scholarly journals Clinical Manifestations, Diagnosis and Treatment of Congenital Arthrogryposis in Children

2003 ◽  
Vol 10 (2) ◽  
pp. 79-85
Author(s):  
O L Malakhov ◽  
I S Kosov ◽  
I A But-Gusaim ◽  
S A Mikhaylova ◽  
O A Malakhov ◽  
...  

Experience in treatment of limb contractures and deformities in children with congenital arthrogryposis is presented. The main principles of treatment were detected. Complex of diagnostic and curative measures including conservative treatment of patients stating from birth is described in details. Conservative treatment consists of therapeutic exercises, massage, physiotherapy, special braces and plaster bandages. Surgical treatment method using external fixation devices is presented. The method of biocontrol disturbance detection is given and the use of functional biocontrol (FBC) method for the treatment of this pathology is well grounded. Early results of FBC use are evaluated as positive ones that confirms the expedience of further use of FBC for the treatment of patients with congenital arthrogryposis.

2007 ◽  
Vol 6 (3) ◽  
pp. 43-50
Author(s):  
V. A. Koubyshkin ◽  
I. A. Kozlov ◽  
N. I. Yashina ◽  
T. V. Shevchenko

The experience of surgical treatment of 154 patients having chronic pancreatitis with preferential injury of the pancreas head which underwent different operative interventions: isolated resection of pancreatic head ( based upon Berger surgery - 24, Frey surgery - 39), pancreatoduodenal resection ( with gastric resection - 22, with preserved pylorus - 43) and drainage surgeries - 26 is presented in the article. The surgery of isolated resection of pancreatic head has less number of nearest unfavorable results compared with pancretoduodenal resection with preserved pylorus. Proximal resection of the pancreas the variants of which are different isolated resection of pancreatic head is superior upon surgeries with full or partly resection of the duodenum due to fast normalization of the motor-evacuation function, less rate of the intestinal reflux and portion character of duodenal evacuation. In the follow-up period after pancreatoduodenal resection, atrophic processes occur in distal areas of the pancreas which are followed by clinical manifestations of exo- and endocrinous insufficiency. The surgery of longitudinal pancreatic jejunostomy does not avoid pathologic changes in the organ head and pain syndrome.


2018 ◽  
pp. 27-35
Author(s):  
E. A. Zagryadskiy ◽  
A. M. Bogomazov ◽  
E. B. Golovko

OBJECTIVE. Determine the frequency of clinical manifestations of hemorrhoids and constipation in people seeking advice about hemorrhoids. In the course of the treatment of patients with hemorrhoids phlebotropic evaluate the effectiveness of therapy micronized purified flavonoid fraction (MPFF). MATERIALS AND METHODS. This multicenter study, including screening and observation part, which is part of the International Research «CHORUS» (Chronic venous and hemorrhoid diseases evaluation and scientific research), conducted in nine centers in different regions of Russia, 80 doctors of Coloproctology. In the screening group included 2668 patients who had investigated the incidence of constipation, as a risk factor for hemorrhoids. Conservative treatment, the foundation of which was, Moffitt therapy, received 1952 patients with stage I-IV hemorrhoids. Evaluating the effectiveness of the treatment was evaluated on the basis of a questionnaire. RESULTS. The questionnaire shows that constipation suffered - 766 (28,8 %) patients. Violation of defecation patterns and changes in stool consistency was observed in 1155 (43,9%) and 633 (25.5 %), respectively. At the same time, 288 (11,1 %) indicated a tendency to loose stools and diarrhea. Conservative treatment, the foundation of which is phlebotropic MPFF therapy conducted in patients of observational group has shown its efficiency in all grades of hemorrhoids. During the entire observation period of conservative treatment was effective in 1489 (76,3 %) patients. Surgical treatment was performed in 463 (23 %) patients grade I-IV hemorrhoids, the main part of patients with grade III -199 (43,1 %) and grade IV hemorrhoids - 68 (64,2 %). CONCLUSION. Conservative treatment of hemorrhoid disease, which is the basis on phlebotropic MPFF therapy, is effective at all stages of hemorrhoids, but in patients with grade III and grade IV disease requires surgical treatment.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Algirdas Puisys ◽  
Viktorija Auzbikaviciute ◽  
Renata Simkunaite-Rizgeliene ◽  
Dainius Razukevicius ◽  
Rokas Linkevicius ◽  
...  

The aim of this case report is to show that bone remineralization around dental implants with a history of peri-implantitis is possible after irritant factors are removed and only conservative treatment is performed. Patient came to the clinic after three years of dental implant placement complaining about swelling, sensitivity and gingiva color changes at the posterior part of the maxilla. During radiographic and intraoral examinations peri-implantitis of the #24 implant site was diagnosed. The surgical treatment method was rejected and performed conservative treatment instead. The outcome is promising; periapical radiographs three months later showed bone remineralization as well as stable bone after 10 years. A key clinical message: Bone remineralization around dental implants with a history of peri-implantitis is possible after irritant factors are removed and conservative treatment performed.


2019 ◽  
pp. 48-53
Author(s):  
V. M. Svistushkin ◽  
E. V. Sinkov ◽  
G. L. Shumkova ◽  
E. L. Amelina ◽  
S. A. Krasovsky

Among diseases of ENT organs at patients with the CF prevails chronic rhinosinusitis. Stagnation of the infected dense slime in the paranasal sinus and violation of nasal breath aggravates weight of a course of lung pathology. Timely inspection and treatment of pathology of the top airways at patients with CF is necessary. In surgical treatment method of a choice is expanded FESS. This technique allows to keep anatomy of a facial skeleton and to provide a drainage the paranasal sinus. Supervision by the ENT specialist and conservative treatment of a chronic rhinosinusitis has to is carried out during all life of the patient with CF. Continuous use of local mukolitichesky and antibacterial therapy is necessary. As method of delivery of medicines the compressor inhaler with the mode for the chronic rhinosinusitis can serve.


2004 ◽  
Vol 11 (3) ◽  
pp. 57
Author(s):  
I. O Pankov

Fifty patients with intraarticular fractures of tibial condyle were treated by transosseous osteo­synthesis with application of external fixation devices. Peculiarities of transosseous osteosynthe­sis in various types of intraarticular condyle fractures have been described. In 44 patients the follow up period made up 1—12 years. Favorable results have been noted in 43 (97.7%) patients including excellent and good results in 35 (79.5%) patients.


2019 ◽  
Vol 16 (1) ◽  
pp. 38-47 ◽  
Author(s):  
V. P. Snishchuk ◽  
A. Yu. Mushkin

Objective.To analyze epidemiological and clinical features of degenerative disease of the spine complicated by radicular syndrome in children, as well as the effectiveness of its treatment on the example of one of the largest regions of the Russian Federation.Material and Methods.Design of the study corresponds to a retrospective cohort clinical and epidemiological study for 17 years. The study included 201 patients aged 10–17 years with degenerative changes in the spine complicated by radicular syndrome. An epidemiological analysis included the assessment of the regional incidence of degenerative diseases of the spine in children, and clinical analysis – the effectiveness of conservative and surgical treatment. The age and sex structure of the cohort, the level of pathology, the effectiveness of surgical treatment, and age-related features of early spinal discosis in children as compared with degenerative lesions of the spine in adults were analyzed.Results.The epidemiological frequency of degenerative diseases accompanied by clinical manifestations and requiring special treatment in the Leningrad Region was assessed as 8.7 per 100 thousand children aged 10–17 years. Conservative treatment was effective in 172 patients, and 29 patients were treated with surgery. Surgical results were followed up for 1 to 16 years after surgery and were evaluated as excellent, good, and satisfactory respectively in 4 (14 %), 20 (69 %), and 5 (17 %) cases. Complications were reported in two cases: migration of the interbody stabilizing implant and positional neuropathy of the peroneal nerve associated with the position on the operating table.Conclusion. The epidemiological analysis conducted on a regional cohort of the Leningrad Region can be used in assessing the potential need for conservative and surgical treatment of children with degenerative pathology in other regions of Russia. Conservative treatment of this pathology is quite effective, and surgical decompression of nerve roots was required only in 14.4 % of cases.


2021 ◽  
pp. 103-108
Author(s):  
O. S. Gerasimenko ◽  
Y. I. Gaida ◽  
A. V. Okolets ◽  
K. R. Muradian

Summary. Combat injury of the abdomen, according to the ATO / OOS is from 6.7 to 9 %. The specificity of gunshot wounds to the abdomen causes the development of functional disorders and complications (51–81 %) and, as a consequence, a high mortality rate (12–31 %). Objective: To improve the effectiveness of surgical treatment of purulent-septic complications in the wounded with combat trauma to the abdomen (BTC). Materials and methods. The Military Medical Clinical Center of the Southern Region (VMKC PR) analyzed the treatment of 86 wounded who were hospitalized with purulent-septic complications of BTZ from 2014 to 2020, taking into account the location, clinical manifestations and severity of injury, used modern treatment methods , namely: puncture and drainage interventions under the control of ultrasonography and installation of NPWT systems. Comprehensive treatment was supplemented with antibacterial therapy and oxygen barotherapy. First of all, the wounded underwent puncture and drainage interventions under ultrasonic navigation and gradual rehabilitation for diagnostic and therapeutic purposes. NPWT therapy was used in 11 patients with extensive wounds and purulent-septic complications of the soft tissues of the anterior abdominal wall. Thus, the use of interventional sonography, as the primary diagnostic and treatment method for the treatment of purulent-inflammatory complications of combat trauma to the abdomen, has improved the quality of diagnosis and reduced traumatic interventions, which has reduced postoperative complications and inpatient treatment. Results and discussion. Eleven (14.2 %) cases of puncture and drainage interventions were ineffective, in connection with which we had to resort to traditional methods of treatment — opening and drainage of purulent-inflammatory foci and the use of NPWT-therapy. Vacuum therapy is an effective method of treatment of purulent-septic complications of gunshot wounds of the soft tissues of the abdomen, which in combination with puncture-drainage interventions, can reduce by 2.5 times the number of repeated operations (mainly multi-stage surgical treatments), thereby reducing 1.8 times the length of stay of patients in the hospital. Conclusions. Thanks to the use of modern methods it was possible to improve the results of surgical treatment of purulent-septic complications in the wounded with purulent-septic complications of combat trauma to the abdomen. The use of the latest techniques has helped reduce the number of invasive treatments, accelerate recovery, reduce bed rest, reduce intoxication, and increase the rate of return of servicemen.


2020 ◽  
Vol 26 (4) ◽  
pp. 527-531
Author(s):  
A.M. Dzhuraev ◽  
◽  
B.U. Kholmatov ◽  
Kh.M. Karimov ◽  
A.R. Khashimov ◽  
...  

Introduction Fibular hemimelia is a rare congenital malformation of lower limbs with associated deformities of the knee and ankle joints. There is no consensus among the authors regarding the choice of treatment method, appropriate timing of surgery, strategy and postoperative rehabilitation. Objective To explore clinical manifestations of the deformities and review outcomes of pediatric surgical treatment of fibular hemimelia. Material and methods Surgical treatment was performed for 11 children with fibular hemimelia at the Department of Pediatric Orthopedics, RSSPMCTO RUz between 2014 and 2019. Clinical and instrumentation studies were produced for all patients. Results Outcomes of surgical treatment were evaluated using functional characteristics with 7 rated as good and 4 as fair. Conclusion External fixation offers an effective treatment option in the pediatric surgical management of fibular hemimelia.


2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Moletta Lucia ◽  
Capovilla Giovanni ◽  
Gavagna Laura ◽  
Cornaviera Giorgia ◽  
Taufer Marco ◽  
...  

Abstract Aim Pharyngo-oesophageal perforation is a rare, life-threatening complication of cervical spine surgery. Only isolated cases are reported in the English literature and correct management of these patients remains poorly defined. The aim of this study is to review our experience to better clarify the appropriate treatment of this dreadful complication. Background and Methods Data regarding demographics, clinical course, diagnosis, management and outcomes of 13 patients (8 M, 5F, mean age 49 years) with oesophageal perforation after cervical spine surgery were collected during the period from 2002 to 2019. Results Pharyngo-oesophageal perforation occurred at a median of 8 days (range 0-4745 days) after cervical spine surgery. Clinical manifestations included neck abscess in 7 cases, fever in 3 cases, dysphagia and regurgitation in 3 cases. In 2 patients conservative management with fasting and antibiotics was attempted but, in both cases, a subsequent surgical intervention was required. All patients underwent surgical treatment. A step-up approach with initial surgical drainage of a purulent cervical collection was performed in 7 patients, delaying definitive surgery after resolution of cervical infection. Definitive surgical treatment with total or partial removal of spine fixation devices, autologous bone graft insertion or plate/cage replacement, anatomical suture of the fistula and suture line reinforcement with myoplasty (either with sternocleidomastoid or pectoralis major muscle flap) was performed in 10 patients. Perforation recurred in two cases, requiring further surgical management. At a median follow-up of 23 months (range 5-149 months) all patients exhibited permanent resolution of the perforation. Conclusions Pharyngo-oesophageal perforation following cervical spine surgery is a rare but dreadful complication: prompt recognition and treatment of these injuries is critical to minimize morbidity and mortality. Partial or total removal of the fixation devices, direct suture of the oesophageal defect and coverage with tissue flaps seems to be an effective surgical approach in these patients.


Medicina ◽  
2008 ◽  
Vol 45 (1) ◽  
pp. 37 ◽  
Author(s):  
Kęstutis Maslauskas ◽  
Rytis Rimdeika ◽  
Jolita Rapolienė ◽  
Žilvinas Saladžinskas ◽  
Donatas Samsanavičius ◽  
...  

Hands actively participate in daily activities of a human; therefore, hands are the most vulnerable parts of the human body. People injure hands so often because namely hands are in the closest position to the dangerous equipment. According to the data of various authors, the injuries of hands and fingers make even 30–75% of all industrial traumas, and burns of hands account for about 6% of all traumas of hands. The aim of the study was to compare the effectiveness of active surgical treatment method with conservative treatment method, applied for the treatment of deep dermal partial skin thickness burns of the hands, wrists, and forearms of distal third. Materials and methods. A total of 49 patients with burned hands participated in the perspective study of random sample (totally 79 hands). All these patients were treated in the Department of Plastic and Reconstructive Surgery, Hospital of Kaunas University of Medicine, during the period of 2001–2005. The patients were assessed after 3, 6, and 12 months. Results. Applying conservative method of treatment of deep partial skin thickness burns, the frequency of infectious complications was increased. In order to evaluate the state of scar, we applied the scale of Vancouver and analyzed the pigmentation of a scar, its height, flexibility, and color. After statistical analysis had been performed, we determined that more changes of skin were seen in the group, which received active surgical treatment (P<0.05). Conclusions. Statistically significantly fewer complications were in the group of active surgical treatment in the early (fewer infectious complications, smaller area of unnaturalized autograft) and in the late (scars were less rough, with less changes of pigmentation) postoperative periods


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