Pediatric Traumatology, Orthopaedics and Reconstructive Surgery
type: channel
description: ISSN (print): 2309-3994, ISSN (online): 2410-8731 Founders: H.Turner Scientific Research Institute for Children's Orthopedics , Eco-Vector Editor-in-Chief: Baindurashvili A.G., academican of RAS, Doctor of Sc., Full Professor Frequency / Assess: 4 issues per year / Subscription Included in: White List (3rd level), Higher Attestation Commission List, RISC, Scopus, Embase
publisher: Eco-Vector
language: ru-RU
publication name: Pediatric Traumatology, Orthopaedics and Reconstructive Surgery
issn: 2309-3994
copyright: Authors who publish with this journal agree to the following terms: Authors retain copyright and grant the journal exclusive license to first publication. Authors are able to distribute the manuscript and/or the article in accordance with Self-Archiving policy of the journal (see details). The manuscript can be accepted for publication only by decision of the Editor-in-Chief and the Editorial board of the journal in accordance with the Manuscript stelection policy of the journal (see details). Published Article will be distributed in print and electronic version an will be available under subscription with Delayed Open Access or in Immediate Open Access under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). The access model depends on the publisher's decision or is determined by a separate Open Access publishing agreement with the authors. An exclusive license for publication granted by authors allows the publisher to use the article in the following ways: Reproduction of the Article or its sections or parts, as well as the metadata of the Article in any languages, in any material form, including on paper and electronic media, as a separate work in the journal and/or databases (local or in the Internet) of the publisher and/or other persons, at the discretion of the publisher; Distribution of the Article or its sections or parts, as well as the metadata of the Article in any languages, on any medium as part of the journal and/or databases of the publisher or other persons, at the discretion of the publisher, or as an independent work around the world whether on Open-Access terms or for a fee without remuneration to the Author; Making the Article or any of its sections or parts, as well as the Article’s metadata in any languages, publicly available in such a way that any person can access the Article from any place, including via the Internet, and at any time of their own choosing; Granting permission/s for the…
items: A Photometric Method for Measuring Ankle Dorsiflexion Reproducibility in Young Athletes
items: Surgical treatment of knee flexion contracture in patients with cerebral palsy: a review
items: Prevalence of Musculoskeletal Diseases Among Children in Saint Petersburg, Russia
items: Ischemic stroke of the cervical spinal cord: a review and case report
items: Enchondromas of the hand in children: current concepts in etiopathogenesis, diagnosis, and treatment: a review
items: Eduard V. Ulrikh (1937–2025)
items: Clinical and MRI features of patellar instability in children
items: Assessment of sagittal balance parameters in adolescents with severe thoracic idiopathic scoliosis
items: Transitional lumbosacral vertebrae in children with pelvic fractures: frequency of diagnosis and distribution of types and subtypes
items: Stress fractures in upper extremities of athletes: a review
items: Assessment of amplitude-frequency characteristics of postural sway at the pressure centers of the contralateral lower limbs of young athletes
items: Comparative analysis of arthroscopic techniques for fixation of tibial intercondylar eminence avulsion fractures in children
items: Idiopathic avascular necrosis of the femoral head in young rhythmic gymnasts: a clinical and radiological assessment
items: https://bakhtiniada.ru/turner/article/view/312529
items: Inversion injury of ankle joint and foot in children: association with sports participation and comorbidities (analysis based on medical information system data)
items: Alla Vladimirovna Ovechkina
items: Differentiated stabilometric assessment of postural control in nonathlete children and comparison with young athletes
items: Patient-specific 3D template with radiopaque markers for pediatric pedicle screw fixation: comparison with freehand technique
items: Hip arthroplasty for bilateral pathologic hip dislocation in children
items: Surgical treatment of severe pectus excavatum in an adolescent: a case report
items: Combined reconstruction of femoral condylar osteochondral defects in adolescents: clinical cases and a review
items: Role of genetic determinants in the development of congenital scoliosis: a review
items: Hallux valgus in equino-planovalgus foot deformity in children with cerebral palsy and its etiopathogenesis: a review (part 1)
items: Use of autologous mesenchymal stem cells derived from adipose tissue for the treatment of hyaline cartilage defects in laboratory animals: a literature review
items: Innervation of bones. Sensory innervation. Part I: a literature review
items: Ultrasound evaluation of the tibial graft structure during fixation with the Ilizarov device in patients with achondroplasia
items: Transient brachial plexopathy in adults and children: a literature review
items: Additive technologies in surgical treatment of congenital spinal deformities in children: a literature review
items: Elbow fracture sequelae in children
items: Results of foot assessment in healthy preschool children: visual assessment, FPI-6, dorsiflexion: a population study
items: Anatomy and biomechanics of posterolateral angle structures of the knee joint
items: Effects of a long-term triceps surae stretching program on the pennation angle of triceps surae heads in children with hypermobile flat foot and Achilles tendon shortening
items: Potential use of bisphosphonates in children with Legg–Calvé–Perthes disease with signs of osteoarthritis. Interim results from a single-center study
items: Evaluation of the efficacy of a novel customized guide with visual control function in children with congenital spinal deformity
items: Analysis of vertebrotomy treatment in children with congenital scoliosis with unsegmented rod and rib synostosis
items: Efficiency of the decision support system for determining the severity of scoliotic spinal deformity by the analysis of radiographs
items: Slipped capital femoral epiphysis in children engaged in sports
items: Features of vertical body balance in children with asymmetric pectus excavatum before and after surgical correction
items: Usefulness and accessibility of information on the treatment of children with congenital clubfoot: results of a survey of parents
items: Efficacy of a new customized navigation template for placement of transpedicular screws for unilateral access in children with congenital spinal deformity and thoracic malformation
items: Amplified pain and complex regional pain syndrome in children: clinical cases and literature review
items: Features of the state of bone tissue in children with cerebral palsy. Part 1. Etiological aspects. A literature review
items: Experimental burn models for evaluating wound healing agents and its current situation and existing disadvantages: a literature review
items: Impact of pectus excavatum deformity on the cardiopulmonary function: a literature review
items: Valentin A. Neverov
items: Prognostic efficiency of diagnostic blockade as a method of modeling the result of selective neurotomy of the motor branches of the median nerve in patients with cerebral palsy
items: Musculoskeletal injuries and pain in children involved in sports: A literature review
items: Advantages of using template guides in children for the correction of congenital spinal deformities and thoracic anomalies
items: Clinical and radiological variants of the nail–patella syndrome: Why is it important to make a correct diagnosis?
items: Dynamics of feet dorsiflexion after percutaneous Achilles lengthening for correction of flat feet in children

A Photometric Method for Measuring Ankle Dorsiflexion Reproducibility in Young Athletes
type: item
description: BACKGROUND: Ankle dorsiflexion is one of the most important biomechanical indicators of the potential functional capacity of the foot. Its quantitative assessment is crucial in clinical evaluation, and in determining children’s readiness for sports and their potential risk of sports-related injuries. AIM: This study aimed to evaluate the reproducibility of a photometric method for measuring ankle dorsiflexion angles in young athletes in relation to the conventional goniometric method. METHODS: This study included 30 children aged 6–12 years who participated in regular sports activities and had not been diagnosed with orthopedic disorders. Dorsiflexion was measured by two independent specialists using goniometry and photometry based on anatomical landmarks. Inter-rater reliability was assessed using the intraclass correlation coefficient (ICC). The agreement between the methods was analyzed using Bland–Altman plots. RESULTS: There were statistically significant differences (t-test: p = 0.04) in mean dorsiflexion angles between the goniometry measurement (17.15°) and the photometry measurement (18.1°). Photometry-based measurements exhibited higher inter-rater reliability (ICC = 0.91) than goniometry-based measurements (ICC = 0.78). CONCLUSION: These findings indicate that the photometric method of measuring ankle dorsiflexion in children is a reliable and reproducible tool that can be recommended for practical use and monitoring for physically active children.
creator: Leonid V. Gorobets
creator: Andrey V. Sapogovskiy
creator: Evgenii V. Melchenko
creator: Aleksandr N. Kasev
creator: Vladimir M. Kenis
rights: Copyright (c) 2025 Эко-Вектор
date: 2025-06-25
publication date: 2025-06-25
volume: 13
number: 2
starting page: 154
ending page: 160
doi: 10.17816/PTORS680803

Surgical treatment of knee flexion contracture in patients with cerebral palsy: a review
type: item
description: Knee flexion contracture is the most common lower limb deformity among patients with cerebral palsy, with a prevalence of 47%–53%. Its prolonged persistence leads to marked functional impairments, such as increased energy expenditure during walking and decreased motor activity in children, and the emergence of secondary orthopedic complications, which significantly affects patients’ quality of life. This review analyzed published scientific data on current surgical methods for the correction of knee flexion contracture in patients with cerebral palsy, evaluating their clinical effectiveness, determining frequency of complications, and identifying factors influencing the choice of optimal treatment strategy. The studies were determined using PubMed, Google Scholar, Cochrane Library, Crossref, and eLibrary. The search was conducted without language restrictions, covering the period from 1952 to 2024. Seventy-four sources were reviewed, including original articles and systematic reviews on surgical treatment of knee flexion contracture in patients with cerebral palsy. The primary surgical correction methods for knee flexion contracture in children with cerebral palsy are hamstring lengthening and distal femoral extension supracondylar osteotomy. Hamstring lengthening is considered the main surgical procedure and most appropriate option for patients of all age groups. Notably, femoral osteotomy has shown high clinical effectiveness in older patients, particularly in those with marked distal femoral deformities. Both methods yield favorable outcomes, but may be associated with certain complications. Furthermore, this review discusses alternative techniques, including tendon transfers and temporary hemiepiphysiodesis, and combined approaches. The conducted scientific data review confirmed the effectiveness of surgical treatment of knee flexion contracture in patients with cerebral palsy. However, in selecting a particular surgical procedure, individual anatomical and clin…
creator: Alina R. Mustafaeva
creator: Vladimir А. Novikov
creator: Valery V. Umnov
creator: Sergei V. Vissarionov
rights: Copyright (c) 2025 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0
license: https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2025-06-25
publication date: 2025-06-25
volume: 13
number: 2
starting page: 202
ending page: 214
doi: 10.17816/PTORS678129

Prevalence of Musculoskeletal Diseases Among Children in Saint Petersburg, Russia
type: item
description: BACKGROUND: Most musculoskeletal diseases are diagnosed in childhood, allowing for the prevention of chronic progression and subsequent disability in adulthood. In recent years, monitoring pediatric morbidity has gained increasing scientific and practical importance, leading to the reassessment of key organizational strategies. AIM: This study aimed to conduct a comparative analysis of the overall morbidity of musculoskeletal and connective tissue diseases among children in Saint Petersburg from 2017 to 2023. METHODS: Based on official statistical reports from 2017 to 2023, the prevalence of musculoskeletal and connective tissue diseases among children aged 0–14 years and adolescents aged 15–17 years in Saint Petersburg was compared with national averages in Russia. Morbidity trends were analyzed per 1,000 of the respective pediatric population. The analysis was carried out using a quantitative assessment of the odds ratio for the occurrence of musculoskeletal conditions, overall and by individual disease forms, as presented in the statistical bulletins. Statistical significance was inferred when the 95% confidence interval for the odds ratio did not include 1 (p < 0.05). Data analysis was performed using Microsoft Office 2010 (Word and Excel). RESULTS: The prevalence of musculoskeletal and connective tissue disorders among children in Saint Petersburg was extremely high, showing an upward trend and a widening gap compared with the national average in Russia. During the COVID-19 pandemic, the growth rates of most disease categories outpaced those of the preceding period. Among children aged 0–14 years in Saint Petersburg, the odds ratio showed an increase for reactive arthropathies (by 23.6%), deforming dorsopathies (by 27.4%), and other musculoskeletal conditions (by 23.0%). Among adolescents, increased odds were observed for juvenile arthritis (7.9%), arthropathies overall (13.3%), deforming dorsopathies (15.5%), and other disorders (22.7%). In contrast, both age …
creator: Dmitriy N. Kokushin
creator: Vera V. Sokolova
creator: Anna V. Zaletina
creator: Vadim V. Kirilenko
creator: Lyubov L. Sharafutdinova
creator: Natalya A. Guryevа
rights: Copyright (c) 2025 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0
license: https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2025-06-24
publication date: 2025-06-24
volume: 13
number: 2
starting page: 161
ending page: 171
doi: 10.17816/PTORS678341

Ischemic stroke of the cervical spinal cord: a review and case report
type: item
description: BACKGROUND: Ischemic spinal cord stroke is a rare condition, accounting for approximately 1% of all spinal cord strokes. The relevance of this publication is determined by the rarity of the condition, the complexity of differential diagnosis with other acute onset myelopathic syndromes, the severity of spinal stroke outcomes, and insufficient awareness among physicians regarding this condition in children. CASE DESCRIPTION: We present a clinical case of acute myelopathic syndrome in an 8-year-old child. Magnetic resonance imaging of the cervical spinal cord correlated with the clinical findings and indicated impaired circulation in anterior spinal artery at the cervical spinal level. DISCUSSION: Acute impairment of spinal cord circulation may be caused by systemic hypotension; occlusion of spinal cord-supplying vessels (traumatic, iatrogenic, thrombotic, or embolic); arterial dissection; arteriovenous malformations and fistulas; or hypercoagulable states. CONCLUSION: In pediatric patients presenting with acute myelopathic syndrome, ischemic stroke of the spinal cord should be considered in the differential diagnosis alongside inflammatory and infectious conditions, particularly in children with significant risk factors. Early recognition of acute impairment of spinal cord circulation is particularly important for timely neuroimaging, consultations with related specialists, and initiating etiotropic or symptomatic treatment upon identification of the underlying cause of acute spinal cord ischemia, as well as early rehabilitation.
creator: Alina M. Khodorovskaya
creator: Olga E. Agranovich
creator: Margarita V. Savina
creator: Ekaterina V. Petrova
creator: Sergey F. Batkin
creator: Anna D. Dreval
creator: Daniil B. Vcherashniy
rights: Copyright (c) 2025 Eco-Vector
date: 2025-06-24
publication date: 2025-06-24
volume: 13
number: 2
starting page: 182
ending page: 191
doi: 10.17816/PTORS658670

Enchondromas of the hand in children: current concepts in etiopathogenesis, diagnosis, and treatment: a review
type: item
description: The prevalence of benign bone tumors among pediatric patients highlights the relevance of such investigations for orthopedic practice. This article focuses on hand enchondromas in children. Despite the relative frequency of this condition, the lack of clinical guidelines for this disease area underscores the relevance of the publication. A total of 69 full-text articles were selected from 387 sources identified through searches in CyberLeninka, eLibrary, PubMed, and Scopus from 1990 to 2023. This review presents current views on the etiopathogenesis, diagnostic and therapeutic challenges, and prognosis of hand enchondromas in children. Radiography and computed tomography are the primary diagnostic methods for hand enchondromas. Histological verification of diagnosis is mandatory. Particular attention should be given to surgical treatment strategies, including the optimal timing and extent of intervention, selection of grafting material, risk factors, and frequency of recurrence. The scientific data analysis enabled the systematization of data on the etiopathogenesis of hand enchondromas, identification of diagnostic priorities, clarification of diagnostic and differential diagnostic criteria, and refinement of approaches to treatment strategy and methods. The choice of treatment strategy, including the method and timing of intervention, should be individualized, taking into account tumor localization and histogenesis, as well as any additional diagnostic findings and the risk of complications. In recent years, specialists have tended to favor early surgical intervention over wait-and-see approaches, with the choice between autograft and allograft being determined by the clinical context. Autografts are considered the gold standard; however, the use of allografts for restoring the structural and functional integrity of bone in cases of injury is a reasonable and well-substantiated alternative, even in the light of the high risks of donor site morbidity. Such decision…
creator: Lilia A. Cherdantseva
creator: Maria V. Duginova
creator: Elena V. Gubina
creator: Irina A. Kirilova
rights: Copyright (c) 2025 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0
license: https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2025-06-24
publication date: 2025-06-24
volume: 13
number: 2
starting page: 192
ending page: 201
doi: 10.17816/PTORS676913

Eduard V. Ulrikh (1937–2025)
type: item
description: On June 2, 2025, the outstanding pediatric surgeon—one of the founders of Russian spinal surgery and the founder of the Saint Petersburg school of pediatric vertebral surgeons—Professor Eduard V. Ulrikh, Doctor of Medical Sciences, passed away suddenly. He was 87 years old—only 87, because his sharp and lucid mind, firm handshake, brilliant erudition, unwavering will, remarkable capacity for work, selfless dedication to his profession, and keen intuition for identifying cutting-edge trends in spinal surgery remained unaffected by age.
creator: Aleksandr Yu. Mushkin
creator: Alexandr V. Gubin
creator: Sergey O. Ryabykh
rights: Copyright (c) 2025 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0
license: https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2025-06-24
publication date: 2025-06-24
volume: 13
number: 2
starting page: 227
ending page: 229
doi: 10.17816/PTORS682870

Clinical and MRI features of patellar instability in children
type: item
description: BACKGROUND: Patellar instability refers to recurrent dislocations and subluxations of the patella relative to the femoral trochlear groove. This condition is one of the most common disorders of the knee joint in pediatric patients. Both bone and soft tissue structures act as stabilizers of the patella, and alterations in any of these components may contribute to patella instability. Magnetic resonance imaging (MRI) findings related to the osteochondral and soft tissue structures of the patellofemoral joint in children with patellar instability, as well as their correlation with clinical presentation, are of practical interest. AIM: This study aimed to assess the key MRI features of the patellofemoral joint zone in pediatric patients with patellar instability and evaluate their clinical manifestations. METHODS: Epidemiological, clinical, and MRI data were analyzed for patients with patellar instability and anterior cruciate ligament injury. The study included 52 patients in the main group and 44 patients in the comparison group with anterior cruciate ligament injury. No statistically significant differences in age distribution were observed. RESULTS: Significant differences were identified between the groups in terms of Wiberg patellar type, presence of a patellar apprehension sign, and patellar hypermobility. Differences were also noted in the lateral inclination and depth of the trochlear groove, as well as in the frequency of clinical signs such as patellar apprehension and patellar hypermobility (p < 0.001). CONCLUSION: Trochlear dysplasia is a key predisposing factor for the development of patellar instability in pediatric patients. This study confirmed statistically significant differences in the parameters characterizing trochlear dysplasia, as well as the influence of this factor on patellar instability in children, including its correlation with clinical manifestations.
creator: Sergey A. Lukyanov
creator: Vyacheslav I. Zorin
rights: Copyright (c) 2025 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0
license: https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2025-06-23
publication date: 2025-06-23
volume: 13
number: 2
starting page: 145
ending page: 153
doi: 10.17816/PTORS678328

Assessment of sagittal balance parameters in adolescents with severe thoracic idiopathic scoliosis
type: item
description: BACKGROUND: In recent years, the concept of sagittal balance has become increasingly important in the treatment of spinal deformities of various etiologies. However, the number of studies analyzing sagittal balance parameters in patients with idiopathic scoliosis is limited, especially those involving individuals with severe deformities. AIM: This study aimed to evaluate global and regional sagittal balance parameters in adolescents with severe thoracic idiopathic scoliosis. METHODS: The study included 45 patients aged 12–17 years diagnosed with thoracic idiopathic scoliosis (Lenke types 1, 2, and 3), presenting with a primary curve magnitude ranging from 80° to 150°, according to the Cobb method. Radiographic examinations were performed to assess both regional and global sagittal balance parameters, as well as characteristics of frontal plane spinal deformity. The patients were divided into two groups based on the global sagittal balance values. Descriptive, correlation, regression, and comparative statistical analyses of the data were conducted. RESULTS: A positive correlation was observed between the magnitude of frontal plane spinal deformity and thoracic kyphosis values. The regression analysis indicated that when the primary curve exceeded approximately 100°, thoracic kyphosis values tended to rise above 60°. Thoracic hyperkyphosis was the predominant sagittal deformity in these patients; however, neither thoracic kyphosis nor the primary curve magnitude in the frontal plane showed statistically significant correlation with any of the global sagittal balance indicators. These indicators correlated more strongly with spinopelvic parameters (pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), and PI–LL). CONCLUSION: Surgical treatment of severe idiopathic scoliosis should obligatorily consider correction methods that produce a corrective effect on the kyphotic component of the deformity. The development of pronounced anterior imbala…
creator: Sergei V. Vissarionov
creator: Timofey S. Rybinskikh
creator: Marat S. Asadulaev
creator: Dmitriy N. Kokushin
creator: Sergei M. Belyanchikov
creator: Vakhtang G. Toria
rights: Copyright (c) 2025 Эко-Вектор
date: 2025-06-23
publication date: 2025-06-23
volume: 13
number: 2
starting page: 128
ending page: 137
doi: 10.17816/PTORS678872

Transitional lumbosacral vertebrae in children with pelvic fractures: frequency of diagnosis and distribution of types and subtypes
type: item
description: BACKGROUND: Various aspects of transitional lumbosacral vertebrae in children remain relevant due to a lack of research on several critical issues. For instance, the frequency of diagnosis and the distribution of different types and subtypes of this condition in the pediatric population remain unknown. The clinical features, particularly pain as the main symptom, have not been sufficiently studied. Furthermore, effective and pathogenetically based approaches to the treatment and prevention of low back pain associated with transitional lumbosacral vertebrae in different pediatric groups have not yet been developed. AIM: The study aimed to determine the prevalence and structure of transitional lumbosacral vertebrae in children with pelvic fractures. METHODS: This study included 41 children who sustained pelvic fractures between 2022 and 2024, with transitional lumbosacral vertebrae in 10 patients. The diagnostic protocol adhered to the standard for patients with pediatric trauma and included mandatory computed tomography of the lumbar spine and pelvis. Pelvic fractures were classified according to the Tile/AO classification system. Acetabular fractures were assessed using the classification criteria proposed by Judet et al. Transitional lumbosacral vertebrae types and subtypes were categorized based on the Castellvi classification. RESULTS: The diagnostic frequency of transitional lumbosacral vertebrae was found to be 24.4% ± 6.7% of clinical cases. Subtype IIa was the most common, accounting for 50.0% ± 15.8% of cases, followed by subtype IIIb, which occurred in 30.0% ± 14.5% of patients. Subtypes Ia and IIb each represented 10.0% ± 9.4% of the observed cases. The study revealed that, unlike in adult patients, a distinguishing feature of the condition in children was the absence of the main symptom, namely, pain in the lumbosacral junction. CONCLUSION: The high diagnostic frequency of this condition, which often remains latent for some time, highlights the importance…
creator: Evgeni G. Skryabin
creator: Alexey Yu. Krivtsov
rights: Copyright (c) 2025 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0
license: https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2025-06-19
publication date: 2025-06-19
volume: 13
number: 2
starting page: 138
ending page: 144
doi: 10.17816/PTORS678050

Stress fractures in upper extremities of athletes: a review
type: item
description: Stress (overuse) fractures of the upper extremities are a relatively uncommon condition typically observed in athletes. Due to their gradual onset, typically mild clinical symptoms, and sometimes unremarkable imaging findings, such injuries are frequently overlooked. The article aims to present data on the pathogenesis, clinical presentation, diagnostics, and treatment strategies of COVID-19. A scientific data search was conducted in the PubMed (MEDLINE) database and via the Google search engine from 1975 to 2024 using combinations of the operators OR and the following keywords: стрессовые переломы (stress fractures), нагрузочные переломы (overuse fractures), верхние конечности (upper extremities), and спортсмены (athletes). A total of 70 sources were selected, including 22 published within the past decade. Stress (overuse) fractures are reported in approximately 40% of athletes, with 80%–95% occurring in the lower extremities and only 5%–20% occurring in the upper extremities. Stress fractures result from repetitive mechanical loading of the bone and are compounded by fatigue of the surrounding muscles, leading to an increase in the rate of bone resorption by osteoclasts to exceed the rate of new bone formation by osteoblasts. Magnetic resonance imaging is the primary diagnostic modality. In most cases, bone healing occurs with load restriction and activity modification (avoidance of repetitive trauma-inducing movements). Surgical intervention is often required in stage III gymnast wrist fractures, avulsion fractures of the medial epicondyle with displacement ≥10 mm, complete or partial tears of the ulnar collateral ligament of the elbow, olecranon fractures, and carpal bone fractures. Although relatively rare, upper extremity stress fractures can cause significant problems and hinder athletic progression. A thorough medical history, physical examination, and analysis of the mechanism of injury will allow clinicians to raise suspicion of this condition. Load restri…
creator: Olga E. Agranovich
creator: Sergei V. Vissarionov
creator: Ekaterina V. Petrova
creator: Svetlana I. Trofimova
creator: Andrey V. Sapogovskiy
creator: Alina M. Khodorovskaya
creator: Evgeny D. Blagovechtchenski
rights: Copyright (c) 2025 Эко-Вектор
date: 2025-06-19
publication date: 2025-06-19
volume: 13
number: 2
starting page: 215
ending page: 226
doi: 10.17816/PTORS676981

Assessment of amplitude-frequency characteristics of postural sway at the pressure centers of the contralateral lower limbs of young athletes
type: item
description: BACKGROUND: The development of instrument-based methods for the functional diagnostics of adaptive body changes in children engaged in sports activities is a currently relevant area of research. AIM: This work examined the amplitude characteristics of postural sway at the pressure centers of the contralateral lower limbs in young athletes in motionless standing positions across a frequency range. METHODS: Amplitude-frequency characteristics were analyzed during motionless standing in 18 children aged 7–10 years, of both sexes, who regularly participated in track and field. The postural sway parameters of the pressure centers under both feet were recorded using two stabilometric platforms. Measurements were collected in the low-frequency range (up to 1.0 Hz) for 20 seconds and the high-frequency range (1.0–6.0 Hz) for 1 second. The deviation angle α (°) of the sway axis of the lower limbs from the midline axis was determined. The first peak amplitudes and frequencies of sway were measured: а1, а2, and а3 (mm) and f1, f2, and f3 (Hz) in the low-frequency range, respectively; and А1, А2, and А3 (mm) and F1, F2, and F3 (Hz) in the high-frequency range. The control group comprised 18 children with typical daily physical activity levels. RESULTS: In young athletes, more favorable amplitude-frequency characteristics of postural sway at the low- and high-frequency ranges were identified compared with age-matched peers not engaged in sports and leading sedentary lifestyles. This effect was manifested by a frequency shift in sway, a reduction in all peak sway amplitudes at both the low- and high-frequency ranges, lower asymmetry of sway amplitudes, and the stable synchronization of pressure center oscillations across the entire frequency spectrum. CONCLUSION: Amplitude-frequency parameters of postural sway at the pressure centers of the contralateral lower limbs should be considered while training younger school-aged children for sports to prevent neuromuscular imbalance due …
creator: Igor E. Nikityuk
rights: Copyright (c) 2025 Eco-Vector
date: 2025-06-19
publication date: 2025-06-19
volume: 13
number: 2
starting page: 172
ending page: 181
doi: 10.17816/PTORS677678

Comparative analysis of arthroscopic techniques for fixation of tibial intercondylar eminence avulsion fractures in children
type: item
description: BACKGROUND: Avulsion fracture of the tibial intercondylar eminence is a rare injury, which commonly occurs in adolescents aged 8–14 years, and may result in disability caused by improper bone union. Several surgical techniques for the treatment of patients with such fractures have been developed, involving various methods of fixation for the avulsed fragment of the tibial intercondylar eminence. AIM: To evaluate the effectiveness of the novel technique for the treatment of type III tibial intercondylar eminence avulsion fractures according to the Meyers–McKeever–Zariczny classification in children with open growth plates and compare its outcomes to those of arthroscopically assisted reduction and fixation of the avulsed fragment using a Herbert screw. METHODS: Functional outcomes in 45 children aged 14–17 years with tibial intercondylar eminence fractures were analyzed at 3, 6, and 12 months after surgery. Group A included 22 children who underwent arthroscopic fixation with a Herbert screw. Group B comprised 23 children who underwent arthroscopic fixation using a self-tightening suture loop following the novel method. RESULTS: Group B demonstrated better anteroposterior and rotational stability of the knee than group A. Postoperative functional assessment scores (IKDC 2000, Lysholm Knee Scoring Scale, and Tegner Activity Scale) were significantly better in group B than in group A (p = 0.00006). In group A, postoperative complications were observed in 18.1% of cases (p ≤ 0.05), including screw fracture (4.5%) and aseptic synovitis due to a foreign body reaction (13.6%). No postoperative complications were noted in group B (p < 0.05). CONCLUSION: The proposed technique for treating tibial intercondylar eminence avulsion fractures in children with open growth plates is more reliable and safer compared with Herbert screw fixation and may be recommended for clinical practice.
creator: Marsel R. Salikhov
creator: Vladislav V. Avramenko
creator: Gleb E. Batalov
creator: Vadim V. Kemkin
rights: Copyright (c) 2025 Eco-Vector
date: 2025-04-18
publication date: 2025-04-18
volume: 13
number: 2
starting page: 26
ending page: 37
doi: 10.17816/PTORS646266

Idiopathic avascular necrosis of the femoral head in young rhythmic gymnasts: a clinical and radiological assessment
type: item
description: BACKGROUND: Osteonecrosis of the femoral head is a severe and rapidly progressive degenerative-dystrophic disorder and is commonly detected in children professionally engaged in rhythmic gymnastics. It is characterized by destructive changes in the femoral head, resulting in hip joint function impairment and, consequently, poor clinical outcomes. The radiographic anatomy of the hip joints is insufficiently studied, especially considering the impact of intense and specific physical loads, course and progression of the disease, and reasons behind its delayed diagnosis and late initiation of treatment. AIM: To provide a clinical and radiological characterization of the hip joints in young rhythmic gymnasts diagnosed with idiopathic avascular necrosis of the femoral head and identify factors contributing to delayed diagnosis and late treatment initiation. METHODS: Medical histories and imaging findings of 45 young rhythmic gymnasts aged 12–17 years diagnosed with idiopathic avascular necrosis of the femoral head were analyzed. RESULTS: Most patients exhibited a severe clinical course due to total or subtotal involvement of the femoral head. Distinctive anatomical features of the hip joint in young rhythmic gymnasts included dysplastic morphology with impaired stability indices, valgus epiphyseal formation resembling a Kalamchi type II deformity, and a tendency toward acetabular retroversion. These characteristics contributed to the development of pathological changes, such as femoral head extrusion and deformation. Delayed diagnosis and initiation of treatment was due to insufficient awareness of this pathology among parents, coaches, and physicians; gradual development of clinical symptoms without a history of overt trauma; and diagnostic errors during the early stages of the disease. CONCLUSION: In adolescents, their congenital anatomical features of the hip joint contribute to a more severe course of avascular necrosis of the femoral head. Early differential diagnosi…
creator: Ivan Y. Pozdnikin
creator: Pavel I. Bortulev
creator: Dmitrii B. Barsukov
creator: Tatiana V. Murashko
rights: Copyright (c) 2025 Eco-Vector
date: 2025-04-18
publication date: 2025-04-18
volume: 13
number: 2
starting page: 14
ending page: 25
doi: 10.17816/PTORS646480

https://bakhtiniada.ru/turner/article/view/312529
type: item
title: Diagnostic value of synovial calprotectin (S100A8/A9) in differential diagnosis of juvenile idiopathic arthritis and pigmented villonodular synovitis in children: preliminary results of a single-center study
description: BACKGROUND: Juvenile idiopathic arthritis is the most common chronic inflammatory musculoskeletal disease in children. Its most prevalent clinical subtype is oligoarthritis. Pigmented villonodular synovitis, also known as tenosynovial giant cell tumor, is a rare benign synovial disorder, which may clinically resemble oligoarthritis. Differential diagnosis between juvenile idiopathic arthritis and pigmented villonodular synovitis is challenging. Intra-articular steroids used in juvenile idiopathic arthritis therapy may induce negative effects in patients with pigmented villonodular synovitis. Orthopedic and surgical procedures used to rule out pigmented villonodular synovitis are burdensome for children. Magnetic resonance imaging may yield similar findings for both conditions at early stages. Several studies revealed that serum calprotectin is a promising biomarker for juvenile idiopathic arthritis. AIM: To assess synovial fluid calprotectin concentrations in children with oligoarthritis and pigmented villonodular synovitis. METHODS: The synovial fluid concentrations of calprotectin, interleukin-6, and tumor necrosis factor-alpha in 42 children with oligoarthritis and 12 children with diffuse pigmented villonodular synovitis of the knee joint were obtained by enzyme-linked immunosorbent assay. In patients with juvenile idiopathic arthritis, cytokine levels were determined at disease onset, and prior to therapeutic and diagnostic arthroscopy in those with pigmented villonodular synovitis. RESULTS: Synovial calprotectin significantly increased in children with oligoarthritis (108 [28.2; 237] μg/mL) compared to those with pigmented villonodular synovitis (1.53 [1.26; 1.69] μg/mL; p < 0.001). No statistically significant differences were found in synovial tumor necrosis factor-alpha and interleukin-6 concentrations between patients with juvenile idiopathic arthritis and those with pigmented villonodular synovitis. ROC analysis showed a synovial calprotectin threshold of…
creator: Aleksey N. Kozhevnikov
creator: Elena A. Derkach
creator: Aleksandra A. Porohova
creator: Sergey A. Lukyanov
rights: Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2025-04-18
publication date: 2025-04-18
volume: 13
number: 2
starting page: 5
ending page: 13
doi: 10.17816/PTORS635368

Inversion injury of ankle joint and foot in children: association with sports participation and comorbidities (analysis based on medical information system data)
type: item
description: BACKGROUND: Ankle joint and foot injuries are the most common type of musculoskeletal trauma in children. Their mechanism of injury mainly determines the pattern of damage. AIM: To optimize the diagnosis and treatment of inversion injuries of the ankle joint and foot in children and assess their association with sports participation and comorbidities. METHODS: Outpatient medical records of patients treated at the consultative and diagnostic department between 2014 and 2023 were analyzed. Overall, 1518 cases involving ankle joint and foot injuries were determined, including 111 patients referred with a preliminary diagnosis of sprain and an inversion injury mechanism. RESULTS: The study included boys and girls aged 10–16 years, one-third of them participated in sports, primarily team and gymnastic disciplines. Recurrent inversion injuries occurred more often in children who participated in sports, which should be considered when planning training programs and return to sport. Analysis of the incidence of injuries associated with inversion trauma showed that ligament sprains were most common in nonathlete children (39%), whereas bone fractures predominated in children who participated in sports (38%). CONCLUSION: This study revealed a high incidence of bone and ligament injuries associated with inversion trauma in children and elucidated the contribution of sports participation to these injuries. The broader use of magnetic resonance imaging and ultrasound, along with the refinement and standardization of their protocols, improves the understanding of inversion injuries of the foot and facilitates development of more effective diagnostic and treatment algorithms.
creator: Andrey V. Sapogovskiy
creator: Vladimir M. Kenis
creator: Olga Е. Agranovich
creator: Svetlana I. Trofimova
creator: Ilya A. Abramov
creator: Ekaterina V. Petrova
creator: Aleksandr N. Kasev
rights: Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2025-04-18
publication date: 2025-04-18
volume: 13
number: 2
starting page: 38
ending page: 48
doi: 10.17816/PTORS653455

Alla Vladimirovna Ovechkina
type: item
description: Alla Vladimirovna Ovechkina, Candidate of Sciences in Medicine, Assistant Professor, leading expert at the H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery of the Ministry of Health of the Russian Federation, and Honored Doctor of the Russian Federation, celebrates her 80th birthday. Alla Ovechkina has devoted over 50 years of her professional life to the H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery. In 1988–2025, she served as the center’s Scientific Secretary. She became an indispensable assistant to eight successive directors of the H. Turner Center with her energy, dedication, and impeccable professionalism. Alla Ovechkina’s scientific work has been focused on the conservative management of spinal disorders in children.
creator: Anna V. Zaletina
rights: Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2025-04-18
publication date: 2025-04-18
volume: 13
number: 2
starting page: 118
ending page: 119
doi: 10.17816/PTORS655666

Differentiated stabilometric assessment of postural control in nonathlete children and comparison with young athletes
type: item
description: BACKGROUND: Monitoring the functional parameters of the musculoskeletal system is crucial for evaluating children’s adaptive responses to physical activity. Such health monitoring of children participating in sports should be systematic. Stabilometry is a promising method for the functional assessment of the musculoskeletal system in young athletes. AIM: To develop criteria for the differentiated assessment of postural control in children based on analysis of asymmetry in stabilometric parameters of the contralateral lower limbs centers of pressure and compare these findings with those obtained in young athletes. METHODS: A two-stage study of postural balance in healthy children was conducted using dual stabilometric platforms. In stage 1, a control group including 59 children aged 5–16 years who were not involved in sports and whose physical activity did not exceed routine daily levels was investigated to determine the range of normal stabilometric parameters. The children were divided into four age subgroups: 16 children aged 5–6 years, 13 aged 7–10 years, and 15 each aged 11–13 years and 14–16 years. In stage 2, 15 boys and girls aged 7–10 years who regularly trained at sports schools in Saint Petersburg were examined. RESULTS: In the control group, postural balance gradually improved with age starting from 5 to 6 years and reached its highest levels by age 14–16 years. In the main group, regular sports training with increased physical loads in children aged 7–10 years did not adversely affect postural balance or the balance between contralateral lower limbs. This may be associated with a gentle exercise methodology that provides balanced and age-appropriate training loads adjusted for the physiological characteristics of children. The quality of postural control was better in young athletes than in their nonathlete peers, with median stabilometric parameters of 80% and 72%, respectively (p < 0.05). Lower center of pressure velocities and smaller statokinesiogram…
creator: Igor E. Nikityuk
rights: Copyright (c) 2025 Eco-Vector
date: 2025-04-18
publication date: 2025-04-18
volume: 13
number: 2
starting page: 49
ending page: 61
doi: 10.17816/PTORS642714

Patient-specific 3D template with radiopaque markers for pediatric pedicle screw fixation: comparison with freehand technique
type: item
description: BACKGROUND: Accuracy and precision are crucial in pedicle screw implantation in children with congenital spinal deformities combined with thoracic cage anomalies. The use of patient-specific navigation templates supplemented with radiopaque markers significantly improves screw positioning accuracy and reduces the risk of complications. AIM: To evaluate the effectiveness of a novel patient-specific surgical template with radiopaque markers and accuracy of pedicle screw placement in children with congenital spinal deformities combined with thoracic cage anomalies, compared with the freehand technique. METHODS: The study included 26 patients (aged 4–9 years) who underwent surgery at a specialized center. The patients were grouped into two: group 1 (n = 13) underwent screw placement using the new template with radiopaque markers and group 2 (n = 13) underwent screw placement using the freehand technique. Screw placement accuracy was evaluated using the Gertzbein scale based on postoperative radiographs and computed tomography. Statistical analysis was performed using the Student’s t-test, with p < 0.05 indicating significance. RESULTS: In the navigation template group, 100% of screws were placed correctly (grade 0). In the freehand group, 80.5% of screws were correctly positioned; 16.9% showed deviations up to 2 mm (grade 1), and 2.6% showed deviations >2 mm (grade 2). The use of the navigation template significantly reduced the time required for bone canal preparation compared with the freehand method. CONCLUSION: Navigation templates with radiopaque markers demonstrate high accuracy and correctness in pedicle screw placement in children with congenital spinal deformities, reducing malposition risk and shortening operative time. Their widespread implementation may enhance the safety and effectiveness of surgical treatment in this patient population.
creator: Vakhtang G. Toria
creator: Sergei V. Vissarionov
creator: Ramil R. Kubanov
rights: Copyright (c) 2025 Eco-Vector
date: 2025-04-18
publication date: 2025-04-18
volume: 13
number: 2
starting page: 62
ending page: 69
doi: 10.17816/PTORS646353

Hip arthroplasty for bilateral pathologic hip dislocation in children
type: item
description: BACKGROUND: Pathologic hip dislocation is a severe complication of septic arthritis and hematogenous osteomyelitis of the proximal femoral metaphysis in young children. Bilateral involvement of the hip joints results in more severe anatomical and functional impairments, requiring greater treatment efforts. In such cases, rehabilitation may take years and involves staged surgical correction and continuous conservative management. Meeting these requirements is crucial, as insufficient or inadequate treatment may result in contractures, restricted hip mobility, and progression of secondary deformities. AIM: To analyze the outcomes of surgical treatment in children with bilateral pathologic hip dislocations treated with hip arthroplasty using demineralized osteochondral allografts and highlight rehabilitation aspects required to achieve favorable short- and long-term postoperative outcomes. METHODS: Surgical outcomes in 11 children (22 hip joints) aged 1.5–10 years with bilateral destructive pathologic hip dislocations who underwent hip arthroplasty using demineralized osteochondral allografts were analyzed. RESULTS: Long-term follow-up (1–12 years) demonstrated radiologically confirmed joint stability in 86.4% of cases and preservation of at least 80 of hip flexion range. CONCLUSION: Hip arthroplasty with demineralized osteochondral allografts in children with destructive pathologic hip dislocations is an effective method for restoring hip joint function, providing stability and preserving range of motion over the long term. A consistent, systematic, and comprehensive treatment approach is critical for successful rehabilitation and for restoration and long-term preservation of hip function in children with bilateral hip involvement.
creator: Yuriy E. Garkavenko
rights: Copyright (c) 2025 Eco-Vector
date: 2025-04-18
publication date: 2025-04-18
volume: 13
number: 2
starting page: 70
ending page: 76
doi: 10.17816/PTORS642389

Surgical treatment of severe pectus excavatum in an adolescent: a case report
type: item
description: BACKGROUND: Pectus excavatum is a malformation characterized by deformities of the cartilaginous parts of the ribs and sternum of varying severity and accounts for 75%–91% of all chest wall deformities. Surgical treatment of pectus excavatum in children remains an urgent issue, despite the considerable number of existing surgical correction techniques. These techniques are not universally applicable, especially for asymmetric and rigid forms, requiring ongoing modification and improvement. CASE DESCRIPTION: A 17-year-old patient underwent surgical correction of a severe pectus excavatum complicated by a history of cardiac surgery, namely, median sternotomy and mitral valve prosthesis placement. The surgical procedure involved the release of major vital anatomical structures, the use of an external fixation device providing high corrective force during surgery, and gradual intraoperative correction under cardiac function monitoring. DISCUSSION: Correction of severe pectus excavatum following prior median sternotomy is associated with a high risk of complications, including fatal events such as asystole or massive hemorrhage. In such cases, a minimally invasive thoracoplasty with an additional subxiphoid approach and sternal elevation using an external fixation device is recommended. Conventional sternal elevation techniques (e.g., bone hooks, sutures, and clamps) have been found to be not advisable for pronounced rigid deformities owing to the risk of sternal injury. Moreover, isolated thoracoscopy using the standard MIRPE technique does not ensure the integrity of intrathoracic structures, and traditional bar-flipping maneuver for immediate and forced correction of pectus excavatum is inappropriate. CONCLUSION: Patients with pectus excavatum exceeding the threshold for severe deformity, particularly those with previous cardiac surgery, require a treatment different from standard thoracoplasty. The presented approach, involving the release of major vital anatomical s…
creator: Dmitry V. Ryzhikov
creator: Bahauddin H. Dolgiev
creator: Sergei V. Vissarionov
creator: Julia O. Zhukova
creator: Irina A. Boroznyak
rights: Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2025-04-18
publication date: 2025-04-18
volume: 13
number: 2
starting page: 77
ending page: 85
doi: 10.17816/PTORS654520

Combined reconstruction of femoral condylar osteochondral defects in adolescents: clinical cases and a review
type: item
description: BACKGROUND: A leading cause of femoral condylar lesions in children and adolescents is dystrophic processes resulting in subchondral bone destruction followed by overlying cartilage involvement. The most common pathological conditions include osteochondritis dissecans and corticosteroid-induced osteonecrosis. Currently, there is no consensus on the optimal surgical approach for treating osteochondral defects of the femoral condyles. CASE DESCRIPTIONS: Two clinical cases of adolescents with extensive osteochondral defects of the femoral condyles are presented. DISCUSSION: This article provides a review, existing classification systems, and an overview of surgical options for deep osteochondral defects of the femoral condyles. Existing methods induce good to excellent clinical outcomes. However, the absence of randomized and comparative studies of these treatment approaches does not allow for a clear determination of the optimal surgical strategy. In most contemporary studies, outcomes are assessed using indirect imaging methods, which negatively correlate with clinical results and may distort accuracy of treatment outcome interpretation. CONCLUSION: Osteochondral defects of the femoral condyles remain a critical problem in pediatric and adolescent orthopedics and traumatology. Considering the variety of existing surgical techniques (from revascularization osteoperforation to joint replacement), combined reconstruction using autologous bone grafts and collagen membranes may offer stable and favorable clinical and functional outcomes. TRANSLATE with x English Arabic Hebrew Polish Bulgarian Hindi Portuguese Catalan Hmong Daw Romanian Chinese Simplified Hungarian Russian Chinese Traditional Indonesian Slovak Czech Italian Slovenian Danish Japanese Spanish Dutch Klingon Swedish English Korean Thai Estonian Latvian Turkish Finnish Lithuanian Ukrainian French Malay Urdu German Maltese Vietnamese Greek Norwegian Welsh Haitian Creole Persian TRANSLATE with COPY THE URL BELOW …
creator: Sergey Y. Semenov
creator: Vyacheslav I. Zorin
rights: Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2025-04-18
publication date: 2025-04-18
volume: 13
number: 2
starting page: 86
ending page: 96
doi: 10.17816/PTORS649883

Role of genetic determinants in the development of congenital scoliosis: a review
type: item
description: BACKGROUND: Congenital scoliosis is a multifactorial disorder resulting from disturbances during vertebral embryogenesis. Defects occurring at any stage of fetal development may lead to congenital scoliosis and progressive spinal deformity. Recent studies highlighted genetic factors as crucial determinants of the development of this condition. AIM: To review the sources on the genetic basis of congenital scoliosis, focusing on molecular regulatory mechanisms, mutation frequencies, and the contribution of specific genes. METHODS: Sources were retrieved using keyword searches in PubMed, Google Scholar, Cochrane Library, Web of Science, Lens.org, and eLibrary over the past 25 years. The inclusion criteria were full-text availability, meta-analyses, systematic reviews, cohort studies of patients with congenital scoliosis, experimental animal models, and case–control studies. The exclusion criteria included lack of full-text access, patents, utility models, and studies without clinical data. Finally, 54 publications were selected for detailed analysis. RESULTS: The identified genes were categorized into four: susceptibility genes (LMX1A, PTK7, SOX9, TBX6, and TBXT); genes wherein mutations directly cause syndromes or monogenic disorders associated with scoliosis (FBN1); genes with copy number variations (DHX40, DSCAM, MYSM1, and NOTCH2); and genes showing abnormal methylation in patients with scoliosis (COL5A1, GRID1, GSE1, RGS3, SORCS2, IGH1, IGH3, IGHM, KAT6B, and TNS3). CONCLUSION: Analysis of scientific sources revealed the presence of predisposing genetic factors associated with the development of congenital scoliosis in its various phenotypic forms. Data from large-scale studies clarified the etiological factors and were beneficial for predicting the course of congenital scoliosis, and findings from studies with smaller samples may help define future directions for identifying genetic determinants of this disorder.
creator: Sergei V. Vissarionov
creator: Polina А. Pershina
creator: Sergey E. Khalchitsky
creator: Marat S. Asadulaev
rights: Copyright (c) 2025 Eco-Vector
date: 2025-04-18
publication date: 2025-04-18
volume: 13
number: 2
starting page: 97
ending page: 107
doi: 10.17816/PTORS636350

Hallux valgus in equino-planovalgus foot deformity in children with cerebral palsy and its etiopathogenesis: a review (part 1)
type: item
description: BACKGROUND: Hallux valgus in children with cerebral palsy is an understudied problem. Treatment approaches are generally applied as a secondary measure, often after the child starts complaining at an older age following correction of contractures and other foot deformities. Moreover, there are no established methods for the early prevention or treatment of hallux valgus. Understanding the fundamental mechanisms of etiopathogenesis and biomechanical disturbances during gait is crucial for developing preventive and therapeutic strategies for this patient population. AIM: To analyze international studies of foot deformities in children with cerebral palsy and compare these findings with biomechanical studies in patients with idiopathic hallux valgus without neurological pathology. METHODS: Sixty-four scientific articles and publications retrieved from multiple databases without time restrictions were reviewed. RESULTS: Equinoplanovalgus foot deformity is a major etiopathogenetic factor in the development of hallux valgus in children with cerebral palsy. Biomechanical alterations associated with hallux valgus are characterized by limited dorsiflexion of the hallux, excessive dorsiflexion of the first ray, restricted supination of the hindfoot and midfoot, and increased plantar flexion of the ankle joint during the terminal stance phase. In equinoplanovalgus deformity, excessive pronation of the hindfoot and midfoot cannot be compensated because of the limited range of motion of the midtarsal joint, causing restricted midfoot supination and the inability to activate the locking mechanisms of the midfoot and forefoot during terminal stance. CONCLUSION: Any biomechanical disturbance within the complex multisegmental structure of the lower extremity that reduces hindfoot and midfoot supination, causes first ray eversion, and limits hallux dorsiflexion may contribute to deformity. The diversity of motor disorders, contracture patterns, and deformities in children with cerebr…
creator: Valery V. Umnov
creator: Dmitriy S. Zharkov
creator: Vladimir А. Novikov
creator: Dmitriy V. Umnov
rights: Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2025-04-18
publication date: 2025-04-18
volume: 13
number: 2
starting page: 108
ending page: 117
doi: 10.17816/PTORS641652

Use of autologous mesenchymal stem cells derived from adipose tissue for the treatment of hyaline cartilage defects in laboratory animals: a literature review
type: item
description: BACKGROUND: Degenerative/dystrophic cartilage diseases are an epidemiologically important challenge in modern traumatology and orthopedics. The use of autologous mesenchymal stem cells to repair cartilage defects is currently the most promising treatment option. AIM: The aim of this paper was to review the literature on the use of adipose tissue-derived mesenchymal stem cells to repair articular cartilage defects in laboratory animals. MATERIALS AND METHODS: Recent and historical Russian and English literature was searched in Google Scholar, Cyberleninka, PubMed, eLibrary, Mendeley, Science Direct databases for over 20 years. A total of 113 papers were selected, and 25 papers that met the inclusion criteria were selected based on full-text materials and abstracts. RESULTS: Literature shows that autologous adipose-derived mesenchymal stem cells stimulate hyaline cartilage regeneration. The vast majority of studies show that the addition of both differentiated and undifferentiated cells accelerates cartilage repair, regardless of the composition of the vehicle matrix or gel. Adipose-derived mesenchymal stem cells can also be used as a stand-alone technology without any vehicles. CONCLUSIONS: There is still no ideal graft to restore cartilage tissue, despite a wide range of technologies, surgical techniques and materials for repairing cartilage defects. However, mesenchymal stem cells improve the rate of defect repair and may become a new therapeutic strategy for degenerative/dystrophic cartilage diseases.
creator: Polina A. Pershina
creator: Yuri A. Novosad
creator: Kristina N. Rodionova
creator: Marat S. Asadulaev
creator: Vyacheslav I. Zorin
creator: Pavel I. Bortulev
creator: Sergey V. Vissarionov
rights: Copyright (c) 2024 Эко-Вектор https://eco-vector.com/for_authors.php#07
date: 2024-12-15
publication date: 2024-12-15
volume: 13
number: 2
starting page: 499
ending page: 510
doi: 10.17816/PTORS635941

Innervation of bones. Sensory innervation. Part I: a literature review
type: item
description: BACKGROUND: Bone remodeling is a complex multifactorial process regulated by endocrine, paracrine, and mechanical factors. Nearly two decades ago, research showed that the nervous system is also involved in regulating bone remodeling. However, there is a very limited number of Russian publications on bone innervation mechanisms. AIM: The aim of this paper was to review publications that address the role of sensory innervation in regulation of bone metabolism and some pathophysiology of bone pain. MATERIALS AND METHODS: Data were searched in English and Russian in PubMed, Google Scholar, Cochrane Library, Crossref, eLibrary databases. Information was analyzed and synthesized for the purposes of this paper. Most studies in this review were published within the last 20 years. RESULTS: All structural parts of the bone are innervated by sensory nerve fibers that are receptive to nociceptive information. The type of bone pain depends on both the location and the nature of the disease process. Pain signals from the bones to the central nervous system are transmitted by A-delta and C-fibers, each with its own conduction velocity, neurotransmitters, receptor characteristics, and functions. In addition, sensory nerves regulate bone homeostasis by expressing calcitonin gene-related peptide and substance P as their major neurotransmitters. Sensory nerves play a key role in development of primary and secondary ossification centers during endochondral and intramembranous ossification. Some studies show that nerve fibers are present in articular cartilage at some point in time. CONCLUSIONS: Sensory fibers are an important link in the nervous regulation of bone and cartilage metabolism. Impaired sensory innervation leads to impaired bone remodeling and slows endochondral ossification and, consequently, bone growth and development. This should be considered, especially in patients with early onset bone innervation disorders. To prescribe the correct treatment, it is important to und…
creator: Alina M. Khodorovskaya
creator: Olga E. Agranovich
creator: Margarita V. Savina
creator: Yuri E. Garkavenko
creator: Evgeny V. Melchenko
creator: Yana A. Filin
creator: Konstantin E. Gorelik
rights: Copyright (c) 2024 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2024-12-15
publication date: 2024-12-15
volume: 13
number: 2
starting page: 511
ending page: 522
doi: 10.17816/PTORS642092

Ultrasound evaluation of the tibial graft structure during fixation with the Ilizarov device in patients with achondroplasia
type: item
description: BACKGROUND: Bone regeneration during fixation needs to be evaluated due to clinical measures taken to prevent possible complications, such as evaluation of the correct segment axis, verification of the equality of the extended and contralateral segments (with repeated lengthening), maintenance of fixation rigidity, functional control of the load on the operated limb, and the patient’s motor activity. All of these factors have a direct impact on the structure and maturation of the distraction graft and readiness for device removal. It is relevant to study the proximal graft in bilocal treatment based on the greatest elongation (5.5 [5.0; 6.0] cm) compared to the distal graft. Proximal graft maturation affects the timing of device removal. AIM: The aim was to evaluate the structure of the tibial distraction graft in achondroplasia patients of different ages during the fixation period. MATERIALS AND METHODS: AVISUS Hitachi (Japan) was used for ultrasound scanning with a 7.5 MHz linear sensor. The graft was evaluated using standard programs. The study included achondroplasia patients aged 6–9 years (group I, n = 15) and 10–15 years (group II, n = 15). The study was conducted at 5, 30, 60, and 90 days (with repeated limb lengthening) from the start of the fixation period. In group I of monolocal tibial lengthening, the elongation was 6.5 [6; 7] cm. For bilocal leg lengthening in groups I and II, the proximal graft elongation was 5.5 [5.0; 6.0] cm, and the distal graft elongation was 2.5 [2.0; 3.0] cm. RESULT: In groups I and II, a favorable course of osteogenesis was observed, with typical stages of graft formation. Group II showed slower development of typical structures, resulting in longer fixation times. Therefore, the fixation time was 55 ± 5 days (p ≤ 0.05) in group I and 63 ± 3 days (p ≤ 0.05) in group II (in case of favorable progression). The exception was 1 patient (out of 10 patients with repeated leg lengthening), who developed a hypoechoic cyst-like lesion i…
creator: Tatyana I. Menschikova
creator: Anna M. Aranovich
rights: Copyright (c) 2024 Эко-Вектор https://eco-vector.com/for_authors.php#07
date: 2024-12-15
publication date: 2024-12-15
volume: 13
number: 2
starting page: 427
ending page: 436
doi: 10.17816/PTORS637440

Transient brachial plexopathy in adults and children: a literature review
type: item
description: BACKGROUND: Transient brachial plexopathy such as burner or stinger syndrome is a mild injury of the brachial plexus caused by forced movements of the arm or cervical spine, less often by direct impact of a traumatic factor in the supraclavicular region. It occurs mainly in athletes involved in contact sports. Clinically, transient brachial plexopathy is characterized by a sudden, sharp, stabbing pain that spreads from the neck to the fingertips and usually lasts from a few seconds to several minutes. Considering the lack of Russian literature on this disease, this article will be useful for trauma orthopedists, neurologists, sports doctors, trainers and rehabilitation specialists. AIM: The aim of this paper was to review current data on the pathogenesis, diagnosis, and treatment of transient brachial plexopathy and ways to maintain the ability of patients to participate in sports. MATERIALS AND METHODS: Publications were searched in PubMed (MEDLINE) databases and Google from 1965 to 2024 using combinations of OR, AND operators and keywords such as “transient brachial plexopathy,” “stinger syndrome”, “burner syndrome”, “sports medicine”, “children.” A total of 49 papers were selected, 13 of which were published in the last 10 years. RESULTS: The disease is diagnosed in 18.8%–65.0% of American football and rugby players. Stinger syndrome is reported in children when they fall from a chair and hit their shoulder on a table, when they hit a wall while running, accompanied by a sharp tilt of the head to the opposite side of the shoulder lesion. It is also reported in patients with shoulder hypermobility. Transient brachial plexopathy is caused by damage to the C5–C6 roots of the spinal cord or upper trunk of the brachial plexus. The pain syndrome usually lasts from a few seconds to a few minutes. It may be accompanied by paresthesia, numbness, and weakness of the upper extremity. Most symptoms of stinger syndrome (55.5%) develop during competition and resolve less than …
creator: Olga E. Agranovich
creator: Svetlana I. Trofimova
creator: Ekaterina V. Petrova
rights: Copyright (c) 2024 Эко-Вектор https://eco-vector.com/for_authors.php#07
date: 2024-12-15
publication date: 2024-12-15
volume: 13
number: 2
starting page: 489
ending page: 498
doi: 10.17816/PTORS635344

Additive technologies in surgical treatment of congenital spinal deformities in children: a literature review
type: item
description: BACKGROUND: Despite the availability of many surgical treatment options, the surgical management of congenital spinal deformities in preschool children remains a significant and pressing problem. Current techniques for transpedicular screw placement have some limitations. AIM: The aim of the study was to evaluate the results of surgical treatment of children with congenital thoracic and lumbar deformities with impaired vertebral development based on literature data. MATERIALS AND METHODS: This article reviews the literature on surgical techniques for congenital spinal deformities using additive technologies. Data searches were performed using keywords in the PubMed and eLibrary databases. A total of 396 papers were selected for 2000–2023, of which 51 were thematically relevant. RESULTS: It is too early to draw conclusions about the positive results of using additive techniques, especially in the surgical treatment of congenital deformities in preschool children with hemivertebrae, due to the small number of patients described in the literature by different authors. CONCLUSIONS: After reviewing several articles on the use of guides for transpedicular screw placement in congenital thoracic and lumbar anomalies in early preschool children with impaired vertebral development, it is concluded that this promising technique provides high accuracy of screw placement, reduces the number of complications, but further research is needed.
creator: Serik Zh. Serikov
creator: Olzhas S. Bekarisov
creator: Sergey V. Vissarionov
creator: Seidali S. Abdaliyev
creator: Daniyar Zh. Yestay
rights: Copyright (c) 2024 Эко-Вектор https://eco-vector.com/for_authors.php#07
date: 2024-12-15
publication date: 2024-12-15
volume: 13
number: 2
starting page: 481
ending page: 488
doi: 10.17816/PTORS635765

Elbow fracture sequelae in children
type: item
description: BACKGROUND: Fractures of elbow joint bones are the most common type of fracture in children. Despite methodological advances in managing these injuries, adverse anatomic and functional outcomes are still common in clinical practice. AIM: The aim was to evaluate the structure of primary injuries and primary treatment strategies to evaluate the sequelae of elbow bone fractures in children. MATERIALS AND METHODS: Based on inclusion criteria, a retrospective cohort (n = 115) was formed. Clinical, historical and radiological data were evaluated in patients with sequelae of elbow fracture, admitted for surgical treatment in the clinic of the H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery of Russia in 2022–2023. The Shapiro–Wilk test (for less than 50 subjects) or the Kolmogorov–Smirnov test (for more than 50 subjects) were used to test the normality of quantitative parameters. The Pearson’s chi-squared test was used to compare percentages in the contingency table analysis. RESULTS: The mean age of patients in the study population was 11 years (ranging from 4 to 17 years). The duration of injury is 15.6 ± 1.0 months (min = 3; max = 65). Based on the structure of the sequelae, three groups were identified: patients with contracture (42 cases; 36.5%), patients with deformity (31 cases; 27%), and patients with both contracture and deformity (42 cases; 36.5%). Supracondylar fractures of the humerus (40%) and apophyseal fracture of the medial epicondyle (31%) were the most common primary injuries. Primary conservative treatment of the fracture was performed in 82 (71%) patients, primary surgery was performed in 33 (29%) children, and 17 patients were switched from conservative to surgical treatment. A total of 31 (27%) children had repeated procedures. CONCLUSIONS: Contractures are the most common adverse outcome of elbow fractures in children. Characteristics of conservative treatment and repeated procedures indicate a need for better …
creator: Vyacheslav I. Zorin
creator: Sergey A. Lukyanov
creator: Daniil Yu. Grybok
rights: Copyright (c) 2024 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2024-12-15
publication date: 2024-12-15
volume: 13
number: 2
starting page: 419
ending page: 426
doi: 10.17816/PTORS636376

Results of foot assessment in healthy preschool children: visual assessment, FPI-6, dorsiflexion: a population study
type: item
description: BACKGROUND: The reason for conducting this study was the lack of Russian literature on the relationship between visual foot assessment using the Foot Posture Index (FPI)-6 and foot dorsiflexion in preschool children. AIM: The aim was to evaluate the relationship between visual foot assessment, FPI-6 and dorsiflexion in healthy preschool children. MATERIALS AND METHODS: The study included 81 children aged 5–7 years (162 feet). All children were examined using visual foot assessment, FPI-6, assessment of passive dorsiflexion, Beighton hypermobility score, and anthropometric measurements (height/weight). Dorsiflexion was assessed with posterior segment stabilization and the knee joint in flexion and extension. The Kolmogorov–Smirnov test was used to assess the normality of the data distribution, followed by the use of parametric and non-parametric statistical tests. The analysis of variance (ANOVA) was used to compare the means of three groups. The Pearson’s test was used to assess correlations. RESULTS: Flat feet was diagnosed in 41.0% of children. There were 2 times more boys than girls in the group with flat feet and 1.5 times more girls in the group without flat feet. The FPI-6 scores of the same feet were at least 8 in children with flat feet and 0 to 4 in children without flat feet. Moderate to medium correlations were found between the clinical diagnosis of flat feet and FPI-6 scores. In 95% of the children aged 5–7 years, dorsiflexion with the knee joint in extension was 11.4°–34.2°. Mean dorsiflexion difference between flexed and extended knees was 24.1° ± 9.5°. ANOVA showed no significant difference in dorsiflexion between children with and without flat feet. CONCLUSIONS: The mean dorsiflexion in preschool children was 22.8° ± 5.7°. No reliable difference in dorsiflexion between children with and without flat feet was demonstrated. Gastrocnemius muscle retraction was evaluated quantitatively.
creator: Alyona Yu. Dimitrieva
rights: Copyright (c) 2024 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2024-12-15
publication date: 2024-12-15
volume: 13
number: 2
starting page: 437
ending page: 444
doi: 10.17816/PTORS641748

Anatomy and biomechanics of posterolateral angle structures of the knee joint
type: item
description: BACKGROUND: Structural injuries of the posterolateral angle of the knee are rare. However, these conditions are characterized by high-energy etiologic mechanisms and cause rapidly progressive degenerative processes in the knee joint. There is currently no consensus on the need for reconstructing damaged posterolateral angle structures for effective knee stabilization with surgery. Understanding the effects of anatomical elements of the posterolateral angle on posterolateral knee rotational instability is of theoretical and practical importance. AIM: The aim of this study was to evaluate anatomy and morphometry of the popliteal tendon and the fibular collateral ligament, including their zones of attachment to the femur and the role of these structures in the posterolateral rotational and frontal instability of the knee joint. MATERIALS AND METHODS: A single-center comprehensive topographic and anatomical study used 50 unfixed anatomical specimens of the lower extremities (30 females, 20 males). The mean age was 30 to 60 years. Patients died from causes other than musculoskeletal disorders. Precise dissection of the posterolateral angle components (popliteus tendon and peroneal collateral ligament) was performed with detailed examination and documentation of the morphometric characteristics of the femoral attachment sites of the studied structures. The posterolateral angle structures were then sequentially dissected to determine their effect on posterolateral rotational instability and tibial varus deviation (varus stress test) and posterior tibial translation (posterior drawer test). RESULTS: After dissection of the fibular collateral ligament, the maximum varus deviation of the knee joint was 5° ± 3.0°. A more significant external rotation of the tibia of 11.0° ± 1.5° was achieved after popliteal tendon release. The intersection of the posterior cruciate ligament resulted in a maximum posterior tibial displacement relative to the femur by 9 (7.9–10.2) mm. CONCLUSION…
creator: Marsel R. Salikhov
creator: Vladislav V. Avramenko
creator: Gleb E. Batalov
creator: Ekaterina V. Sannikova
rights: Copyright (c) 2024 Эко-Вектор https://eco-vector.com/for_authors.php#07
date: 2024-12-15
publication date: 2024-12-15
volume: 13
number: 2
starting page: 445
ending page: 452
doi: 10.17816/PTORS635815

Effects of a long-term triceps surae stretching program on the pennation angle of triceps surae heads in children with hypermobile flat foot and Achilles tendon shortening
type: item
description: BACKGROUND: Triceps surae retraction plays a key role in the pathogenesis of flat feet in children. This is a pennate muscle. The pennation angle is defined as the angle between triceps surae fascicles and aponeurosis. AIM: The aim of the study was to evaluate the effect of a long-term triceps surae stretching program on the pennation angle of the triceps surae head in children with flat feet and Achilles tendon shortening. MATERIALS AND METHODS: The study included a total of 82 children with hypermobile flat feet and Achilles tendon shortening. The pennation angle was measured by ultrasound. Triceps surae stretching was recommended for 6 months as a basic exercise. SPSS v.26.0 was used for statistical analysis of data. RESULTS: The study group included 63 children who performed stretching exercises and the control group included 19 children who did not perform stretching exercises at the required intensity. The study group showed a significant improvement in the Foot Posture Index (FPI)-6, while the control group showed no change. The baseline foot dorsiflexion was 4.84° ± 0.10° in the study group and 4.81° ± 0.17° in the control group. After 6 months of stretching, dorsiflexion was 11.34° ± 0.24° in the study group and 4.85° ± 0.19° in the control group (p < 0.01). The pennation angle of the triceps surae heads showed a significant increase in the medial head of the gastrocnemius and soleus muscles. CONCLUSIONS: A long-term stretching program in children with flat feet resulted in a significant increase in foot dorsiflexion. These changes were associated with morphological and functional muscle restructuring, manifested by a significant increase in the pennation angle of the medial head of the gastrocnemius and soleus muscles. Further research will identify the mechanisms underlying anatomical and functional muscle restructuring and their effects on anatomical foot parameters in flat feet.
creator: Leonid V. Gorobets
creator: Vladimir M. Kenis
rights: Copyright (c) 2024 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2024-12-15
publication date: 2024-12-15
volume: 13
number: 2
starting page: 453
ending page: 462
doi: 10.17816/PTORS642366

Potential use of bisphosphonates in children with Legg–Calvé–Perthes disease with signs of osteoarthritis. Interim results from a single-center study
type: item
description: BACKGROUND: Legg–Calvé–Perthes disease is a multifactorial disease with a non-inflammatory and avascular mechanism of necrotic lesions. In some cases, children may have more aggressive disease with signs of osteoarthritis. This variant of Legg–Calvé–Perthes disease is characterized by active inflammation of the bone tissue and arthritis, often leading to severe deformity of the femoral head and early coxarthrosis. The problem of treating osteoarthritis in children with Legg–Calvé–Perthe disease is not solved due to the low effectiveness of non-steroidal anti-inflammatory drugs (NSAIDs). Osteoclast inhibition therapy with bisphosphonates in adults with idiopathic aseptic necrosis of the femoral head has been pathogenetically accepted. The use of bisphosphonates in children with Legg–Calvé–Perthe disease and osteoarthritis has not been evaluated. AIM: The aim of the study was to evaluate the efficacy and safety of bisphosphonates in children with Legg–Calvé–Perthes disease who presented with signs of osteoarthritis. MATERIALS AND METHODS: The study used data on the treatment of 14 children (mean age 7.5 ± 2.4 years, 71.4% girls) with Legg–Calvé–Perthe disease (at the impression fracture stage) and active hip osteoarthritis. All children had torpid arthritis refractory to NSAID therapy and present for at least 3 months. Treatment included ibandronic acid at 1.0 mg and 1.5 mg per infusion every 3 months in children younger than 7 years old and older than 7 years old, respectively. Five consecutive infusions were performed in the study. Treatment outcomes were assessed at 6, 12, and 18 months based on combined clinical, imaging, and laboratory changes. A modified SCORING OF HIP MRI FOR JIA score was used to assess osteoarthritis activity. RESULTS: All children showed a decrease in hip pain after the first infusion of ibandronic acid. The inactive phase of osteoarthritis during bisphosphonate treatment was achieved in 78.5% (11) of children after three consecutive infusio…
creator: Alexey N. Kozhevnikov
creator: Dmitry B. Barsukov
creator: Pavel I. Bortulev
creator: Sergey A. Braylov
rights: Copyright (c) 2024 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2024-12-15
publication date: 2024-12-15
volume: 13
number: 2
starting page: 463
ending page: 472
doi: 10.17816/PTORS636471

Evaluation of the efficacy of a novel customized guide with visual control function in children with congenital spinal deformity
type: item
description: BACKGROUND: The use of customized surgical guides for transpedicular screw placement improves the accuracy and safety of the procedure in children with congenital spinal deformities. AIM: The aim of the study was to develop and perform a comparative analysis of the effectiveness of a new surgical guide with cutouts for visual control during transpedicular screw placement in pediatric patients with congenital spinal deformities associated with thoracic curvatures. MATERIALS AND METHODS: The study included 30 patients with congenital deformities of the spine and thorax who underwent surgery between June 2022 and June 2023. The patients were divided into the group that used the new guide and the group that used the freehand technique. Screw placement accuracy was assessed using the Gertzbein scale based on postoperative computed tomography data. Results were compared using Student’s t-test for independent samples because the data were normally distributed, as verified by the Shapiro–Wilk test. Statistical significance was defined as a p < 0.05. RESULTS: The new guide demonstrated high accuracy, with 97.7% of screws placed without deviation (Grade 0). Only 2.3% of the screws deviated up to 2 mm (Grade I), which did not affect the complication rates. The freehand technique had lower accuracy rates; approximately 89.7% of the screws were placed correctly (Grade 0), 7.5% had a deviation of up to 2 mm (Grade I), and 2.8% had a deviation of more than 2 mm (Grade II and above). CONCLUSIONS: A new customized guide with visual control cutouts provides high accuracy, reliability and ease of use, making it a promising clinical tool for treating congenital spinal deformities.
creator: Vakhtang G. Toriya
creator: Sergey V. Vissarionov
creator: Polina А. Pershina
rights: Copyright (c) 2024 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2024-12-15
publication date: 2024-12-15
volume: 13
number: 2
starting page: 473
ending page: 480
doi: 10.17816/PTORS641742

Analysis of vertebrotomy treatment in children with congenital scoliosis with unsegmented rod and rib synostosis
type: item
description: BACKGROUND: Congenital anomalies of vertebral development account for 2%–11% of cases in the general structure of nosologies that cause spinal deformity. An unsegmented rod (unilateral violation of vertebral segmentation) is attributed to a prognostically unfavorable malformation. Rib synostosis causes the development of thoracic insufficiency syndrome. AIM: To analyze the results of treatment of children with congenital scoliosis caused by an unsegmented rod and rib synostosis by vertebrotomy. MATERIALS AND METHODS: This cohort, retrospective, monocenter study evaluated the treatment results of 55 patients. The patients were divided into two groups: group 1, children aged 2–8 years, the scope of intervention was wedge-shaped osteotomy of a non-segmented rod at the apex of the deformity, and group 2, children aged 8–18 years, the scope of intervention was wedge-shaped osteotomy at the apex of the deformity and two linear osteotomies of a non-segmented rod in the cranial and caudal directions. Clinical, radiological, and statistical research methods were used. RESULTS: Significant correction of scoliosis was achieved in 65.5% of patients aged 2–7 years (group 1) and 56.3% in children aged 8–18 years (group 2). Hypokyphosis of the thoracic spine was observed in the patients. The percentage of correction of kyphosis was 21.1% in group 1 and 19.1% in group 2. Lung volume increased by 27.9% (p = 0.01776) in group 1, and lung volume on the concave side increased by 23.5% (p = 0.04975) and on the convex side by 29.6% (p = 0.01073). Improvement in the overall respiratory impedance reached 47.3% (p < 0.05). In group 2, a insignificant increase was found in VVC by 12.6% (p = 0.3509) and FEV1 by 8.7% of the initial (p = 0.1534), as well as an increase in total lung volume of 13.3% (p = 0.1527) and the contribution of the lung along the concave side of 18.8% (p = 0.1535), and the lung along the convex side was 8.4% (p = 0.169), indicating no significant impact on lung developme…
creator: Marat S. Asadulaev
creator: Sergei V. Vissarionov
creator: Anton S. Shabunin
creator: Kristina N. Rodionova
creator: Yury A. Novosad
creator: Vakhtang G. Toriya
creator: Dmitry N. Kokushin
creator: Nikita O. Khusainov
creator: Aleksandra N. Filippova
creator: Dmitry V. Ryzhikov
rights: Copyright (c) 2024 Эко-Вектор
date: 2024-09-24
publication date: 2024-09-24
volume: 13
number: 2
starting page: 293
ending page: 306
doi: 10.17816/PTORS626814

Efficiency of the decision support system for determining the severity of scoliotic spinal deformity by the analysis of radiographs
type: item
description: BACKGROUND: In 2020, a decision support system was developed at expense of grant from Innovation Promotion Fund and integrated into medical base of prosthetic and orthopedic center “Sсoliologic.ru.” It is the first computer program for determining severity of scoliotic spinal deformity in analysis of radiographs. AIM: To evaluate performance of a computer program for determining Cobb angle by comparing obtained automated data with manual measurement data by various specialists. MATERIALS AND METHODS: From medical base of prosthetic and orthopedic center “Sсoliologic.ru,” 411 digital radiographs of spine of children and adolescents were selected, which were drawn by a radiologist (BP-etalon), an orthopedic traumatologist with 5 years of experience and experience in vertebrology (OO), and an orthopedic traumatologist with less than 1 year of experience and no experience in vertebrology (OB) and computer program (KP). The number and proportion of exact matches and mean absolute percentage error (MAPE) of results of measuring the Cobb angle of reference data were compared with indicators obtained by OO, OB, and KP in, for various types of scoliosis according to the classification of Rigо, as well as in determining the main arc. Bland–Altman graphs were used. The mean absolute deviation (MAD) and MAPE for the main arc with magnitude ranging from 20° to >50° were calculated. RESULTS: The exact matches of KP with standard were 21%. Hence, every fifth measurement of the Cobb angle on X-ray, calculated automatically, was identical to standard. The highest proportion of matches with standard was noted in OO (33%), and the lowest in OB (16%). The highest accuracy of KP was found at types E1 and E2, and the arc of 3 was 30% and 24%, respectively. The proportion of KP matches with standard increased to 61%, with an error of 3°, and to 75%, with an error of 5°; with an error of 7°, the proportion of matches reached 84%. Moreover, the proportion of coincidences of a non-experience…
creator: Grigori A. Lein
creator: Natalia S. Nechaeva
creator: Mikhail O. Demchenko
creator: Nikita S. Koch
creator: Artyom G. Levykin
rights: Copyright (c) 2024 Эко-Вектор
date: 2024-09-24
publication date: 2024-09-24
volume: 13
number: 2
starting page: 307
ending page: 316
doi: 10.17816/PTORS629748

Slipped capital femoral epiphysis in children engaged in sports
type: item
description: BACKGROUND: Epiphysis displacement factors in slipped capital femoral epiphysis are defined as an external mechanical impact on the affected joint of different orientation and intensity, the nature of which may determine the type, direction, and severity of epiphysis displacement. There may be differences in the immediate causes of dislocation and in the nature of the course and timing of detection of the disease in children who were engaged in sports compared to those who were not engaged in sports. Identifying these differences may be beneficial for preventing the occurrence of epiphyseal displacement in slipped capital femoral epiphysis. AIM: To determine the immediate causes of epiphyseal displacement and the peculiarities of the course of SCFE in children practicing sports. MATERIALS AND METHODS: The study included 256 patients aged 11–14 years with slipped capital femoral epiphysis who were admitted at our center, from whom 68 patients were subsequently selected. The main group included 34 children who were engaged in sports and whose first symptoms of the disease appeared during training. The control group included 34 children who were not engaged in sports activities and whose first symptoms of the disease appeared for no apparent reason. Clinical, radiologic, and statistical methods of research were used. RESULTS: In the main group, no severe forms of slipped capital femoral epiphysis such as bilateral displacement, acute displacement with chronic displacement, and early complications of the disease were noted, whereas in the control group, the number of patients with such conditions was 6 (17.6%), 4 (11.8%), and 1 (2.9%), respectively. Additionally, in 2 (5.9%) children of the main group, an extremely rare “valgus” displacement of the epiphysis was detected. Both cases occurred in gymnast girls owing to the use of a special “split” sitting technique. CONCLUSIONS: Severe forms of slipped capital femoral epiphysis are less frequent in children who practiced …
creator: Dmitrii B. Barsukov
creator: Pavel I. Bortulev
creator: Ivan Yu. Pozdnikin
creator: Tamila V. Baskaeva
rights: Copyright (c) 2024 Эко-Вектор
date: 2024-09-24
publication date: 2024-09-24
volume: 13
number: 2
starting page: 317
ending page: 325
doi: 10.17816/PTORS633171

Features of vertical body balance in children with asymmetric pectus excavatum before and after surgical correction
type: item
description: BACKGROUND: Currently, minimally invasive repair of pectus excavatum are being developed. However, studies on the physiological aspects of the patient’s body in response to surgery are limited. Recently, researchers have become interested in the functional diagnosis of the state of the musculoskeletal system in patients with this pathology. AIM: To assess the dynamics of vertical body balance in patients with severe right-sided pectus excavatum before and after minimally invasive reconstructive operations aimed at eliminating deformity. MATERIALS AND METHODS: Clinical radiation and stabilometric studies of 22 patients aged 13–16 years with right-sided pectus excavatum were conducted. Group A included patients with a low body mass index of 16.0 (15.3–17.7) kg/m2. Group B consisted of ten patients with normal body mass index values of 18.5 (17.7–20.4) kg/m2. In patients of both groups, an analysis of the stabilometric parameters of the movement of the general body pressure center and individually the pressure centers of the left and right lower extremities was performed before surgery and 1.5–2 years after. The patients underwent the same type of bone reconstructive surgery that is, minimally invasive repair of pectus excavatum. The stabilometric parameters of the patients were compared with similar parameters of 20 healthy children in the control group. RESULTS: In both groups of patients, a deterioration in vertical balance was recorded before surgery compared with healthy children. In group A, a relatively stable balance of the total body pressure center was revealed, with a deterioration in the movement parameters of the pressure centers of the left and right lower extremities. In contrast, in group B, the mechanism for ensuring a vertical stance was the opposite: a less stable balance of the general center of body pressure against the background of greater postural stability of the contralateral lower extremities was observed. This indicates heterogeneous locomot…
creator: Igor E. Nikityuk
creator: Yuriy E. Garkavenko
creator: Dmitry V. Ryzhikov
creator: Bahauddin H. Dolgiev
rights: Copyright (c) 2024 Эко-Вектор
date: 2024-09-24
publication date: 2024-09-24
volume: 13
number: 2
starting page: 335
ending page: 348
doi: 10.17816/PTORS633528

Usefulness and accessibility of information on the treatment of children with congenital clubfoot: results of a survey of parents
type: item
description: BACKGROUND: Treatment of congenital clubfoot remains controversial from both specialists and parents regarding the details of its practical application, individual effectiveness, and follow-up, rehabilitation treatment, prevention, and treatment of relapses. The assessment of parental attitudes using an online survey optimizes doctor–patient interaction. Information available to parents regarding the diagnosis and treatment of children with congenital clubfoot is lacking. AIM: This study aimed to assess the usefulness and accessibility of information for parents about the treatment of children with congenital clubfoot. MATERIALS AND METHODS: To assess the usefulness and accessibility of information about the treatment of congenital clubfoot, a survey of the patients’ parents was conducted using an electronic fillable form proposed for anonymous completion in a thematic group dedicated to the treatment of congenital clubfoot on the social network “VKontakte”; the study included 5500 participants at the time of the survey (2 weeks), with 328 responses received. RESULTS: Most parents noted a lack of information regarding clubfoot treatment before it actually began. The preferred source of information was Internet resources (i.e., websites of medical institutions and social networks). Achilles tenotomy and wearing braces raised the most questions, requiring additional information from both doctors and alternative sources. The possibility of errors and complications in wearing braces caused the greatest concern among parents, as well as possible relapses and the correctness of prescriptions during the rehabilitation treatment. Online parent communities and physician blogs are considered significant information sources. Most parents prefer to expand information about congenital clubfoot on the Internet, including social networks and popular resources. CONCLUSIONS: Analysis of the results of an anonymous survey of parents of children with congenital clubfoot showed a signi…
creator: Vladimir M. Kenis
creator: Alexey G. Baindurashvili
creator: Pavel S. Shpulev
creator: Andrey V. Sapogovskiy
creator: Evgenii V. Melchenko
creator: Gusein N. Rustamov
creator: Aleksandr N. Kasev
creator: Khushnud K. Rustamov
rights: Copyright (c) 2024 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2024-09-23
publication date: 2024-09-23
volume: 13
number: 2
starting page: 327
ending page: 334
doi: 10.17816/PTORS634027

Efficacy of a new customized navigation template for placement of transpedicular screws for unilateral access in children with congenital spinal deformity and thoracic malformation
type: item
description: BACKGROUND: Surgical treatment of congenital spinal deformities combined with thoracic development anomalies in children is an urgent and a complex problem in surgical practice. The surgical method of correcting congenital deformities caused by segmentation disorder of the lateral surfaces of vertebral bodies and unilateral rib synostosis is aimed at correcting the existing deformity using a transpedicular system. This technique is effective for treating this group of patients. However, it requires precise and accurate installation of the supporting elements of the metal structure owing to the high risk of damage to the neurovascular structures in the area of surgical intervention. A solution to this problem is the use of an individualized guide template with rib support for unilateral access in children with congenital deformities of the thorax and spine. AIM: To perform a comparative analysis of the results of using an individual rib-supported guide template for transpedicular screw placement and the “free hand” method in children during surgical correction of congenital spinal deformities accompanied by thoracic development anomalies. MATERIALS AND METHODS: The study included 14 patients who underwent surgical treatment for congenital deformity of the thoracic spine against the background of segmentation disorder of the lateral surfaces of the vertebral bodies in combination with thoracic anomalies. The patients were divided into two groups. Group 1 included six patients operated on using a new navigation template guide, and group 2 consisted of eight patients who underwent installation of support elements using the “free hand” method. The following parameters were compared: time spent at the stage of formation of bone canals for the support elements of the metal structure and accuracy and correctness of support element installation. Clinical data included demographic information and the size of the scoliotic arch, number of support elements, and presence of comp…
creator: Vakhtang G. Toriya
creator: Sergey V. Vissarionov
rights: Copyright (c) 2024 Эко-Вектор
date: 2024-09-23
publication date: 2024-09-23
volume: 13
number: 2
starting page: 349
ending page: 359
doi: 10.17816/PTORS634877

Amplified pain and complex regional pain syndrome in children: clinical cases and literature review
type: item
description: BACKGROUND: Musculoskeletal pain is a common reason for visiting pediatric clinics. Causes of chronic musculoskeletal pain include various inflammatory or noninflammatory conditions. Amplified pain syndrome refers to a wide range of conditions manifested by chronic pain, the common feature of which is central and/or peripheral sensory amplification of pain. Complex regional pain syndrome is characterized by spontaneously occurring or provoked by irritating stimuli pain of high intensity, disproportionate to the actual injury or other stimulus, and the presence of several concomitant vegetative and motor disorders. CLINICAL CASES: This article presents three clinical cases of pediatric patients with chronic musculoskeletal pain and an analysis of the current literature on chronic pain in children. DISCUSSION: Complex regional pain syndrome is more common in adolescent girls, and conflict or psychological trauma is a common trigger. Symptoms of disproportionate burning pain (causalgia) with trophic changes may indicate complex regional pain syndrome. To date, there are no generally accepted pharmacological treatments recommended for children with complex regional pain syndrome. Nonsteroidal anti-inflammatory drugs (ibuprofen) and paracetamol and their combination are commonly administered in cases wherein symptoms of chronic pain first appear. CONCLUSIONS: Currently, a multidisciplinary approach, including physical, psychological, medical, and invasive methods, appears to be the most adequate treatment method for musculoskeletal pain. The use of analgesics should comply with approved protocols of pain management in pediatric practice.
creator: Vladimir M. Kenis
rights: Copyright (c) 2024 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2024-09-23
publication date: 2024-09-23
volume: 13
number: 2
starting page: 361
ending page: 376
doi: 10.17816/PTORS634985

Features of the state of bone tissue in children with cerebral palsy. Part 1. Etiological aspects. A literature review
type: item
description: BACKGROUND: The growth of the human body is the most significant period of development of the bone tissue, because it is during this period that the size, shape, and architectonics of bone are formed against the background of increasing body weight and increasing physical exertion. Considering a number of pathological factors of the underlying disease (alimentary, neurological, hormonal, stress, and physical), bone tissue in children with cerebral palsy grows and develops with deviations from the norm. АIM: To present up-to-date generalized information about the features of bone tissue in children with cerebral palsy to orthopedic traumatologists, neurologists, and physical therapy specialists. MATERIALS AND METHODS: Studies on the problem of bone tissue condition in patients with cerebral palsy were analyzed. Data published over the past 20 years were searched in the scientific databases PubMed, Google Scholar, Cochrane Library, Crossref, and eLibrary without language restrictions. RESULTS: In the last 20 years, the number of studies about pediatric osteoporosis has increased. The gold standard for determining the level of bone mineral density is dual-energy X-ray absorptiometry. However, its use in children has presented some difficulties and limitations. In children, the relationship between bone mineral density values and the risk of fractures has not been well studied, which does not allow us to discuss about osteoporosis based on densitometric bone mineral density data alone. In patients with cerebral palsy, a decrease in bone mineral density and bone mass during growth was found. Previous studies showed that the main factors associated with a decrease in bone mineral density in this group of patients include neuroendocrine causes due to growth retardation against the background of CNS damage, alimentary factors, decreased calcium and vitamin D concentrations, systemic use of glucocorticoids, intake of antiepileptic drugs, decreased motor activity, and low mus…
creator: Vladimir A. Novikov
creator: Valery V. Umnov
creator: Dmitry S. Zharkov
creator: Dmitry V. Umnov
creator: Alina R. Mustafaeva
creator: Olga V. Barlova
rights: Copyright (c) 2024 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2024-09-23
publication date: 2024-09-23
volume: 13
number: 2
starting page: 377
ending page: 388
doi: 10.17816/PTORS634903

Experimental burn models for evaluating wound healing agents and its current situation and existing disadvantages: a literature review
type: item
description: BACKGROUND: Burns remain a crucial part of the structure of injuries in Russia and abroad. Therefore, providing high-quality medical care to burn victims is relevant. Despite the large number of proposed solutions to this condition, developments in the field of tissue engineering and medical materials science still lack standardization and consideration of specific features of animal burn models for their testing. Many studies showed minor and major disadvantages from a technical and descriptive point of view. AIM: To analyze and identify the main disadvantages of existing burn models to assess the effect of wound healing agents. MATERIALS AND METHODS: This article examines the search results in the databases Google Scholar and PubMed using the keywords “burns,” “rats,” “animal model,” and “wound healing.” Sixty publications were analyzed. RESULTS: Seven quality criteria for the animal burn model have been determined, which allow obtaining reliable results and reproducing the described experiment: indication of the terms of quarantine and conditions of keeping laboratory animals, detailed description of the technique of applying burn injury, presence of one burn on a laboratory animal, presence of a control biopsy, indication of the absolute value of the initial burn area, presence of surgical treatment of burn wounds, and correct use of formulas for the planimetric assessment of wound healing. CONCLUSIONS: A solution to the problem of creating a standardized model may be a more detailed description of techniques and following the proposed quality criteria.
creator: Yury A. Novosad
creator: Aleksandr Yu. Makarov
creator: Kristina N. Rodionova
creator: Anton S. Shabunin
creator: Sergei V. Vissarionov
rights: Copyright (c) 2024 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2024-09-23
publication date: 2024-09-23
volume: 13
number: 2
starting page: 389
ending page: 400
doi: 10.17816/PTORS635258

Impact of pectus excavatum deformity on the cardiopulmonary function: a literature review
type: item
description: BACKGROUND: Pectus excavatum deformity is the most common chest wall malformation. Currently, surgeons and researchers of this problem have no consensus on whether pectus excavatum is a purely aesthetic problem or whether pectus excavatum disturbs the function of the cardiopulmonary system. AIM: To analyze publications on the effect of pectus excavatum on the cardiorespiratory system and the functional features of the heart and lung after thoracoplasty in patients with pectus excavatum. MATERIALS AND METHODS: Data were searched in the scientific databases PubMed, Google Scholar, Cochrane Library, Crossref, and eLibrary without language limitation. In this article, the method of analysis and synthesis of information was used. Most of the studies included in the analysis were published in the last 20 years. RESULTS: In patients with pectus excavatum, severity of cardiorespiratory dysfunction depends on the degree of chest deformity. According to obtained data, the pulmonary function test in patients with pectus excavatum in the majority of cases revealed restrictive pattern (formed vital capacity <80% of the norm, with normal ratio of forced expiratory volume in 1 minute to forced lung capacity). In most cases, echocardiography showed compression of the right heart chambers. Comparative analysis of the pre- and postoperative study of cardiorespiratory system in most cases indicated improvement and adaptation of the cardiopulmonary system to stress after surgical intervention. CONCLUSIONS: Funnel chest is an aesthetic problem wherein a severe degree of deformity leads to impaired respiratory mechanics and dysfunction of the cardiovascular system. Surgical restoration of the volume of the retrosternal space allows improvement of the functional capabilities of the heart and lungs.
creator: Alina М. Khodorovskaya
creator: Dmitry V. Ryzhikov
creator: Bahauddin H. Dolgiev
rights: Copyright (c) 2024 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2024-09-23
publication date: 2024-09-23
volume: 13
number: 2
starting page: 401
ending page: 411
doi: 10.17816/PTORS635318

Valentin A. Neverov
type: item
description: Valentin A. Neverov, Honored Physician of the Russian Federation, Doctor of Medical Sciences, Professor, celebrates his 80th birthday. V.A. Neverov is the president of the Russian Association of Traumatologists-Orthopedists of St. Petersburg and Leningrad Region, a member of the editorial board of the journals Grekov’s Bulletin of Surgery and Traumatology and Orthopedics of Russia, and a member of the dissertation council on traumatology and orthopedics. His main scientific research focuses on reconstructive and restorative surgery of the musculoskeletal system and hip arthroplasty.
creator: Board Editorial
rights: Copyright (c) 2024 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2024-06-28
publication date: 2024-06-28
volume: 13
number: 2
starting page: 285
ending page: 286
doi: 10.17816/PTORS633118

Prognostic efficiency of diagnostic blockade as a method of modeling the result of selective neurotomy of the motor branches of the median nerve in patients with cerebral palsy
type: item
description: BACKGROUND: A feature of the disease course in patients with spastic cerebral palsy is a combination of motor neurological disorders with contractures in extremity joints. Neurosurgical methods are currently the main treatment for correcting the pathological tone of the “spastic hand.” However, the decreased tone does not affect secondary (fixed) contractures; therefore, the effectiveness of this type of treatment is extremely dependent on the accurate selection of a certain category of patients. Presumably, diagnostic blockade of the median nerve can create a reversible model for planned neurosurgical treatment. The inclusion of this technique as a standard for examining a patient with spastic cerebral palsy before invasive tone-lowering treatment can radically promote treatment effectiveness. AIM: This study aimed to assess the prognostic effectiveness of diagnostic blockade as a method of modeling the result of selective neurotomy of the motor branches of the median nerve in patients with cerebral palsy. MATERIALS AND METHODS: A longitudinal prospective study enrolled 39 children (aged 5–18 years) with spastic cerebral palsy. Before neurosurgical treatment, each patient underwent a diagnostic n. medianus under electrical stimulation and ultrasound control. After a diagnostic blockade, only patients who had a good functional and goniometric response were selected for the study, which served as an indication for selective neurotomy of the median nerve, and orthopedic treatment was performed in children with a negative event. Patients referred for neurotomy underwent a standardized examination before treatment during the diagnostic blockade and after neurosurgical treatment. The examination included the assessment of the amplitude of passive and active movements in the joints of the upper extremities, muscle tone, and functional capabilities of the upper extremities and dynamometry. RESULTS: In comparison with the initial data, a significant increase in the amplitud…
creator: Vladimir А. Novikov
creator: Valery V. Umnov
creator: Dmitriy S. Zharkov
creator: Olga V. Barlova
creator: Alina R. Mustafaeva
creator: Sergei V. Vissarionov
rights: Copyright (c) 2024 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2024-06-28
publication date: 2024-06-28
volume: 13
number: 2
starting page: 173
ending page: 183
doi: 10.17816/PTORS631798

Musculoskeletal injuries and pain in children involved in sports: A literature review
type: item
description: BACKGROUND: In children, sports aims to obtain positive emotions and improve health and personal development. Sports injuries are associated with various risk factors, such as sex, age, previous injuries, and early specialization. AIM: This study aimed to analyze published data on the epidemiology, etiology, pathogenesis, and diagnosis and treatment of musculoskeletal injuries and associated pain in children engaged in sports. MATERIALS AND METHODS: The literature regarding the epidemiology, diagnosis, and treatment of pain in children involved in sports was explored. The literature search garnered 64 publications, including original articles, reviews, and normative documents. RESULTS: For most athletes, pain commonly occurs during training and competition. Injuries are an inherent risk when playing sports. However, coaches and parents can minimize the risk of injury by ensuring that they choose the right sports activities, use appropriate equipment, follow the rules, use safe practice, and provide adequate supervision. The negative consequences of sports injuries must be balanced with the social, psychological, and health benefits of sports participation. CONCLUSIONS: Treatment of injuries and analgesia must be implemented effectively to prevent pain from becoming chronic and reduce psychological burden on the young athletes.
creator: Vladimir M. Kenis
creator: Alexey G. Baindurashvili
creator: Andrey V. Sapogovskiy
creator: Evgenii V. Melchenko
creator: Aleksandr N. Kasev
creator: Pavel S. Shpulev
rights: Copyright (c) 2024 Эко-Вектор https://creativecommons.org/licenses/by-nc-nd/4.0/
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date: 2024-06-27
publication date: 2024-06-27
volume: 13
number: 2
starting page: 271
ending page: 283
doi: 10.17816/PTORS633296

Advantages of using template guides in children for the correction of congenital spinal deformities and thoracic anomalies
type: item
description: BACKGROUND: In children, progressive congenital deformities of the thoracic spine combined with thoracic anomalies require surgical intervention to correct the curvature and prevent further progression during the child’s growth. Surgical correction of congenital deformity caused by segmentation disorders of the lateral surfaces of the vertebral bodies with unilateral rib synostosis aims at full correction of the existing curvature using the transpedicular spinal system and is an effective and reliable treatment option for these patients. However, this technology requires precise and correct installation of the supporting elements of the metal structure to exclude possible irreversible complications. A solution is the use of template guides in the installation of the support elements of the spinal metal structure. AIM: This study aimed to conduct a comparative analysis of the results of using template guides for the placement of transpedicular screws with the free-hand method in children during surgical correction of congenital spinal deformities combined with thoracic anomalies. MATERIALS AND METHODS: The results of surgical treatment of 20 patients, aged 3–9 years, were analyzed retrospectively to compare the time and accuracy of spinal metal support element placement with and without the use of template guides. The data collected included demographic information, time of bone canal formation, accuracy of spinal transpedicular screw placement, and various complications. RESULTS: Compared with the free-hand method, the use of template guides in the surgical correction of congenital spinal deformities combined with thoracic anomalies in children reduces the time of bone canal formation and increases the accuracy of metal screw placement. These results confirm the efficacy and safety of using template guides during spinal surgery in children with these congenital malformations. CONCLUSIONS: The use of template guides is an effective and reliable method of inserting tr…
creator: Vakhtang G. Toriya
creator: Sergei V. Vissarionov
creator: Vadim A. Manukovskiy
creator: Polina A. Pershina
rights: Copyright (c) 2024 Эко-Вектор
date: 2024-06-27
publication date: 2024-06-27
volume: 13
number: 2
starting page: 217
ending page: 223
doi: 10.17816/PTORS632132

Clinical and radiological variants of the nail–patella syndrome: Why is it important to make a correct diagnosis?
type: item
description: BACKGROUND: Nail–patella syndrome is an autosomal dominant disease caused by LMX1B mutations, characterized by a combination of dermatological and musculoskeletal abnormalities. The classic tetrad of the nail–patella syndrome includes hypoplasia of the nail plates, absence or hypoplasia of the patella, elbow joint contractures, often accompanied by posterior subluxation of the radial head, presence of “iliac horns” on radiographs of the pelvic bones, and renal changes. However, its diagnosis and treatment are not described in sufficient detail in domestic and foreign literature. AIM: This study aimed to analyze the variability of clinical and radiological manifestations in children with nail–patella syndrome. MATERIALS AND METHODS: Nine patients with nail–patella syndrome were examined and treated (aged 4 months to 14 years). All children presented to the H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery with a diagnosis of congenital multiple arthrogryposis. The examination results excluded this diagnosis. The diagnosis of nail–patella syndrome has been verified. RESULTS: Various variants of the nail–patella syndrome have been identified, with lesions to only the elbow joints (n = 3), damage to the upper and lower extremities (n = 5), and damage to only the lower extremities (n = 1). All patients had hypoplasia of fingernail plates. However, the pathognomonic sign – “iliac horns” on radiographs of the pelvic bones – was noted only in 33% of cases. Regarding functional disorders of the kidneys, proteinuria was observed in one patient, which appeared at the age of 15 years. In two cases, the parents suffered from this disease. A genetic examination was performed in three patients: a pathogenic variant in LMX1B was detected in a heterozygous state. All patients underwent conservative treatment for knee and elbow joint contractures and foot deformities. When casting, the presence of dislocation of the radial head or patella was co…
creator: Ekaterina V. Petrova
creator: Svetlana I. Trofimova
creator: Olga E. Agranovich
creator: Tatiana V. Markova
rights: Copyright (c) 2024 Эко-Вектор
date: 2024-06-26
publication date: 2024-06-26
volume: 13
number: 2
starting page: 225
ending page: 236
doi: 10.17816/PTORS630082

Dynamics of feet dorsiflexion after percutaneous Achilles lengthening for correction of flat feet in children
type: item
description: BACKGROUND: Achilloplasty is one of the most common procedures in the reconstruction of various foot deformities. Achilles tendon lengthening is often used in most reconstructive interventions in patients with flatfeet. Literature data reflecting the dynamics of foot dorsiflexion after percutaneous achilloplasty are limited. AIM: This study aimed to determine the foot dorsiflexion dynamics in children with flatfeet at different time points after foot reconstruction in combination with percutaneous Achilles tendon lengthening. MATERIALS AND METHODS: The study included the observation results of 159 children (260 feet) aged 12 (9–17) years having flatfeet with Achilles tendon shortening after flatfoot reconstruction and percutaneous Achilles tendon lengthening. Dynamic follow-up was performed for 3 years after foot reconstruction. The obtained data were analyzed statistically by nonparametric one-factor analysis of variance, Kruskal–Wallis and post hoc test, pairwise comparisons, and Dwass–Steel–Critchlow–Fligner test. RESULTS: At follow-up after Achilles tendon lengthening, significant differences were obtained in the magnitude of the initial foot dorsiflexion up to 2 years after surgery, and other indicators were not significantly different. Foot dorsiflexion with tarsal joint stabilization was significantly different at all stages of follow-up compared with baseline. Foot dorsiflexion tended to decrease throughout the follow-up period. CONCLUSIONS: After reconstructive interventions on the feet in combination with percutaneous Achilles tendon lengthening, the dorsiflexion of the feet decreased over time. At 2 and 3 years after Achilles surgery, dorsiflexion was not significantly different from baseline. The angle of dorsiflexion of the feet with the tarsal joint stabilization 3 years after Achilles tendon lengthening was significantly different from the initial level, but throughout the follow-up there was also a tendency to its gradual decrease.
creator: Andrey V. Sapogovskiy
creator: Olga E. Agranovich
creator: Vladimir M. Kenis
creator: Svetlana I. Trofimova
creator: Ekaterina V. Petrova
rights: Copyright (c) 2024 Эко-Вектор
date: 2024-06-26
publication date: 2024-06-26
volume: 13
number: 2
starting page: 161
ending page: 171
doi: 10.17816/PTORS630489