Introduction

This article discusses the problem of clubfoot in children with fibular hemimelia (FH). FH is a rare congenital disease characterized by underdevelopment of the fibula and leading to deformity of the foot and lower leg. Clubfoot in FH is even rarer and has its own peculiarities in diagnosis and choice of treatment option.

The purpose of the study

To study the features of clubfoot in fibular hemimelia, develop a treatment strategy and determine the most effective methods for correcting deformity against the background of growth, depending on the types of deformity.

Materials and methods

To achieve this goal, an analysis of literary sources was conducted (using the scientific article databases PubMed (30 articles), Google Schlolar (13 articles), Elibrary (10 articles), Cyberleninka (13 articles) in the period from 1982 to 2022), and clinical cases of treatment of patients in Yaroslavl with clubfoot and fibular hemimelia were studied.

Results

The study revealed the diagnostic features of clubfoot in FH, which must be taken into account in conservative and surgical treatment, distinguishing it from idiopathic clubfoot. The criteria for the diagnosis and classification of FH were also determined. The results obtained confirm the need for early access to specialists and timely initiation of treatment. The use of complex methods allows achieving high results and improving the quality of life of patients with this disease. 

The aim to study the features of callus formation in patients with the presence and absence of a local infectious process in the bone in case of deficiency/ excess of soft tissue.

Rationale. Due to the constant increase in the number of patients with complications of fractures of the shin bones (ostitis, osteomyelitis, false joint, infected false joint), there is a need to rationalize and improve their treatment methods.

Materials and Methods. In the course of a single-center retrospective study, 82 patients were selected. All this patients underwent tibial defect replacement using various methods at the Ilizarov Center. Timelimit from 2010 to 2024. When processing the primary documentation, 29 cases were excluded due to various reasons (the most common was the lack of final radiographs, because patients completed treatment at their place of residence). The average age of the remaining 56 patients was 42 years. Two main groups were obtained: 1- in which the bone fragment was transported to replace the defect while maintaining the segment length, and 2— segment shortening with following length restoration. The studied indicators in the groups were: the relative size of the defect (the ratio of the length of the defect to the original segment length), the volume of distraction regenerate, the minimum diameter of distraction regenerate in one of the radiographic projections, the ratio between minimum diameter and relative size of the defect, the morphometric type of distraction bone regenerate in Li Ru classifications and the age of the patient. The average defect value was 27.2% (minimum 12%, maximum 63%). All surgical procedures were performed by experienced surgeons. After the osteotomy the distraction was delayed for a 7-10 days , then the distraction mode was 1,0 mm/day until X-ray confirmation of the clear space between the fragments. Most of the patients were then discharged on an outpatient basis with the recommended distraction speed 0.5 mm/day.

Results. A check was carried out on the normality of the distribution of signs in all groups according to Shapiro-Wilk. Next, a comparison was performed for the reliability of differences between patients with the presence/absence of a local infectious process, who performed the same type of bone replacement method (either segment bone transport or shortening with following length restoration).Minimal statistically significant differences in age and type of Li regenerate were found in patients who underwent bone transport. There were no statistically significant differences in all other indicators in both groups. The resulting indicators for assessing distraction regeneration are its minimum diameter and the type of regenerate according to Ru Li, because of asymmetric load on the entire structure of the regenerate, even the presence of a large volume makes it impossible to carry out a functional load on the segment. The absence of the influence of a local infectious process in bone and soft tissues around on distractive neoosteogenesis has been statistically proven. After conducting a correlation analysis of the main indicators in both groups and comparing them, it was proved that distractive osteoneogenesis proceeds better in conditions of an excess of soft tissues, that is, with segment shortening with following length restoration.

The relevance of this study is determined by the necessity to assess kinematic balance in patients with degenerative-dystrophic hip joint disorders at different stages of surgical treatment and rehabilitation. The main objective of the research is to analyze compensation mechanisms after hip arthroplasty, the dynamics of functional recovery, and factors influencing motor activity in patients.

Methods: The study involved 710 patients, divided into two groups based on the applied therapeutic methods. Functional status assessment was conducted using stabilometry, podography, goniometry, electromyography, and statistical analysis. Kinematic parameters were evaluated through gait phase analysis and postural control assessment.

Results: The study demonstrated that hip arthroplasty contributes to restoring kinematic balance, reducing pain syndrome, and improving functional outcomes. However, patients with post-traumatic hip disorders exhibited residual functional limitations. Personalized rehabilitation strategies, incorporating biomechanical analysis and 3D modeling, yielded superior outcomes compared to conventional approaches.

Conclusion: The findings confirm the necessity of a personalized approach to rehabilitation in patients undergoing hip arthroplasty. A detailed examination of biomechanical characteristics and the optimization of rehabilitation programs enhance the effectiveness of medical interventions and improve patients’ quality of life.

Introduction.

To date, the need to replace bone mass defects of the proximal humerus when performing total reverse shoulder arthroplasty is a debated issue. Therefore, it became necessary to study the possibilities of using personalized 3D augments of the proximal humerus. Purpose of the study: to analyze the results of surgical treatment with the use of personalized 3D augments of the proximal humerus and to compare them with the results of traditional methods of surgical treatment.

Materials and methods:

There were 90 patients with bone defects of the proximal humerus who underwent total reverse shoulder joint arthroplasty were included in the study. The study distinguished 2 groups of patients: Group 1 - 46 (51.1%) patients who underwent surgical treatment using custom-made 3D augments of the proximal humerus, Group 2 - 44 (48.9%) patients who underwent surgical treatment using the traditional technique. Such data as total operation time, intraoperative blood loss, number of postoperative complications, as well as functional results of treatment based on the data of SCI, DASH and VAS scales were analyzed. The average follow-up period was 14.8 months.

Results:

statistically significant (p<0.05) reduction of the average operation time, intraoperative blood loss and the number of postoperative complications in the 1st group of patients was observed. Analysis of the scale-questionnaire data also showed statistically significant (p<0,05) better functional results of treatment in the 1st group of patients.

Conclusion:

According to the results of the study we can conclude that in case of the proximal humerus bone loss the use of 3D customized augments has many advantages, such as: shorter average operative time and intraoperative blood loss, as well as fewer complications. It should also be noted that the augmentation of proximal humerus provides better functional results of treatment, stability in the joint and prevention of dislocations.

Introductions. The study was initiated due to the problem of coxa-vertebral syndrome (combined degenerative changes in the hip joint and spine) with shortening of the limb on the coxarthrosis side, which causes complex disorders including pain, spinal deformity, pelvic curvature, gait and statics. The underestimation of the importance of developing a comprehensive approach to the treatment of these patients was the basis for this study. 

Objective. To evaluate the effectiveness of the system of complex treatment of patients with coxa-vertebral syndrome in the presence of limb shortening on the side of coxarthrosis.

Materials and methods. We examined and treated 68 patients diagnosed with coxovertebral syndrome with unilateral limb shortening. In the main group surgical treatment (total hip arthroplasty with limb alignment) was supplemented with therapeutic complex (systemic drug therapy, physiotherapy, physical therapy, physical training, massage, manual therapy, etc.), and in the comparison group - not.

Results. It was found that in the main group the objective results of treatment were significantly better, and patient satisfaction with the results of treatment was significantly higher than in the comparison group.

Conclusion. The obtained results allow us to recommend the developed system for complex treatment of patients with coxovertebral syndrome in the presence of limb shortening on the side of coxarthrosis. 

In recent decades, orthopedic science has identified a number of fundamental areas in restoring the functional capabilities of patients based on the use of high-tech methods for treating musculoskeletal pathologies. Arthroplasty has become a key element in solving the problems of late stages of joint diseases,  especially of the lower extremities. However, systemic pathologies, including autoimmune skeletal diseases, especially rheumatoid arthritis (RA) and ankylosing spondylitis (AS), pose unique challenges that require a specialized approach. The importance of endoprosthetics for replacing the hip and knee joint in the complex treatment of AS cannot be overestimated. Radical interventions can relieve pain, restore joint function and improve the quality of life of such a complex group of patients. They play an important role in restoring the patient's physical activity and mitigating the effects of severe skeletal pathology. Without solving the fundamental problem of healing, the method helps to improve the patient's quality of life, which makes it indispensable today. The purpose of the work is to consider treatment options and analyze publications of domestic and foreign authors on the issues of ankylosing spondylitis with an emphasis on surgical correction of late stages of articular manifestations. Source search methodology. To prepare the literature review, the electronic database of scientific literature PubMed (MEDLINE) was used. The literature was searched using the following keywords: ankylosing spondylitis, rheumatoid arthritis, hip replacement The following INCLUSION CRITERIA were used: randomized controlled clinical trials, clinical cases, systematic reviews, meta-analyses. EXCLUSION CRITERIA were articles without a full-text version, duplicate publications. Preference was given to works over the past 5-10 years. 

Introduction. The consequences of calcaneal fractures cause persistent disability of patients and decrease their quality of life. Typical manifestations include hindfoot deformity, flatfoot and subtalar arthrosis. Persistent post-traumatic deformities over time lead to pathologic biomechanics of the foot and impaired kinematics and kinetics of the lower limbs and pelvis. To improve function, reduce pain syndrome, and prevent arthrosis of adjacent joints, it is necessary to correct the deformity and stabilize the hindfoot of the injured foot surgically.

The aim of the research: To determine the current state of the problem of surgical treatment of stale calcaneal fractures based on the analysis of domestic and foreign literature.

Materials and methods. Publications were searched in the following scientific electronic platforms - Pubmed, eLIBRARY with a search depth of 36 years (from 1988 to 2024). A keyword search was conducted and potentially relevant papers were identified. After reviewing the full texts of the studies, a systematic parsing of the data was performed, followed by identification of key parameters. The results were highlighted, analyzed and summarized. Results. The paper touches upon the issues devoted to clinical manifestations, methods of radial diagnosis, classification and surgical approaches to the correction of various types of deformities resulting from improper heel bone fracture fusion. Successful correction of posttraumatic deformity of the calcaneus requires a comprehensive and comprehensive examination of the patient. Modern systems of deformity classification and correction help orthopedists in choosing the optimal surgical tactics, but the issue of performing these interventions in routine practice remains controversial and requires further study and discussion.