[Surgical treatment of hip subluxation and luxation in children with spinal hernia consequences]. / Khirurgicheskoe lechenie podvyvikha i vyvikha bedra u detei s posledstviiami spinnomozgovykh gryzh.

AIM: To determine surgical tactics for hip subluxation and luxation in children with spinal hernia consequences. MATERIAL AND METHODS: The study included 134 patients with hip subluxation and luxation with consequences of cerebrospinal hernias who were examined at the Turner Research Institute for Children's Orthopedics in 2006-2016. The main group consisted of 69 patients who received surgical treatment with hip joint stabilization. The control group included 65 children without surgery. Within each group patients were divided into 2 subgroups depending on level of spinal cord injury by using of Sharrard technique. RESULTS: In patients with high lesion (Th and LI-LII) surgical treatment led to impairment of motor function in most cases (71%) (archival material); in case of LIII-LIV and LV-SI segments 25 of 45 (55%) patients improved motor performance while in control group motor function was deteriorated in 13 of 35 (37%) cases. CONCLUSION: Neurosegmental level allows to predict the motor function and to determine surgical tactics.

Effects of spinal cord stimulation on motor functions in children with cerebral palsy.

Is it possible to regulate the functional properties of abnormally developed spinal neuronal locomotor networks using transcutaneous spinal cord stimulation? This question has been studied in twenty-eight participants (∼9 yrs) with spastic cerebral palsy, and mainly Gross Motor Function Classification System for Cerebral Palsy level III. The participants were randomly assigned to two groups. The experimental group received transcutaneous spinal cord stimulation at two spinal levels (over T11 and L1 spinous processes), combined with locomotor treadmill training, whereas the participants of the control group received locomotor treadmill training only. After spinal cord stimulation in the experimental group we found an incremental increase in knee torque whereas in the control group this effect was absent. The amplitude of hip motion increased in both groups. A decrease of co-activation of hip and muscles of the lower extremities was observed in the experimental group while in the control group co-activation decreased only in hip muscles. The results support the idea that locomotor function can be improved significantly with the combination of training and transcutaneous spinal cord stimulation than with training alone.

[The regulation of balance in the children presenting with severe cerebral palsy following the treatment with the use of the locomotor training in combination with the electrical stimulation of leg muscles and spinal cord]. / Regulyatsiya balansa u detei s tyazhelymi formami detskogo tserebral'nogo paralicha posle lokomotornykh trenirovok v kombinatsii s elektrostimulyatsiei myshts i spinnogo mozga.

One of the cerebral palsy (CP) symptoms is the impairment of the ability to maintain upright standing. The objective of the present study was to investigate the effect of the locomotor training combined with electrical transcutaneous spinal cord stimulation (TSCS) and functional electrical stimulation (FES) of the muscles to facilitate the restoration of the vertical posture function in the children presenting with cerebral palsy. PATIENTS AND METHODS: This article is designed to present the results of the study that included 19 patients at the age from 6 to 12 years. The severity of the CP clinical manifestations was estimated to be around 3 in accordance with The Gross Motor Function Classification System (GMFCS). All the patients underwent 15 half-hour daily sessions of robotic mechanotherapy with the use of a locomotor training device. In 8 patients from the main group, each locomotor training session was accompanied by the TSCS and FES procedures. The patients of the control group underwent the locomotor training alone. RESULTS: The dynamics of regaining the standing posture regulation was evaluated by stabilometry that has revealed a significant increase of postural stability in the children of the main group in comparison with those in the control group. It was apparent as a statistically significant (p<0.05) reduction of the length and the area of the center of pressure (COP) projection with open eyes (the 167 mm and 112 mm2 decrease of the median, respectively). In addition, the tendency toward the normalization of the COP projection in the sagittal plane was documented. CONCLUSION: The present study has demonstrated the normalization of the impaired balance control system in the children presenting with the severe form of cerebral palsy under the influence of the combined treatment with the use of transcutaneous spinal cord stimulation and functional electrical stimulation of legs muscles supplemented by the locomotor training.

[Neurorehabilitation of Patients with Cerebral Palsy].

Cerebral palsy is one of the common diseases that cause significant motor impairments. This review deals with new methods of motor rehabilitation of children with cerebral palsy in terms of modern physiology, as well as with summarized and analyzed results of experimental studies on the effectiveness of these methods.

[Botulinum toxine treatment and the formation of antibodies to botulotoxin in patients with cerebral palsy].

The aim of the study was to search for the association between efficacy of botulinum treatment (dysport) and the formation of antibodies to botulinum toxin in children with cerebral palsy (CP). Fourteen children with CP received dysport, 42 children (29 with CP and 13 patients with paresises of other etiologies) were not treated with this drug. No association between the presence of antibodies in blood serum and efficacy of treatment was found. However, further research of the role of antibody genesis as a factor influencing the formation of reaction to treatment is needed.

[Early surgical treatment of low-voltage electric burns of the hand in children]. / Rannee khirurgicheskoe lechenie pri nizkovol'tnykh élektroozhogakh kisti u detei.

Electrical burns give not more than 8% in the structure of burns in children. Most of the children suffer from burns by electrical current of 220 V, and invalidisation of the children can result from inadequate surgical treatment. Advantages of early operative treatment (primary or delayed necrectomy with different kinds of primary skin plastic) are proved as compared with traditional plastic of the granulating wounds. This method can be considered to be the method of choice in treatment of children with low voltage electrical burns of the hand.

[First experience with the surgical treatment of young infants with congenital pathology of the locomotor system]. / Pervyi opyt khirurgicheskogo lecheniia detei rannego vozrasta s vrozhdennoi patologiei oporno-dvigatel'nogo apparata.

The authors have revised traditional principles of treatment of children with a congenital pathology of the locomotor system. Early treatment has been shown to be necessary beginning from infancy since the operations have a more favourable course. Normal anatomo-physiological correlations of the locomotor system are being formed from the early days and months of the infants. Good immediate results were obtained in 22 children. The authors recommend to establish terms of the operative interventions for orthopedic abnormalities immediately after birth in the maternity home.

[Rapid diagnosis of the depth of burns in the first few days after trauma]. / Ekspress-diagnostika glubiny ozhoga v pervye dni posle travmy.

An original method of express diagnostics of the burn depth during first days after trauma is described which used an infrared probe based on different ability of healthy and burned skin with different depths of the burn to reflect infrared rays. A description of clinical tests of the method is given, their reliability was 94.2%.

[Early surgical treatment of deep thermal burns in children]. / Rannee khirurgicheskoe lechenie glubokikh termicheskikh ozhogov u detei.

Early one-step dissection of the crust in deep burns of about 40% of the body square surface within 3-7 days after trauma allowed to shorten the period of treatment at the hospital and to improve immediate results of plasty. Lethality was also reduced.

[Use of subnarcotic concentrations of methoxyflurane in children with burns]. / Primenenie subnarkoticheskikh kontsentratsii metoksifliurana u obozhzhennykh detei

A test is described, that makes it possible to determine changes likely to occur in the content of blood sugar after operations in patients with concomitant diabetes mellitus.