Rehabilitation of patients after lower limb replantations by the bone distraction method.

The length of the lower extremities was equalized by the bone distraction method in four patients after replantation of lower legs. A Volkov-Oganesian or Ilizarov distraction apparatus was applied on the replanted lower leg after corticotomy of the tibia and osteotomy of the fibula, and distraction was carried out over 6 to 11 months in small, measured doses. The lower extremities were lengthened from 4 to 8 cm. The lengths of the lower extremities were fully equalized in two patients; they were partially equalized in the other two patients. This made it possible to achieve successful rehabilitation of the patients after lower limb replantation.

[Ischemic necrosis of the gluteal area with sciatic nerve damage in newborn infants]. / Ishemicheskii nekroz iagodichnoi oblasti s porazheniem sedalishnogo nerva u novorozhdennykh.

The pathogenesis of dry gluteal necrosis with the involvement of the sciatic nerve as a severe complication of neonatal resuscitation employing umbilical drug administration has been elucidated by angiographic studies. This complication was found to result from a spasm and subsequent thrombosis of the internal iliac artery induced by intraumbilical drug administration. Guidelines for the prevention of this severe complication are offered.

[Orthopedic rehabilitation of children after combined treatment of malignant bone tumors]. / Ortopedicheskaia reabilitatsiia detei posle kombinirovannogo lecheniia zlokachestvennykh opukholei kostei.

The report is based on the data concerning 27 children who were given radiotherapy and chemotherapy for osteogenic sarcomas (14), Ewing's sarcomas and reticulosarcoma (10) and malignant giant cell tumours (2). The reconstructive conservative treatment (7 patients) were referred for prevention of contractures and fractures. The orthopaedic surgical correction of the appearing false joints, deformations and defects of the bones (20 patients) was performed 4 to 5 years after the termination of the primary treatment. During the reconstructive period 3 patients with malignant giant cell tumours and osteogenic sarcoma died because of metastases. The authors have made a conclusion about the advantage of extrafocal compression and distraction osteosynthesis over other methods of fixation and correction of deformations in children after the treatment of malignant bone tumours.

[The combined treatment of osteogenesis imperfecta in children]. / Kompleksnoe lechenie nesovershennogo kosteobrazovaniia u detei.

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).

[Principles of the treatment of dystrophic bone cysts in children]. / Printsipy lecheniia distroficheskikh kist kostei u detei.

The experience with the treatment of 328 children and juveniles with dystrophic bone cysts is analyzed. Nine patients were cured by conservative methods. The others were operated upon (excohleation--in 4 patients; marginal resection--in 244 patients, segmentary resection in 66 patients etc.). The advantages of the marginal resection and alloplasty by the method of "faggot" are shown.

[Pathomorphology and mineral saturation of the bone tissue in congenital vitamin D-resistant rickets]. / Patomorfologiia i mineral'naia nasyshchennost' kostnoi tkani pri vrozhdennom vitamin D-rezistentnom rakhite.

Fragments of tubular bones obtained in correcting operations from 11 patients aged between 10 and 17 years with congenital vitamin-D-resistant rickets were examined using quantitative microroentgenography, light and electron microscopy. The bone tissue was characterized by reduced mineral saturation of microstructures, marked osteoporosis and numerous resorption foci. The latter were located around osteocytes both in the area of osteones and in inserted plates. Electron microscopy revealed uneven incrustation of the organic matrix with the mineral component as well as disorganization of the ultrastructure of collagen fibrills and associated crystals in the foci of periosteocyte resorption.