ABSTRACT
Experience in treatment of 55 patients with spine deformities developed on the background of systemic hereditary spine diseases is presented. Algorithm of the examination and treatment tactics for this group of patients is presented. Features of surgical technique in dorsal, ventral and combined approaches are described.
Subject(s)
Bone Diseases, Developmental/surgery , Osteochondrodysplasias/surgery , Spinal Diseases/surgery , Adolescent , Algorithms , Child , Child, Preschool , Female , Humans , Kyphosis/diagnostic imaging , Kyphosis/surgery , Male , Neurofibromatoses/surgery , Radiography , Scoliosis/diagnostic imaging , Scoliosis/surgery , Spinal Diseases/diagnosis , Spinal Diseases/geneticsABSTRACT
The technology for producing demineralized bone allografts (DBA) with definable degree of demineralization and sterilization by high energy electron bean was developed in the tissue bank of Central Institute of Traumatology and Orthopaedics (CITO). The authors consider the technology to be one of the ways of producing demineralized bones. The results of the experiments show that time of demineralization process as well as the absorption dose of radioactive high energy electron beam change substantially mechanical toughness and osteoinductive properties of DBA. Mechanical properties of DBA were tested by the universal testing machine 'Zwick 1464'. Quantitative assessment of DBA osteoinductive properties resulted from the investigation of DBA samples in the culture of stromal precursor bone marrow cells and in the culture of human skin fibroblasts. Cloning efficiency of fibroblasts was considered as indecies of proliferative potential of stromal bone marrow cells, i.e. osteogenic precursor cells. The growth of the cell mass after definite time as well as the index of 3H-timidin marked cells within biological inductor were considered as indecies of proliferative potential of skin fibroblasts. The obtained results showed, that inductive properties of allografts improve when the degree of their demineralization increases whereas the dose of high energy electron radiation decreases. Mechanical toughness of DBA deteriorates when both degree of their demineralization and radiation doses increase. This emphasizes the importance of optimizing technological stages in DBA producing. Since 1998 DBA have been used in Russian clinics for bone plasty in traumatology and orthopaedics, maxilla-facial surgery, ophthalmology, and neurosurgery. The resulting analysis is based on case histories of 257 patients operated from March 1998 to July 2002. The majority of patients were children and teenagers of 3-18 years old with prime tumors, tumor-like and systemic inherited diseases of skeleton, post-traumatic complications. Observation periods were from 1.5 to 5 years and 10 months. Good and satisfactory results were obtained in 93.4% cases.
Subject(s)
Bone Demineralization Technique , Bone Transplantation , Adolescent , Adult , Child , Child, Preschool , Frontal Bone , Humans , Leg Bones , Mandible , Transplantation, HomologousSubject(s)
Rickets/drug therapy , Rickets/surgery , Acidosis, Renal Tubular/drug therapy , Acidosis, Renal Tubular/surgery , Adolescent , Child , Child, Preschool , Combined Modality Therapy , Drug Therapy, Combination , Fanconi Syndrome/drug therapy , Fanconi Syndrome/surgery , Follow-Up Studies , Humans , Hypophosphatemia, Familial/drug therapy , Hypophosphatemia, Familial/surgery , Remission InductionABSTRACT
The authors present the results of complex drug and orthopaedic treatment of children with imperfect osteogenesis. 40 patients were treated with a somatotropic hormone, calcitrin and vitamin D metabolites (oxydevit and dihydrocholecalciferol). In 20 of these patients corrective osteotomies of the long bones of the lower extremities combined with metal osteosynthesis with rods and massive plates were performed. In a number of patients osteoplasty with long cortical allografts was made. After the treatment all the children were able to move independently either with the aid of unloading orthopaedic apparatuses (17 patients), or without them (3 patients).
Subject(s)
Osteogenesis Imperfecta/therapy , Bone Plates , Bone Transplantation , Child , Combined Modality Therapy/methods , Drug Therapy, Combination , Follow-Up Studies , Humans , Osteogenesis Imperfecta/diagnosis , Osteotomy , Physical Therapy Modalities/methods , Preoperative CareABSTRACT
The work presents an experience with the treatment of 50 patients with polyossal form of fibrous osteodysplasia on whom 99 operations were performed. A method of plasty of bone defects was elaborated and used in order to eliminate severe deformations of lower extremity bones after removal of pathological tissue in combination with epiosseous nailing osteosynthesis. In patients with short bones the compression-distraction osteosynthesis with bone alloplasty was used. Long-term results of treatment of 48 patients make it possible to recommend the methods of bone alloplasty with extraosseous and intraosseous nailing osteosynthesis as well as compression-distraction devices for practical use.
