Distally Based Sural Flap in Children: Reliability Technique

The distally based sural flap often poses the problem of venous suffering that can lead to necrosis. We present a reconstruction of a loss of substance of the ankle in a 6 years old child, using a distal pedicle sural flap, made reliable by a racket like flap method, which reduces the risk of vascular complications and led to good integration of the flap, with a good functional result. Nevertheless, the aesthetic sequelae remain significant.

Analysis of surgical treatment results of the traumatic cataract with the lens capsule-ligament apparatus destruction and suture fixation of IOL

Purpose. To evaluate the surgical treatment results of traumatic cataract with the lens capsule-ligament apparatus destruction and suture fixation of IOLs. Materials and methods. 33 patients with traumatic cataract with the lens capsule-ligament apparatus destruction and suture fixation of IOLs aged 22 to 68 years were examined. All patients underwent phacoemulsification of traumatic cataract with IOL implantation using standard technology with a 2.0 mm tunnel incision. The result was evaluated on the first day, first and third months of observation. Results. On the 1st day after the operation the BCVA increased from 0.11±0.12 to 0.43±0.26, the IOP decreased from 21.67±1.5 to 20.97±1.2 mm Hg. By the 3rd month of observation the mean BCVA value was 0.61±0.29, IOP – 19.33±1.0 mm Hg. Conclusion. Traumatic cataract phacoemulsification with implantation and suture fixation of IOL is an effective method of treatment, allowing to achieve not only anatomical, but also a good functional result. Key words: traumatic cataract, phacoemulsification, IOL suture fixation.

Neurofibromatosis 2: new perspectives in treatment (case report)

Neurofibromatosis 2 is one of the most prevalence disease among phakomatoses characterized by appearance of new central and peripheral nerve system tumors. The main treatment for this patient is a surgery, but in real time we observe the significant changes in treatment and rehabilitation in this patients including radiation therapy and pharmacotherapy. In this paper, we present the case of a different treatment options in young female with neurofibromatosis. She completed surgical treatment, Gamma Knife radiosurgery and bevacizumab on different stage of disease. Development of genetic and molecular methods and appearance of new way for treatment could help to achieve a good functional result and stable local control but new clinical and fundamental research are needed.

SIMULTANEOUS REMOVAL OF THE NEURINOMA OF THE TRIPLE NERV, LOCALIZED IN THE BACK, MIDDLE, AND SECULAR PITS. CLINICAL OBSERVATION AND REVIEW OF LITERATURE.

The aim of the study is to consider and show the possibilities of methods for surgery of skull base tumors using the example of successful surgical treatment of a patient with widespread trigeminal neuroma located in the posterior, middle and temporal fossae, as well as to analyze international scientific experience on this issue. Materials and methods. In February 2020, a 60-year-old patient with widespread trigeminal neuroma on the left was admitted to the Federal Scientific-Clinical Center of FMBA of Russia in February 2020. After additional examination and preoperative preparation, a planned operation was performed - osteoplastic orbitozygomatic trepanation of the skull, microsurgical removal of the tumor through subtemporal transcavernous access. A good postoperative clinical result was obtained. An analysis of the available scientific literature on this problem is carried out. Results. In the postoperative period, pain and neurological symptoms, hemifacial spasm completely regressed. 1.5 months after the operation, the tumor was totally removed in the control images. In the course of the analysis of available foreign and domestic literature, 65 observations of trigeminal tumors with extracranial growth were found, the total removal of which was performed only in 20% of patients. Conclusion. Despite the extreme complexity of the pathology, the operation through the orbitozygomatic subtemporal transcavernous access allows you to completely remove the common and giant trigeminal neuromas with a good functional result.

Simple Bone Cyst Treated with Percutaneous Steroid Injection

Objectives: Through this study, we want to explore the effectiveness of methylprednisolone injections to treat simple bone cyst (SBC).Methods: We collected the data of all patients with SBC who were treated with percutaneous steroid injection (PSI). The study was conducted in Cipto Mangunkusumo Hospital and we used a computerized search of operative reports to identify all SBC patients who were treated by PSI 3 times between 2013 and 2016.Results: A total of 10 patients were reported in these serial cases, 8 males and 2 females. The average age of these subjects is 7.8 years old. Musculoskeletal Tumor Society functional score determine good result after 3rd injection of steroid. Bone healing evaluation using Chang Criteria showed a good healing proccess.Conclusion: Steroid injection therapy for SBC yielded a good functional result. It gets solid union relatively quickly, simple operation procedure, widely available, with less side effect. Therefore, this procedure could be a choice for treatment of SBCs patient. Further study needs to be conducted with more sample size.

Experience in Treatment of Total Hand Syndactyly in a Child with Apert Syndrome

Experience in surgical treatment of total hand syndactyly in a child with Apert syndrome is presented. Surgical technique that includes the application of МЦТ-01 apparatus, distraction period and interdigital space formation with local tissues, i.e. interchanging triangular or oblique-trapeziform flaps is described. Within 18 months interdigital spaces between II and III, III and IV, IV and V fingers were formed in turn. Besides marked cosmetic effect comparatively good functional result was achieved.

Experience in Treatment of Total Hand Syndactyly in a Child with Apert Syndrome

Experience in surgical treatment of total hand syndactyly in a child with Apert syndrome is presented. Surgical technique that includes the application of МЦТ-01 apparatus, distraction period and interdigital space formation with local tissues, i.e. interchanging triangular or oblique-trapeziform flaps is described. Within 18 months interdigital spaces between II and III, III and IV, IV and V fingers were formed in turn. Besides marked cosmetic effect comparatively good functional result was achieved.

Treatment of Patients with Elbow Osteoarthrosis I-II Stage by Arthroscopy

Comparative assessment of conventional (control group, 30 patients) and arthroscopic (main group, 16patients) treatment techniques was performed by the treatment outcomes of 46 patients aged 20-50 years with I-II stage of elbow osteoarthrosis and resultant flexion-extension contracture. Elbow function was evaluated by MEPS scale prior to and 1 month after operation. The advantage of arthroscopic intervention that enabled to eliminate intraarticular pathology, to initiate early rehabilitation and provided good functional result at short terms — 91 points in the main group versus 74 points in control one.

Laryngeal reconstruction following shrapnel injury in a British soldier: case report

Introduction:Laryngeal injuries are uncommon but result in high mortality and morbidity rates when they do occur. We report a case of laryngeal fracture due to penetrating shrapnel injury, repaired with miniplates.Case report:A 26-year-old soldier was involved in an explosion and sustained a shrapnel wound to his right neck. After immediate airway management at the field hospital he was transferred to the UK, where he underwent a neck exploration, laryngofissure and repair of the thyroid cartilage using miniplates. An endolaryngeal stent was placed, which was removed at a second operation seven days later. Post-operatively, the patient recovered well and his voice improved rapidly. Six months post-operatively, he returned to work.Discussion:The cause and nature of laryngeal injury differs between wartime and peacetime. The methods of diagnosis and management strategies are reviewed. The early recognition of injury and protection of the airway are of paramount importance when dealing with laryngeal injury. Delayed laryngeal reconstruction using miniplates can give a good functional result.

Wrist Arthrodesis Following Ulnar Bar Excision in Fibrodysplasia Ossificans Progressiva

Fibrodysplasia ossificans progressiva is a rare disorder characterized by the progressive development of heterotopic bone in the connective tissues of skeletal muscle, ligaments and tendons. Surgical trauma is one of the most potent stimuli for ossification and surgical treatment is generally considered to be contraindicated in this condition. We report a good functional result in a patient with severe hand disability secondary to an ulna-carpal bar in fibrodysplasia ossificans progressiva.