genortГений ортопедииGenij Ortopedii1028-44272542-131XЦЕНТР ИЛИЗАРОВА10.18019/1028-4427-2021-27-4-475-480genort-34Research ArticleОригинальные статьиOriginal articlesМногоуровневые ортопедические вмешательства у детей со спастическим параличомMultilevel orthopaedic surgery in children with spastic cerebral palsyhttps://orcid.org/0000-0002-8996-867XПопковД. А.PopkovD. A.

Попков Дмитрий Арнольдович, д. м. н., профессор РАН, членкорр. Французской Академии медицинских наук,

г. Курган

Dmitry A. Popkov, M.D., Ph.D., Professor of RAS, correspondent member French Academy of Medical Sciences,

Kurgan

dpopkov@mail.ruЧибировГ. М.ChibirovG. M.

Чибиров Георгий Мирабович, к. м. н.,

г. Курган

Georgy M. Chibirov, M.D., Ph.D.,

Kurgan

georgii_chibirov@mail.ruКожевниковВ. В.KozhevnikovV. V.

Кожевников Вадим Витальевич, к. м. н.,

г. Барнаул

Vadim V. Kozhevnikov, M.D., Ph.D.,

Barnaul

dpopkov@mail.ruГвоздевН. С.GvozdevN. S.

Гвоздев Никита Сергеевич,

г. Курган

Nikita S. Gvozdev,

Kurgan

gvozdev_n.s@mail.ruФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр травматологии и ортопедии имени академика Г.А. Илизарова» Министерства здравоохранения Российской ФедерацииРоссияIlizarov National Medical Research Centre for Traumatology and OrthopedicsRussian FederationФедеральное государственное бюджетное учреждение «Федеральный центр травматологии, ортопедии и эндопротезирования» Министерства здравоохранения Российской ФедерацииРоссияFederal Center for Traumatology, Orthopedics and EndoprostheticsRussian Federation202128082021274№ 4 (2021)475480Copyright © Попков Д.А., Чибиров Г.М., Кожевников В.В., Гвоздев Н.С., 20212021Попков Д.А., Чибиров Г.М., Кожевников В.В., Гвоздев Н.С.Popkov D.A., Chibirov G.M., Kozhevnikov V.V., Gvozdev N.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ilizarov-journal.com/jour/article/view/34

Целью данной статьи стал обзор современной литературы о роли многоуровневых одномоментных вмешательств в хирургии вторичных ортопедических осложнений у детей с ДЦП.

Материалы и методы

Материалы и методы. При подготовке обзора были использованы поисково-информационные источники: научный поисковый портал PubMed, Scopus, ResearchGate, РИНЦ, а также издательские продукты (Elsevier, Springer etc). Статья построена на материале доклада, созданного для впервые проводимой в России образовательной конференции European Pediatric Orthopaedic Society в Центре Илизарова в 2021 году.

Результаты и обсуждение

Результаты и обсуждение. Работа включает обсуждение терминологии, показаний, особенностей хирургической техники и раннего послеоперационного периода, отдаленных результатов лечения при использовании многоуровневых ортопедических вмешательств, а также аспектов ятрогенных ортопедических нарушений у детей с ДЦП.

Заключение

Заключение. Многоуровневые вмешательства для коррекции вторичных ортопедических осложнений у пациентов с ДЦП являются стандартом оказания хирургической помощи. Успех данного вида хирургии зависит от правильности определения показаний и количественных значений коррекции, основывающихся на 3D-анализе походки, от соблюдения специфических технических требований к выполнению операции и проведения ранней реабилитационной программы. Стратегия многоуровневых вмешательств подразумевает максимально возможное снижения количества ортопедических операций и может быть признана успешной, если на протяжении детского периода жизни пациенту выполнялось не более двух многоуровневых реконструктивных вмешательств.

Introduction

Introduction. The purpose of the article was to review the modern literature on the role of multilevel single-stage interventions in the surgery of secondary orthopaedic complications in children with cerebral palsy.

Material and methods

Material and methods. The review was done using the databases of the current sources of scientific information including PubMed, Scopus, ResearchGate, RSCI and Elsevier, Springer publishing products. A report made for the first educational meeting of the European Pediatric Orthopaedic Society held in Russia at the Ilizarov Center in 2021 was used for the contribution.

Results and discussion

Results and discussion. The article discusses terminology, indications, particular techniques and early postoperative period, long-term outcomes of multilevel orthopaedic interventions and aspects of iatrogenic orthopaedic conditions in children with cerebral palsy.

Conclusion

Conclusion. Multilevel intervention is the surgical procedure of choice for the correction of secondary orthopaedic complications in patients with cerebral palsy. The success of the surgery would depend on adequately identified indications and quantitative values of the correction to be performed on the basis of 3D gait analysis, the compliance with specific technical requirements for the procedure and an early rehabilitation program. The strategy of multilevel interventions suggests the greatest possible reduction in the number of orthopaedic surgeries and can be considered successful if the patient undergoes a maximum of two multilevel reconstructive interventions in the childhood.

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The authors declare that there are no conflicts of interest present.