMed, Google Scholar, Cochrane Library, Crossref, and eLibrary were searched for without language limitations.
 RESULTS: Current literature data on heterotopic ossification in patients with central nervous system pathologies are presented. Topical questions of etiology, risk factors, pathogenesis, and clinic and laboratory diagnostics of this pathological process are highlighted.
 CONCLUSIONS: Understanding the risk factors of heterotopic ossification development and their prevention in the context of the modern knowledge of heterotopic ossification pathogenesis may help reduce the incidence of heterotopic ossification in patients with severe central nervous system injury.","PeriodicalId":37631,"journal":{"name":"Pediatric Traumatology, Orthopaedics and Reconstructive Surgery","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135198458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Margarita V. Savina, Olga E. Agranovich, Anna A. Baindurashvili, Alina S. Farkhullina, Ekaterina V. Petrova, Evgeny D. Blagovechtchenski
BACKGROUND: Disorders of the maxillofacial region in children with аrthrogryposis multiplex congenita can be congenital or occur as secondary changes. The lower jaw and associated muscles play important roles in the functioning and development of the maxillofacial region. In children with аrthrogryposis multiplex congenita, the functional activity of the muscles of the maxillofacial region has not been studied.
AIM: To estimate the functional activity of the muscles of the maxillofacial region in children with аrthrogryposis multiplex congenita.
MATERIALS AND METHODS: Surface electromyography was used to examine the masticatory and facial muscles of 47 children aged 317 years with arthrogryposis (main group) and 20 healthy children with orthognathic bite (control group). The main and control groups were examined by a dentist and had not previously received orthodontic treatment. The bioelectric activities of the temporalis and masseter muscles on the right and left sides were simultaneously registered at rest and during functional tests (opening of the mouth, moving the lower jaw forward, jaw compression, and chewing). The average activity amplitudes were taken into account, and asymmetry coefficients were calculated. The obtained data are statistically processed.
RESULTS: Electromyography results, according to different functional tests, revealed disorders in 65%88% of children with аrthrogryposis multiplex congenita. In all samples, the tonic activity of the masticatory muscles increased at rest, the amplitude of the activity of masseter and temporalis muscles decreased, signs of an imbalance of the masticatory muscles such as the hyperactivation of the temporalis muscle compared with the masseter muscle with jaw compression and chewing were noted, and muscle asymmetry indices increased. The frequency and degree of functional muscle disorders prevailed in children with deciduous and temporary occlusion.
CONCLUSIONS: Arthrogryposis multiplex congenita in children is characterized by a high frequency of impaired functional activity of the muscles of the maxillofacial region, which can negatively affect bite formation, chewing function, and articulation.
{"title":"Functional activity of the maxillofacial region muscles in children with arthrogryposis multiple congenita","authors":"Margarita V. Savina, Olga E. Agranovich, Anna A. Baindurashvili, Alina S. Farkhullina, Ekaterina V. Petrova, Evgeny D. Blagovechtchenski","doi":"10.17816/ptors562723","DOIUrl":"https://doi.org/10.17816/ptors562723","url":null,"abstract":"BACKGROUND: Disorders of the maxillofacial region in children with аrthrogryposis multiplex congenita can be congenital or occur as secondary changes. The lower jaw and associated muscles play important roles in the functioning and development of the maxillofacial region. In children with аrthrogryposis multiplex congenita, the functional activity of the muscles of the maxillofacial region has not been studied.
 AIM: To estimate the functional activity of the muscles of the maxillofacial region in children with аrthrogryposis multiplex congenita.
 MATERIALS AND METHODS: Surface electromyography was used to examine the masticatory and facial muscles of 47 children aged 317 years with arthrogryposis (main group) and 20 healthy children with orthognathic bite (control group). The main and control groups were examined by a dentist and had not previously received orthodontic treatment. The bioelectric activities of the temporalis and masseter muscles on the right and left sides were simultaneously registered at rest and during functional tests (opening of the mouth, moving the lower jaw forward, jaw compression, and chewing). The average activity amplitudes were taken into account, and asymmetry coefficients were calculated. The obtained data are statistically processed.
 RESULTS: Electromyography results, according to different functional tests, revealed disorders in 65%88% of children with аrthrogryposis multiplex congenita. In all samples, the tonic activity of the masticatory muscles increased at rest, the amplitude of the activity of masseter and temporalis muscles decreased, signs of an imbalance of the masticatory muscles such as the hyperactivation of the temporalis muscle compared with the masseter muscle with jaw compression and chewing were noted, and muscle asymmetry indices increased. The frequency and degree of functional muscle disorders prevailed in children with deciduous and temporary occlusion.
 CONCLUSIONS: Arthrogryposis multiplex congenita in children is characterized by a high frequency of impaired functional activity of the muscles of the maxillofacial region, which can negatively affect bite formation, chewing function, and articulation.","PeriodicalId":37631,"journal":{"name":"Pediatric Traumatology, Orthopaedics and Reconstructive Surgery","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135198459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
September 29, 2023, is a significant date for Russian medicine. It is 165 years since the birth of an outstanding physician and an honored scientist of the RSFSR, Professor Henry Ivanovich Turner.
A person of high culture and a talented organizer, Professor Turner is widely known in Russia and abroad as a prominent scientist, a unique orthopedic specialist, and a brilliant public figure. His name rightfully stands among great scientists in Russian surgery and orthopedics.
Henry Turner organized and became the head of the first Russian department and clinic of orthopedics in the Military Medical Academy and initiated the foundation of the first Society of Orthopedic Surgeons in the country. He was the first in St. Petersburg to promote first aid and physical training for the military. Despite the abundance of his scientific and clinical achievements, he mainly focused on the struggles for the fate of children with musculoskeletal disorders.
{"title":"165 years since the birth of Henry Ivanovich Turner","authors":"Sergei V. Vissarionov","doi":"10.17816/ptors569250","DOIUrl":"https://doi.org/10.17816/ptors569250","url":null,"abstract":"September 29, 2023, is a significant date for Russian medicine. It is 165 years since the birth of an outstanding physician and an honored scientist of the RSFSR, Professor Henry Ivanovich Turner.
 A person of high culture and a talented organizer, Professor Turner is widely known in Russia and abroad as a prominent scientist, a unique orthopedic specialist, and a brilliant public figure. His name rightfully stands among great scientists in Russian surgery and orthopedics.
 Henry Turner organized and became the head of the first Russian department and clinic of orthopedics in the Military Medical Academy and initiated the foundation of the first Society of Orthopedic Surgeons in the country. He was the first in St. Petersburg to promote first aid and physical training for the military. Despite the abundance of his scientific and clinical achievements, he mainly focused on the struggles for the fate of children with musculoskeletal disorders.","PeriodicalId":37631,"journal":{"name":"Pediatric Traumatology, Orthopaedics and Reconstructive Surgery","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135198219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This is a commentary to the article by Wenger D.R., Mauldin D., Speck G., Morgan D., Lieber R.L. Corrective shoes and inserts as treatment for flexible flatfoot in infants and children. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2023;11(2):253264. DOI: 10.17816/PTORS321250.
{"title":"Commentary to the article by D.R. Wenger et al.: Corrective shoes and inserts as treatment for flexible flatfoot in infants and children","authors":"Vladimir M. Kenis","doi":"10.17816/ptors567901","DOIUrl":"https://doi.org/10.17816/ptors567901","url":null,"abstract":"This is a commentary to the article by Wenger D.R., Mauldin D., Speck G., Morgan D., Lieber R.L. Corrective shoes and inserts as treatment for flexible flatfoot in infants and children. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2023;11(2):253264. DOI: 10.17816/PTORS321250.","PeriodicalId":37631,"journal":{"name":"Pediatric Traumatology, Orthopaedics and Reconstructive Surgery","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135198780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: The clavicle in children is a site of multiple types of injuries, post traumatic pathology being predominant, and generally presents no diagnosis problems; in contrast non-traumatic lesions of the clavicle are rare and may pose a diagnostic and therapeutic problems for the orthopaedic surgeon.
AIM: The objective is to show that the clavicle in children can be a site of infectious, congenital and tumor lesions involving the functional and vital prognosis of the child.
MATERIALS AND METHODS: A retrospective study including 9 patients over an 9 year period from January 2013 to January 2022 was conducted. 4 boys and 5 girls were admitted in our institute with a mean age of 11.2 years (range 616 years). The right clavicle was affected in 8 patients, with no bilateral lesions.
RESULTS: There was a predominance of tumor lesions (4 benign and one malignant). Two patients had a clavicular osteomyelitis. The diagnosis of congenital pseudarthrosis of the clavicle was noted in the other two patients.
CONCLUSIONS: The aetiologies are variable, biopsy remains the key to establish the diagnosis in the majority of cases. Treatment varies according to the type of disease and may include symptomatic, expectant management, drugs therapy or surgical treatment.
{"title":"Non-traumatic pathology of the clavicle in children","authors":"Hatim Jabri, Mohammed Tazi Charki, Hicham Abdellaoui, Karima Atarraf, Moulay Abderrahmane Afifi","doi":"10.17816/ptors397487","DOIUrl":"https://doi.org/10.17816/ptors397487","url":null,"abstract":"BACKGROUND: The clavicle in children is a site of multiple types of injuries, post traumatic pathology being predominant, and generally presents no diagnosis problems; in contrast non-traumatic lesions of the clavicle are rare and may pose a diagnostic and therapeutic problems for the orthopaedic surgeon.
 AIM: The objective is to show that the clavicle in children can be a site of infectious, congenital and tumor lesions involving the functional and vital prognosis of the child.
 MATERIALS AND METHODS: A retrospective study including 9 patients over an 9 year period from January 2013 to January 2022 was conducted. 4 boys and 5 girls were admitted in our institute with a mean age of 11.2 years (range 616 years). The right clavicle was affected in 8 patients, with no bilateral lesions.
 RESULTS: There was a predominance of tumor lesions (4 benign and one malignant). Two patients had a clavicular osteomyelitis. The diagnosis of congenital pseudarthrosis of the clavicle was noted in the other two patients.
 CONCLUSIONS: The aetiologies are variable, biopsy remains the key to establish the diagnosis in the majority of cases. Treatment varies according to the type of disease and may include symptomatic, expectant management, drugs therapy or surgical treatment.","PeriodicalId":37631,"journal":{"name":"Pediatric Traumatology, Orthopaedics and Reconstructive Surgery","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135198042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: The most rare and extremely rare malformation of the upper limb is polymelia, i.e., doubling (triple) limb. In the literature, no more than 20 cases of an increase in the number of lower limbs and only three cases of doubling (triple) of the upper limb (in humans) have been described.
CLINICAL CASE: A 2-year-old child diagnosed with polymelia of the right upper limb was examined and treated at our clinic. Clinical examination revealed two shoulder blades and one clavicle, with a normal anatomical location and development. Behind, an upper limb ended with the stump of the forearm, represented by an underdeveloped ulna. Moreover, the elbow joint was in a state of flexion contracture at an angle of 170, and the ulna was turned posteriorly and 1520 medially. The anterior humerus in the proximal section was underdeveloped, and in the distal section, it articulated in a normally formed elbow joint with the radius and ulna. The hand had five fingers with moderate underdevelopment and deformity of the 5th finger. After examining the bone, muscle, and vascular anatomy of the doubled limb, surgery was performed; as a result, a nearly complete anatomical and functional limb was reconstructed from the two segments of one upper limb.
DISCUSSION: Polymelia is an extremely rare variant of a congenital anomaly of the limbs; thus, only a few cases are reported in the literature, which differs significantly from each other in clinical manifestations. Many questions related to the etiology and pathogenesis of these malformations are unexplored. The doubling of the limbs in animals is caused by both teratogenic environmental factors and genetic mutations. In any case, reconstructive surgery makes it possible to effectively treat children with such anomalies in the development of the limbs and obtain good results.
CONCLUSIONS: The restoration of the upper limb of children with polymelia is quite difficult, but doable. Adequate analysis of all examination data and rational planning of surgical intervention in such cases creates conditions that enable achieving the maximum anatomical and functional results of upper limb reconstruction in children with this developmental anomaly.
{"title":"Polymelia of the upper limb","authors":"Sergey I. Golyana","doi":"10.17816/ptors492255","DOIUrl":"https://doi.org/10.17816/ptors492255","url":null,"abstract":"BACKGROUND: The most rare and extremely rare malformation of the upper limb is polymelia, i.e., doubling (triple) limb. In the literature, no more than 20 cases of an increase in the number of lower limbs and only three cases of doubling (triple) of the upper limb (in humans) have been described.
 CLINICAL CASE: A 2-year-old child diagnosed with polymelia of the right upper limb was examined and treated at our clinic. Clinical examination revealed two shoulder blades and one clavicle, with a normal anatomical location and development. Behind, an upper limb ended with the stump of the forearm, represented by an underdeveloped ulna. Moreover, the elbow joint was in a state of flexion contracture at an angle of 170, and the ulna was turned posteriorly and 1520 medially. The anterior humerus in the proximal section was underdeveloped, and in the distal section, it articulated in a normally formed elbow joint with the radius and ulna. The hand had five fingers with moderate underdevelopment and deformity of the 5th finger. After examining the bone, muscle, and vascular anatomy of the doubled limb, surgery was performed; as a result, a nearly complete anatomical and functional limb was reconstructed from the two segments of one upper limb.
 DISCUSSION: Polymelia is an extremely rare variant of a congenital anomaly of the limbs; thus, only a few cases are reported in the literature, which differs significantly from each other in clinical manifestations. Many questions related to the etiology and pathogenesis of these malformations are unexplored. The doubling of the limbs in animals is caused by both teratogenic environmental factors and genetic mutations. In any case, reconstructive surgery makes it possible to effectively treat children with such anomalies in the development of the limbs and obtain good results.
 CONCLUSIONS: The restoration of the upper limb of children with polymelia is quite difficult, but doable. Adequate analysis of all examination data and rational planning of surgical intervention in such cases creates conditions that enable achieving the maximum anatomical and functional results of upper limb reconstruction in children with this developmental anomaly.","PeriodicalId":37631,"journal":{"name":"Pediatric Traumatology, Orthopaedics and Reconstructive Surgery","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135198773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
On August 14, at the 76th year of life, after a short illness, Sergei Pavlovich Mironov, an outstanding scientist, an excellent organizer, a great clinician, an erudite teacher, a remarkable public figure, doctor of medical sciences, professor, and academician of the Russian Academy of Sciences, passed away suddenly. Domestic healthcare suffered an irreparable loss.
{"title":"Sergei Pavlovich Mironov (1948–2023)","authors":"","doi":"10.17816/ptors568870","DOIUrl":"https://doi.org/10.17816/ptors568870","url":null,"abstract":"On August 14, at the 76th year of life, after a short illness, Sergei Pavlovich Mironov, an outstanding scientist, an excellent organizer, a great clinician, an erudite teacher, a remarkable public figure, doctor of medical sciences, professor, and academician of the Russian Academy of Sciences, passed away suddenly. Domestic healthcare suffered an irreparable loss.","PeriodicalId":37631,"journal":{"name":"Pediatric Traumatology, Orthopaedics and Reconstructive Surgery","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135198779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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