Introduction As reported, brachioplexopathy is a relevant polyetiological disease with an annual incidence from 0.17 to 1.6 per 100,000. There are two basic endoscopic methods of brachial plexus decompression: an  endoscopically-assisted mini-invasive transaxillary approach and fully endoscopic decompression in association with shoulder arthroscopy.

Purpose Compare the two main endoscopic methods of brachial plexus decompression.

Material and methods Twenty-two patients diagnosed with post-traumatic brachioplexopathy were included in the study. There were 8 patients in group 1 and 14 patients in group 2. All patients passed clinical and instrumental examination. Statistical analysis was performed with non-parametric U-criteria of  Mann – Whitney. Differences were considered significant at p < 0.05. Patients of group 1 underwent shoulder joint arthroscopy and fully endoscopic brachial plexus decompression. Patients of group 2 had revision and transaxillary mini-invasive decompression of brachial plexus with video endoscopic assistance.

Results In the first group, upper limb dysfunction according to DASH scale decreased from 52.3 ± 2.2 to 28.8 ± 3.8 points (p < 0.05). In the second group, upper limb dysfunction according to DASH scale decreased from 47.9 ± 4.4 to 26.6 ± 4.3 points (p < 0.05). Discrepancy according to DASH scale before and after surgery in the first group was 23.5 ± 3.6 points and in the second group it was 19.4 ± 5.4 points; the difference between the groups was statistically insignificant (p > 0.05).

Discussion The results of our study are similar to the results of endoscopic brachial plexus decompression in the previously published studies.

Conclusion The methods of endoscopic brachial plexus decompression in association with shoulder joint arthroscopy and isoolated mini-invasive neurolysis and decompression of brachial plexus under videoendoscopic assistance are equally effective in the treatment of brachialplexopathy.

Introduction The upper limb functional limitations in congenital radioulnar synostosis may significantly affect the daily activities of patients. Classifications of the condition are descriptive and have limited practical application.

Purpose Determine a functionally significant quantitative criterion for anatomical changes in the forearm.

Material and methods 92 children (136 forearms) with congenital radioulnar synostosis were examined for  limitations in activities of daily living (ADL), health-related quality of life measured with  PedsQL questionnaire; pronation of the forearm and radiographic parameters. A comparative and  correlation analysis, ROC analysis were performed to determine the relationship between the forearm pronation and limitations of ADL.

Results Statistically significant correlations were revealed between symptoms and the forearm alignment (p < 0.01, rxy = 0.5); subluxation of the ulnar head and forearm alignment (p < 0.001, rxy = 0.6); bowing deformity of the radius, forearm alignment and subluxation of the ulnar head and between the length of the forearm bones and bowing deformity of the radius (p < 0.05, rxy = 0.4 and rxy = 0.5). A statistically significant inverse correlation was revealed between symptoms and PedsQL scores (p = 0.038, rxy = –0.4). Pronation of 45° was the threshold value of the forearm alignment with a high risk of ADL limitation. The area under the ROC curve corresponding to the relationship between symptoms and the forearm alignment was 0.955 ± 0.021 (95 % CI: 0.915–0.995). There was a statistically significant (p < 0.01) decrease in the lumen of the medullary canal in the middle third of the ulnar shaft with the radius lumen being unchanged. Dorsal subluxation of the ulnar head was detected In 30 % of cases.

Discussion The characteristics identified demonstrated changes in the forearm bones with functional impairments being correlated with the forearm pronation.

Conclusion The correlation between the patient’s symptoms and the forearm alignment must be taken into  account in the classification and when determining indications for surgical treatment distinguishing between functional (< 45° pronation) and dysfunctional (≥ 45° pronation) options.

Introduction Small joints replacement is a valid treatment for deforming osteoarthritis and traumatic injuries to  the  phalangeal joints of the hand to restore motor hand functions. Various types of implants differing in shape, biomechanics and material composition have been developed.

The purpose of the study was to evaluate long-term results of the proximal interphalangeal joint arthroplasty of the hand using various implants and identify their advantages.

Material and methods We retrospectively reviewed 78 cases of proximal interphalangeal joint replacement in 64 patients. Outcomes were assessed at 6 months and at follow-up stages with preoperative and postoperative measurements of the range of motion in the joint evaluating pain, radiographs and outcomes measures using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.

Results The range of motion in the prosthetic joint increased significantly at different follow-up periods with all types of implants. The pain syndrome decreased. Radiographs revealed 10 cases of aseptic instability in  the  group of constrained prostheses. The DASH assessment showed high subjective satisfaction with the treatment.

Discussion We could not find papers reporting PIP joint arthroplasty using SBI D.G.T. implant system. A retrospective study of RM Finger arthroplasty of the PIP joint indicated restored joint stability with AROM improvement and with low pain, although it had a high rate of complications. We recorded no complications with this implant model. Some authors would not recommend the RM Finger implant (Mathys) for PIP joint replacement. Arthroplasty of small joints of the hand with MOJE kermik-implantate showed satisfactory outcomes for 82 % of patients at a long term.

Conclusion Arthroplasty of the PIP joint of the hand using various implant designs resulted in greater mobility of the upper limbs, a lower pain due to subjective improvement in the functionality at a long term. Although the procedures were effective with all implant designs the reliability of changes in the parameters was more evident with nonconstrained implants.

Background The thoracic spine pathology can lead to severe disability and discomfort.

This study aims to identify determinant characteristics in patients with thoracic spine pathologies who present with non-regional complaints such as lumbar/cervical pain and others.

Methods A prospective observational descriptive study was conducted at Basrah Teaching Hospital from March 2020 to December 2021, enrolling 114 patients categorized into two groups. Group A included patients with thoracic spine pathology and thoracic pain, while Group B consisted of patients with thoracic spine pathology and non-local symptoms (such as lower lumbar pain, pain in extremities, etc.). Comprehensive clinical evaluations were performed using a specially designed questionnaire.

Results The majority of patients were in the 60-79 age group, with females comprising 55 % in Group A and 60 % in Group B. Smoking was observed in 28.98 % of Group A and 26.66 % of Group B. Symptomatic patients with solitary back pain commonly exhibited dorsal root compression symptoms (49.27 %), lower limb weakness (18.84 %), and sphincter dysfunction (7.24 %). Patients with thoracic plus lower and/or neck pain frequently reported paraesthesia (42.22 %) and cervical root symptoms (48.38 %). Kyphotic deformity was present in 20.28 % of Group A and 11.11 % of Group B, while tenderness was observed in 23.18 % of Group A and 13.33 % of Group B. Plain radiograph changes, including disk space narrowing (44.44 %), subchondral sclerosis (29.63 %), curve alterations (29.63 %), and facet arthropathy (25.9 %), were more prevalent in those with symptomatic thoracic back pain (Group A).

Conclusion Non-local symptoms in thoracic spine pathologies are common, with complicated and multi-site low back pain being more prevalent than isolated back or thoracic pain. Elderly individuals, females, obesity, and comorbidities appear to be predictive risk factors for low back pain development. Paraesthesia emerges as the most common neurological manifestation, while kyphosis and scoliosis are primary presentations of thoracic pathologies. Multi-modalities of imaging, including plain radiographs, MRI, CT scan, and DEXA scan, can aid in detecting back pathologies. The mainstay of managing symptomatic thoracic pathologies is surgical intervention.

Introduction Treatment methods for late stages of ankle osteoarthritis are varied, but the issue of assessing the long-term results of various fixation methods has not yet been studied, and this issue is of great importance in clinical practice.

Purpose To compare the effectiveness of the fixation methods commonly used for ankle arthrodesis in patients with advanced ankle osteoarthritis.

Materials and methods Eighty-two patients with advanced ankle osteoarthritis were treated with ankle fusion between 2019 and 2023 at three major medical institutions. All patients underwent 12-month follow-ups. The patients were divided into four groups depending on the method of surgical fixation of bone fragments.

Results Most patients showed a significant improvement in the function and a decrease in pain intensity after the arthrodesis operation. The comparison of the effectiveness of various surgical fixation methods found that external apparatus screw fixation is characterized by lower blood loss and a relatively short duration of the operation. Plate and screw fixation resulted in higher AOFAS and VAS scores at 3 months postoperatively. However, by the 12th month after surgery, the differences in these two indicators were insignificant.

Discussion Despite the various complications that occur in ankle arthrodesis, it remains effective for  most patients. Among them, the Ilizarov apparatus is more suitable for patients with compromised conditions in the surgical area. Each method of surgical fixation has its own advantages and shortcomings, but the difference in long-term effectiveness is small.

Conclusion Ankle arthrodesis is an effective treatment for advanced ankle osteoarthritis. The choice of surgical method is still subject to the principle of individual approach.

Introduction The Self-reported Foot and Ankle Score (SEFAS) is one of the foot health assessment tools in Sweden. Validation procedures, reliability, validity, sensitivity, approval are essential for the Russian version of the questionnaire with a new language environment.

The objective was to validate the Russian version of the SEFAS questionnaire and approve the tool in the Russian surgical patients with foot disorders.

Material and methods The questionnaires the patients completed preoperatively included SEFAS, SF‑36, a general health survey questionnaire, and the Lower Extremity Functional Scale (LEFS). Patients were requested to  complete the SEFAS questionnaire at 2 months of surgery to assess the sensitivity of the instrument. Based on the case histories clinical researcher recorded general and physical parameters of the patients to include gender, age, socio-demographic data, nature of the foot disorder, a dorsiflexion angle of  the  first metatarsophalangeal joint. To  assess the reproducibility of  the  Russian version of the questionnaire, some patients were requested to complete the SEFAS questionnaire twice preoperatively with an interval of one day.

Results The questionnaire was characterized by good internal consistency and reproducibility indicating acceptable reliability of the Russian version of SEFAS. Statistically significant correlations of varying strength were seen between the SF-36 scores and nearly all the selected questions of the SEFAS Russian version. Statistically significant correlations (moderate to weak) were observed between the LEFS total score and the selected SEFAS questions. Minimal clinically significant changes in MCID scored 3 in the assessment of clinical interpretability of the Russian version of SEFAS.

Discussion The study demonstrated the reliability, validity and sensitivity of the Russian version of the SEFAS questionnaire. The questionnaire appeared to be an informative and clinically interpretable instrument for assessing foot in surgical adult patients with foot disorders.

Conclusion The SEFAS questionnaire can be recommended for Russian trauma and orthopaedic practice to learn the patient's opinion of the condition.

Introduction There are not enough published studies on the impact of early isolated triceps lengthening operations in hemiparesis on the state of motor characteristics and on the development of orthopedic complications in children with GMFCS II.

Purpose Analyze motor locomotion in children with spastic hemiplegia who had not previously been operated on and those who had undergone isolated surgical lengthening of the triceps at an early age.

Material and methods Four groups of children with spastic hemiplegia according to Rodda et Graham types: I) type 2a gait (4 children), II) type 3 (3 children), III) type 4 (7 children), IV) type 4 with previous triceps lengthening (9 children).

Results The features revealed in gait types 2a, 3 and 4 in the sagittal plane correspond to the characteristic and  previously described features. In all groups, asymmetric rotational movements of the pelvis and tilt asymmetry in the frontal plane were observed. In the group of early isolated tricep lengthening, a decrease in  the  moment of  force by pushing with the foot at the end of the single-support phase was revealed, in combination with an increase in the moment of forces of knee joint extension in the single-support phase.

Discussion Early isolated triceps lengthening that weakens its function leads to a compensatory increase in the work of the knee extensors which is similar to the mechanism to of iatrogenic crouch gait, but does not result in a complete loss of walking function in the conditions of a contralateral healthy limb.

Conclusions Movement pathology is present in all three measurement planes in gait types 2a, 3, 4 according to the Rodda et Graham classification. The most pronounced deviations were found in gait type 3. The rotational turn of the pelvis is an initially compensatory mechanism due to intratorsion femur deformity. Isolated triceps lengthening surgeries performed at an early age lead to reduced plantar push strength, increased compensatory work of the knee extensors, and probably do not prevent the orthopedic pathology found in Rodda et Graham's gait type 4.

Introduction The understanding of the biomechanics of movements in the spinopelvic segment plays an important role in the successful treatment of patients with hip-spine syndrome. Analysis of the biomechanical processes occurring in the biokinematic chain of the spine–pelvis–hip during the transition from standing position to sitting position allows us to conclude that the acetabular axis of rotation of the pelvis in space is not the only one. Classical methods for measuring PI, PT, overhang S1 are applicable for patients in a standing position and use the hip joint as a starting point, since it is the point of rotation of the pelvis in space in a standing position. Previously, using mathematical modeling, we described spatial changes in the pelvis during a given change in the body position and showed the presence of a second point of pelvis rotation in space, which appears in a sitting position. We assumed that in a sitting position, it is necessary to use other methods for calculating indicators of spinopelvic relationships for their determination.

Purpose of the study was to evaluate the parameters of patients’ sagittal balance using the proposed alternative method in standing and sitting positions.

Materials and methods Medical documentation and the results of X-ray examination of 20 patients with unilateral idiopathic coxarthrosis who underwent total hip replacement surgery were analyzed. The radiographic parameters were calculated: PI, PT, overhang S1 in standing and sitting positions, anterior inclination of the acetabular component; parameters PI ischial, PT ischial, deviation of the ischial tuberosities in standing and sitting positions were proposed and calculated.

Results The study shows that there is no statistical difference in the values of the angles PI standard for a standing position and PI ischial for a sitting position. It corresponds to objective data and is generally accepted. Examples of changes in radiographic parameters of the sacral slope and the deviation of the ischial tuberosities were shown reflecting the rotation of the pelvis in space through the second, ischial axis, that confirm the biaxial concept of pelvic rotation.

Discussion The calculations demonstrated the possibility of using alternative indicators of spinopelvic relationships (PT, distance of overhang of the sacrum (overhang S1), deviation of the ischial tuberosities). They enabled assessment of the spatial transformation of the pelvis and the ability to predict the spatial position of the acetabulum, which is an important factor for successful treatment of patients with combined pathology of the hip joint and spine.

Conclusion Our findings complement the biaxial concept of pelvic rotation. An alternative method for measuring sagittal balance parameters in a sitting position has been proposed. Further research is required to assess the practical significance of this method.

Introduction Reconstruction of the acetabulum during revision arthroplasty is a challenging task in the setting of massive bone defects. Often the only effective method is impaction bone grafting (IBG). The purpose is to demonstrate the capabilities of the X-Change impaction bone grafting technology in replacing acetabular defects as a method of choice for revision hip arthroplasty.

Materials and methods In the presented series of cases, the use (IBG) turned out to be the method of choice, allowing for high-quality reconstruction. In each presented case, revision hip arthroplasty was performed with augmentation with a reconstructive mesh or trabecular metal augment to create support and contain the defect to retain the osteoplastic material.

Results During follow-up periods of 4.8 to 6.5 years there were no signs of resorption or loosening. According to the Harris hip score the results were 96, 97 and 89 points respectively.

Discussion Impaction bone grafting technology is quite versatile. It can be used in various coditions of revision arthroplasty with contained defects of the acetabulum. In contrast to the use of modular revision augmentation systems and additive technologies it makes possible to achieve dense filling of the smallest defects and profile a bed congruent with the acetabular component. The use of cemented fixation makes it possible to further stabilize the impacted bone chips and use mechanotransduction mechanisms that  stimulate the bone remodeling. The use of IBG has proven to be an effective technique for the reconstruction of medium-sized acetabular defects in combination with mesh and cement cup, as well as in combination with trabecular metal augments.

Conclusion The use of IBG during revision hip arthroplasty can be especially effective for small acetabulum sizes. Combining IBG with trabecular metal augments significantly expands the application of this technology. The use of IBG makes it possible to create a bone reserve, which creates more favorable conditions for inevitable repeated revision interventions.

Introduction Soft-tissue origin joint contractures are a common orthopedic problem. It could be due to various etiologies. Treatment options are available from conservative to surgical methods. These joint contractures slowly become irreversible causing impairment in activities of daily routine. The Ilizarov method is a well established and time-tested method used for management of bone pathologies, but its use in the management of soft-tissue origin contractures is also possible. It has an established role in neoosteogenesis and histogenesis. Fixator assisted soft-tissue stretching done at sustained slow pace leads to histoneogenesis that avoids stretching of neurovascular structures and reduces the possibility of recurrence.

Aims To determine usefulness of the Ilizarov method in management of joint contractures of soft tissue origin; to meet functional requirements of patients; to study complications of Ilizarov method in management joint contractures due to soft tissue origin.

Material and methods A total of 6 cases of soft-tissue origin joint contractures due to tuberculosis, post‑traumatic stiffness, post-burn contracture, deformity due to a snake bite in the age group from 3 to 55 years were treated with gradual distraction of joint with the Ilizarov method from January 22 to October 23. Two cases were of triple knee deformity, two were post-traumatic elbow stiffness, one was post-burn great toe contracture and one was post snake bite valgus foot contracture. All cases were operated with transarticular Ilizarov frame application and gradual distraction of joints and soft tissue with the help of hinge- and rod distractor assembly done. All cases completed follow up of 1 year. Aggressive physiotherapy was given postoperatively.

Results All cases obtained a reasonable functional outcome, with no recurrence of deformity. All patients walk independently.

Conclusion The Ilizarov method can be used for treating joint contractures due to traumatic and non‑traumatic pathologies.

Introduction Some progress has been made in the development of innovative implantation materials for  osteoplastic surgery. However, the problem of bone defect management still remains relevant due to the continued high prevalence of injuries resulting from road accidents, catatrauma, man-made disasters and military operations.

The purpose of the work was to analyze the relevant literature and to identify options for solving the problems of  bone nonunion and defect management using materials developed on the principles of orthobiology and surgical technologies based on autologous repair.

Materials and methods The search for sources was carried out with the ConnectedPapers analytical tool  and  the  capabilities of the eLibrary electronic library using keywords and without restrictions on publication date.

Results and discussion Recent publications contain information about the effectiveness of the combination of  Masquelet technology and Ilizarov bone transport in patients with acquired and congenital defects, including in the conditions of active purulent infection. According to the literature, a promising autologous bone plastic material is the contents of the bone marrow cavity, containing osteogenic growth factors and bone morphogenetic proteins. Biomaterial is collected using the Reamer-Irrigator-Aspirator system (RIA) from the intramedullary canal of the femur or tibia. Currently, the effectiveness of bone morphogenetic proteins rhBMP-2 and rhBMP-7 in the restorative treatment of patients with bone defects and nonunion of various etiologies has actually been proven. The use of bone morphogenetic proteins has been introduced into foreign treatment protocols. Recent positive results of a combination of surgical technologies have proposed the  combined use of the Ilizarov and Masquelet technologies, supplemented by PRP therapy. The basis for  the  expected effect from the combination of surgical technologies and orthobiological materials are the results of preclinical studies of the osteogenic potential of PRP therapy.

Conclusion There are grounds for studying the clinical effect of the combined use of surgical technologies based on autologous reparative processes and materials developed on the principles of orthobiology. It  is  necessary and advisable to clinically implement the use of bone morphogenetic proteins rhBMP-2 and  rhBMP-7 in the reconstructive treatment of patients with bone defects and nonunion of various etiologies. Multicenter clinical studies of a high level of evidence are needed to determine the effectiveness of PRP therapy in the reconstructive treatment of patients with bone nonunion and defects.

Introduction Surgical treatment of stiff elbow caused by ossification often result in poor outcomes due to anatomical and physiological characteristics, significant functional load and higher patient requirements for the elbow functionality.

The purpose was to determine ways of improved surgical treatment for patients with elbow contractures caused by ossification, based on an analysis of literature reporting surgical strategy and outcomes.

Material and methods An internet search of PubMed, Medline, Elibrary.ru, CyberLeninka, Google Scholar, International Clinical Trials Registry of the US National Institutes of Health, ISRCTN Registry of International Standard Randomized Clinical Trial Numbers, German Clinical Trials Registry DRKS, WHO Registry was performed. Search words and phrases included elbow contracture, ossification, surgical treatment, stiff, elbow, surgical treatment, ossification. The search depth was 10 years.

Results and discussion Some important parameters (recurrence of stiffness, pain, decreased quality of life, etc.) are reported as “very unassertive” in patients with stiff elbow due to ossification at mid and long terms (12–24 months or greater). Poor outcomes are reported in approximately 50 % of the cases due to the range of  motion decreased to the preoperative level or less. Many patients (more than 90 % according to some authors) need a repeated surgery and are at risk for the stiff joint.

Conclusion A critical analysis of the literature indicates lack of preoperative instrumentation examination of patients with use of new visualization methods (3D modeling). Preoperative examination and surgical planning based on additive technologies are essential for surgically treated patients with stiff elbow caused by ossification.

Introduction An analysis of the medical literature devoted to various aspects of transitional lumbosacral vertebrae shows that there are very few publications covering the course of this disease in  the  pediatric and adolescent population.

Aim To study the issues of epidemiology, diagnosis, treatment and prevention of transitional lumbosacral vertebrae in paediatric and adolescent patients based on the analysis of current medical literature and illustrate the material with our own clinical observations.

Material and methods To analyze the literature on the topic, 75 papers published between 1984 and 2023 were selected. Among them, there were 7 (9.3 %) domestic literary sources, 68 (90.7 %) were foreign. In the process of searching for scientific articles, the resources of the electronic databases of current medical information PubMed and CyberLeninka were used.

Results and discussion The incidence of transitional vertebrae in children and adolescents is 16.8 % of clinical observations, as reported. In the structure of the transitional vertebrae in children, type II of  the  disease predominates according to the classification Castellvi et al (1984), 43.2 % of cases. The main clinical symptom of the pathology is pain of lumbosacral location, the intensity of which on the visual analog scale in children corresponds to an average of 3.0 points. In adult patients with similar pathology, the average pain intensity measured with the same scale is 7.5 points. The most informative method for  diagnosing the  disease is computed tomography, which allows obtaining both 3D images and sections at the level of pseudarthrosis between the enlarged transverse process (or processes) of the suprasacral vertebra and the wing of the sacrum. To  relieve pain in children with transitional vertebrae, both conservative and surgical methods are used. The most commonly used procedure is pseudarthrectomy. The study of  long-term results one year after the intervention allowed us to record the absence of pain in children who underwent surgery. Prevention measures for transitional lumbosacral vertebrae have not been developed.

Conclusion The analysis of the published literature shows that transitional vertebrae are a frequently diagnosed pathology in children and adolescents. Current methods of imaging are able to accurately detect not only the  presence of the disease, but also to differentiate its type. The main clinical symptom of  transitional vertebrae is pain in the lumbosacral spine which is difficult to relieve with conservative therapy. Pseudarthrectomy is the most frequent surgical method of treatment in children and adolescents that provides stable relief of vertebrogenic pain syndrome. Measures for specific prevention of the disease have not been developed.

Introduction Spastic hemiplegia (a unilateral neurological disorder) is encountered more often in full-term infants. In most cases, the cause of the condition is intrauterine or perinatal stroke. Children with hemiparetic forms maintain cognitive and functional capabilities in combination with the ability to move independently. Among other forms of cerebral palsy, hemiparetic spastic forms range from 10.4 to 15.3 %. Types with mild motor impairments predominate according to the Gross Motor Function Classification System: 87.8 % are level I GMFCS, 7.1 % are level II GMFCS.

The purpose of the work was to summarize information on the use of orthopaedic interventions for  hemiparetic forms of cerebral palsy, both from the point of view of their planning and completeness of correction of anatomical disorders including lower limb length discrepancy, and assessment of functional results based on gait analysis.

Materials and methods The search for publications was carried out in open electronic sources of  medical  literature PubMed, eLIBRARY, Scopus, Elsevier, Springer, Research Gate with a search depth of  20  years (2002–2022). The following inclusion criteria were used: systematic reviews of the literature, review articles, cohort studies on the topic of multilevel interventions for hemiparetic types of cerebral palsy.

Results and discussion Lower limb length discrepancy of 1 cm or more affects the kinematics of the affected and  intact contralateral limb. The unaffected limb is characterized by a compensatory flexion in the hip and  knee joints and excessive dorsal flexion in the stance phase. On the affected side, the contribution of shortening to the development of pathological kinematics of the pelvis and spine is especially important. There is a high probability of equinus contracture after surgical correction due to unresolved discrepancy in  the  length of  the  lower extremities. Methods for correcting length discrepancy are conservative (compensation with  shoes), and surgical lengthening of the lower leg, epiphyseodesis of the contralateral limb, shortening of the contralateral limb. There is no opinion in the literature about the preference of this or that method, and on the necessary magnitude of limb length correction.

Conclusion The assessment of limb length discrepancy and contribution of this orthopaedic component to systemic movement disorders in spastic hemiparesis is based on computed tomography or magnetic resonance imaging, as well as on computer gait analysis. In the literature, the issue of limb length correction is considered separately from the complex of other orthopaedic interventions, while the features of correction with regard to spontaneous growth potential or after growth completion have not been defined. The advantage of  equalizing the limb length in children with temporary epiphyseodesis over distraction osteogenesis is only supposed. There is not enough data on the effect of the limb length correction magnitude in patients with spastic hemiplegia on the parameters of computer gait analysis.

Introduction Limb length discrepancy (LLD) can be debilitating and may cause other medical and social problems. LLD is a serious physical condition and have a significant impact on the patient's quality of life changing the gait, forming pathological adaptive mechanisms and causing long-term musculoskeletal disturbances in children. The objective was to analyze the evolution of tactical approaches to the rehabilitation of patients with lower limb length inequality.

Material and methods The original literature search was conducted on key resources including Scientific Electronic Library (www.elibrary.ru) and the National Library of Medicine (www.pubmed.org). Literature searches included both Russian and English studies. The search strategy was comprised of keywords: lower limbs, limb length inequality, approaches and means of limb length correction, osteosynthesis. Clinical guidelines, clinical recommendations, systematic reviews, randomized controlled trials and multicenter cohort studies were selected for analysis.

Results and discussion Normal individuals can often experience a difference in the length of the lower limbs from several mm to 1.5 cm and have no effect on the gait, condition of adjacent joints and joints of the opposite limb. Some authors report inequality of 5 mm leading to orthopaedic pathology. A variety of  conservative and  surgical treatments are offered for limb length equalization. Elimination of LLD is a  common and  unresolved medical problem. Conservative treatment of LLD can be considered as one of  the  stages of rehabilitation. Some patients can benefit from conservative treatments. Alternatively, surgical equalization is a treatment option for patients with LLD.

Conclusion Surgical methods offered earlier to address LLD had disadvantages, which ultimately minimized their use, and orthopaedic surgeons abandoned some of them due to the high risk of severe complications. The device and the technique developed by Dr. Ilizarov in the 50s of the last century was an epoch-making event in the elimination of LLD and are constantly being improved.

Introduction The diseases of the first metatarsophalangeal (1 MTP) joint that require surgical treatment include osteoarthritis (69 %), rheumatoid arthritis (26 %), tumors, tumor-like diseases and purulent arthritis (5 %). The treatment of arthritic 1 MTP is aimed at reducing pain and improving function. Joint replacement implants are meant to support body weight, maintain the length of the first metatarsal, provide metatarsal‑sesamoid joint functioning and restore joint motion. The purpose of the work was to analyze data from foreign and domestic literature on endoprosthetics of the 1 MTP, and briefly present analytical data on the results of using various implants.

Material and methods The article presents the summary of the Russian and foreign publications on  1 MTP joint replacement. The original literature search was conducted on key resources including PubMed, eLIBRARY, MedLine, Scopus. The search strategy was comprised of keywords: “replacement of  the  first metatarsophalangeal joint”, “surgical treatment of hallux rigidus”, “osteoarthrosis of the first metatarsophalangeal joint”, “results of endoprosthetics of the 1st metatarsophalangeal joint”, "modernization of implants of the 1st metatarsophalangeal joint". Publications brought out between 1968 and 2022 inclusive were analyzed.

Results and discussion The ideal implant should restore functional range of motion, improve function, maintain joint stability, distribute the stress across joint surfaces being wear-resistant. Over the years, various materials have been used to provide simple and reliable designs. Implants have been improved and divided into groups based on material and design, limited degrees of freedom, tribological pair composition, and the amount of articular surface replacement.

Conclusion New generation implants have a more durable design, anatomical shape and improved osseointegration. The advances in joint replacement have resulted in greater patient satisfaction and increased service life. The complication rate for replacement of the 1 MTP joint remains high. This indicates the need for continued research and further work to improve implants to make them more effective and easier to use.