Аппаратно-хирургические методы лечения деформаций коленного сустава у детей
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2002
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Deformations of knee-joint on children consists of 17,2-21,4% orthopedical patology of lower extremities and result in heary invalid of children. To the present clinical manifestations inborn and acofuiring deformations of Knee joint have been stadieal insufficiently. Having methods treatment are many- sfoged and demand longtime of treatment in стационарных and ambulatory conditions.
The aim of research-to learn clinical manifastation and work out rational principles and methods of treatment deformations of Knee joint on children with using apparatussurgical method of treatment.
The work is founded on testing 402 patients which are in treatment in hospitals of children orthopedics/ Science research Institute Traumatology and orthopedy and Republic Centre of childrens Orthopedy Republic of Uzbekistan in last 15 years. In research of patients were used clinical x-rays, elektrofisical and biomechanical methods
of reseach.
In result of having researches was worked oht new classification deformations of knee joint with registration of first-patological changes in elements of knee joint agreeing which inborn and having deformations of addings were parted to three groups: “boned”, “softmuscule” and “combined”. “Boned** deformations of knee joint - they
are deformations with first patelogical changes in bones of knee joint. “Softmuscule’’ deformations are developing in result of first patological changes in tenden – muscle and ligamental apparatus of knee joint and legs. In cach group of deformations were pointed and deformations with deanging or changings of aduings tones.
Results of elektrofisiological and biomechanical researches showed heat in different inbornal and having deformations of knee-joint are checking truly lowing of amplitiude M-answer of guadriceps femori and ceps muskle of knee, deep changes of functional conditions of«fegs. In result of having treatment bioelectrical activity of muscles of Iegs. is getling better but only in inbornal patological epportunity developing of functional condition of muscles of legs are borobred.
Researches hove showed, that in “softmuscule” deformations conservative treatment might have continued untill 3-4 years ad et child. In “boned” deformations of conservative treatment is litle effektive and from 1,5-2 years ad of patient is putting a fuestion about operative treatment.
Principles of an early operative treatment deformations of knee joint on children were given. Three groups of operative disturbs were pointed, corrigirucal, mobilizarucal and stabilized operations. Corrigibl operations are pointed to cheking of esi and dekoloping of true addings of bones of knee joint. Mobilising operations core pointed 28 fo developing normal volume of actions on knee joint. Stabilizating operations punts the aim of stabilisation of knee-joint with the way of hording patological action in ligamental.
With using compression-distraction method open disturbs on bones and tenden - muskle plasticwere worked out 10 new apparatus-surgical methods of treatment deformations of knee joint. To the having worked out methods of treathaving worked out methods of treathment were 7 author registrations and patentts and 3 documents
to rationalizatorical points.
From 402 children to 365 patients were Worked 466 operative disturbs. Frem hem in 229 are corrigible, in 160 - mobilising and in 77 researches -stabilizatingoperations. Funther results of operative treatment were studied iw paried if til 15 years en 274 patients. In result et having operative disturbs on 95?3% children were got good and satisfactory results. Having worked out apparatus-surgical methods of treatment allows to economize on treatment jf one patient from 37030 som til 39560 som.
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Джураев А.М. Аппаратно-хирургические методы лечения деформаций коленного сустава у детей. [Автореф. дис. д-ра мед. наук]. Ташкент: НИИ травматологии и ортопедии Минздрава Республики Узбекистан; 2002. 28 с.