Purpose. To analyze the disability rate and structure in Russia children due to injuries, congenital pathology and diseases of the musculoskeletal system.
Materials and Methods. The disability dynamics of Russia children population due to injuries and diseases of the musculoskeletal system in 2004-2011 analyzed, as well as gender- and age-related composition, the frequency and structure of disability. Rehabilitation of disabled children in the process of medical follow-up by an orthopedist studied on the basis of the St. Petersburg medical institutions.
Results. By the study data, the total number of disabled children due to injuries and diseases of the musculoskeletal system in Russia decreases, the rates of disability per 10000 of population reduce with continuing correlations between disease nosological forms and gender-age structure. This can serve as an indirect indicator of improving the quality of treatment and rehabilitation at all stages of medical care. The continuity in the work of the city outpatient and inpatient health care institutions revealed based on the work of the children orthopedists of St. Petersburg outpatient departments.
Conclusion. Statistical data on the disability of Russia children population will allow to compare the population data of children health in RF subjects, to evaluate the results of treatment and needs of limited children in rehabilitation activities.

Purpose. To evaluate the effectiveness of transosseous osteosynthesis method by Ilizarov in treatment of children with injuries of epiphyseal growth plates.
Materials and Methods. The authors studied the results of treatment of 414 children with traumatic injuries of epiphyseal growth plate using transosseous osteosynthesis techniques and different configurations of the fixator.
Results. Mean periods of fixation depended on fracture localization regarding epiphysis and displacement degree, and they ranged from 23 to 35 days. The damage of skin integuments increased the fixation duration by 5 days on the average. Complete weight-bearing achieved after 2-4 weeks in most cases, and final functional recovery achieved 2-3 months after injury. In the long-term period the outcome was considered as excellent in 90.2% of patients, good one – in 1.9%, satisfactory – in 5.94%, and unsatisfactory – in 1.96% of patients.
Conclusion. The recovery of cartilaginous growth tissue after injury at the level of epiphyseal plate can’t be considered as good because real outcomes not always correspond to the predicted ones. Early, stable, controlled transosseous osteosynthesis using the Ilizarov fixator creates favorable conditions for recovery of the involved growth plate functions, healing of fractures and surrounding soft tissues with further recovery of limb weight-bearing function.

Purpose. To analyze the results of using the method of intramedullary elastic stable osteosynthesis in treatment of forearm bone shaft fractures in children.
Materials and Methods. 22 children at the age of 4-16 years treated using the method of intramedullary elastic stable osteosynthesis (FIN – flexible intramedullary nailing) in the authors’ clinic during 2012. In 4 cases surgical treatment performed after secondary displacement of fragments in a plaster cast, in other cases intramedullary osteosynthesis was a primary method of treatment.
Results. In all cases the authors stated a positive result of treatment: fracture union, recovery of initial range of motion in the joints of the limb operated within first 2-4 weeks after surgery that accompanied by child’s rapid return to the normal daily life, going to school or kindergarten. Among the occurred complications caused by surgical treatment one case of skin perforation with the rod’s free end observed, as well as hematoma formation in the zone of the rod free end and irritation of the radial nerve sensitive branch with the rod’s end in the forearm zone. The implants removed 6 months after surgical treatment, fracture consolidation in proper position achieved with complete functional recovery of the forearm injured in 20 cases.
Conclusion. According to the results, FIN method can be recommended for treatment of forearm shaft fractures in children at the age of 5-16 years.

Purpose. To evaluate the effectiveness of transosseous osteosynthesis technique according to Ilizarov for treatment of olecranon fractures in children and adolescents.
Material and Methods. The analysis of treating 14 patients at the age of below 17 years with closed olecranon fractures used. Transverse (6 – 42.9%) and oblique (6 – 42.9%) fractures dominated by nature. There were comminuted fractures in two cases (14.2%). All the injured subjects underwent osteosynthesis using the Ilizarov fixator.
Results. Standardized “Outcome Classifications: Fracture Outcomes” by ER. Mattis used. Among 12 patients followed-up in the long-term period the result evaluated in 99 points (maximum 100) in 6 patients, in the others the score was 96-98 points. Conclusion. The technique of transosseous osteosynthesis with the Ilizarov fixator for olecranon fractures allows to achieve proper relations in the elbow and provides stable fixation of bone fragments throughout the period of treatment.

Purpose. To analyze the early experience of using intramedullary stable elastic osteosynthesis in the Regional Red Cross Children Hospital of Kurgan.
Materials and Methods. A retrospective analysis of the results of treating shaft femoral fractures using intramedullary stable elastic osteosynthesis made in 25 children. The fractures were closed and localized at the shaft level in all cases. In one case the fracture was pathologic through fibroma. There were no acute vascular and neurological disorders in any case.
Results. The periods of surgical treatment from the time of injury varied within 1-69 days. The implant removed in 17 children, union of proper alignment achieved in all cases with complete recovery of the lower limb function. The complications occurred during treatment had no effects on the periods of consolidation and functional recovery.
Conclusion. The results of treatment suggest the effectiveness of the method of intramedullary elastic stable osteosynthesis for shaft femoral fractures in children at the age of 5 years and older.

Purpose. To analyze the authors’ own experience of using intramedullary stable elastic osteosynthesis in the Kurgan Red Cross Regional Children Hospital for surgical treatment of humeral fractures in children.
Materials and Methods. The experience of using intramedullary stable elastic osteosynthesis of humerus studied retrospectively in a continuous group of 17 patients at the age of 5-17 years. The techniques of antegrade and retrograde monopolar insertion of the rods depending on fracture localization used.
Results. Consolidation of bone fragments achieved in all cases with complete anatomical and functional recovery of the segment injured. The complications occurred included skin perforation with a free end of the rod, splintering during the rod insertion for incomplete spiral fractures (2 cases). The complications didn’t influence treatment tactics and didn’t required additional surgical interventions. In one case additional plaster immobilization required due to a small diameter of the rods in order to avoid secondary displacement.
Conclusion. The experience of using intramedullary stable elastic osteosynthesis in the authors’ group is positive. Surgical technique of the procedure should be carefully observed to prevent possible complications.

Purpose. To analyze the immediate and intermediate results of using femoral aligning osteotomy combined with device-assisted joint decompression in children with Perthes disease.
Materials and Methods. The results of treatment of 16 children with Perthes disease at fragmentation stage analyzed. Mean age during surgery was 7 years and 4 months (6-9 years). Joint distribution according to Catterall criteria: Group III – 9, Group IV – 7. Joint distribution according to Herring criteria: Group В/С – 10, Group С – 6. X-ray image conformed to Stage IV (в) according to Veselovskii classification in all cases. The technique of femoral aligning osteotomy in combination with non-articulation device-assisted decompression, tunnelization, subchondral cellularand- tissue transplantation used. Mean follow-up was 3 years (2-5 years).
Results. Functional outcomes according to McKey: Grade I – 13 joints, Grade II – 3 joints. X-ray results according to Stulberg: Grade I – 2 joints, Grade II – 8 joints, Grade III – 5 joints, Grade IV – 1 joint. The share of good outcomes was 63%, unsatisfactory ones – 6.7%.
Conclusion. The technology presented can be used effectively in treatment of severe forms of Perthes disease as an alternative to known surgical interventions.

Purpose. To analyze the immediate and intermediate results of reconstructive treatment of school-age children with the hip dislocation.
Materials and Methods. The results of treatment studied in 27 children (30 joints) at the age of 7-17 years with congenital dislocation of the hip. Closed dislocation reposition with the Ilizarov fixator performed in all the cases with subsequent stage-by-stage correction of the joint pelvic and femoral components. Clinical and roentgenological assessment made by Colton and Severin criteria.
Results. Dislocation recurrence observed in 2 cases (6.7%), and aseptic necrosis of femoral head noted in 3 cases (10%). Good results achieved in 67%, unsatisfactory ones – in 10%.
Conclusion. The presented technology of the hip reconstruction with the Ilizarov fixator provided sufficient articular stability and didn’t lead to irreversible changes in joint components in most cases despite the marked initial anatomic-and-functional disorders and rejection of conventional reposition techniques.

Purpose. Studying postural-and-tonic organization of the spine in patients with the hip dysplasia using optic computer topography.
Material and Methods. Monitoring of postural disorders, analysis of the spine adaptive activity in postural stereotypes performed in 7-15-old children with the hip dysplasia. The criteria proposed to establish the need and selection of optimum values of lower limb length discrepancy compensation to eliminate postural disorders due to limb functional shortening below 1.5 cm (34 subjects). Results.
Postural disorders registered in 100 % of cases. Posture disturbances in three planes simultaneously registered in 14%, in two planes – in 44% and in one plane – in 42% of cases. The greatest number of the frontal plane postural disturbances during 3-min. instrumental control (misalignments of pelvis and shoulder girdle, trunk lateral tilt, and scoliotic posture) observed in 29 % of cases, topographic signs of Degree 1 scoliosis – in 32%, Degree 2 scoliosis – in 12%, Degree 3 scoliosis – in 0.2% of cases.
Conclusion. Using orthopedic insoles with full shortening compensation recommended if resulting weight-bearing redistributed on functionally dominant limb. The complete disappearance of scoliosis topographic signs after compensation of shortening and its absence during standing up to 3 minutes is the criterion. If weight-bearing in limb shortening correction redistributes on functionally non-dominant limb, using the shoes with complete shortening compensation not recommended. The appearance and gain in scoliosis topographic signs during shortening compensation is the criterion for contraindication.

Purpose. To analyze the possibilities of using the technique of replacement in order to correct the hip deformity and recover the hip function in adolescents with secondary coxarthrosis for dysplasia, traumatic and infection involvement consequences associated with lower limb shortening above 6 cm.
Materials and Methods. The results of surgical treatment demonstrated in 10 patients at the age of 13-18 years with Stage 3 secondary coxarthrosis associated with great limb shortening. Two-staged technique of surgical treatment proposed which allows to restore the limb length and function. The technique is characterized by the hip single-stage intervention. Results. The results of surgery evaluated by the data of radiologic, anthropometric and clinical examination of 10 patients within the periods from 9 months to 3 years. All the components were stable by X-rays and clinically. There was no pain syndrome, nobody used additional supports. The signs of inflammation in the surgery area were absent in all the patients.
Conclusion. The proposed two-staged technique of total replacement in older children with secondary coxarthrosis associated with shortening above 6 cm allows to achieve the limb length discrepancy on the affected side. In this case the pain syndrome can eliminated completely, and the hip function and walking biomechanics restored to a large extent in most cases.

Purpose. To compare the results of using two types of lockable plates (LCPSynthes 100°, 110° and Surfix 90°) for reconstructive interventions in the hip of children with spastic palsy of severe forms in the multilevel surgeries from the point of view of surgery effectiveness and invasiveness.
Material and Methods. The advantage of using the lockable plates with angular stability in multilevel surgeries demonstrated on the basis of the results of 45 reconstructive interventions in the hip of 25 children with severe forms of spastic palsy. Results. Both less surgery duration and less blood loss noted when Surfix 90° plates used, that is of importance for children of level IV and V according to GMFCS, already having some associated chronic diseases.
Conclusion. The use of the lockable plates of different types for proximal femur (LCP Synthes or Surfix) doesn’t influence on the final result, provides stable fixation of osteoporotic bone fragments, rules out the complications such as secondary displacements of fragments, as well as migration of osteosynthesis material.

Purpose. To study leg development after lengthening according to Ilizarov depending on the scope of soft tissue intervention.
Material and Methods. The results studied in 52 consecutive cases of surgical treatment of 38 patients (20 girls and 18 boys) with congenital fibular hemimelia. There were two groups of cases: Group I (25 cases, mean age of patients 7.0±1.5 years) underwent leg bifocal distraction osteosynthesis by the Ilizarov method without intervention in the fibrous fibular band; Group II (27 cases, mean age of patients 5.5±1.8 years) – leg bifocal distraction osteosynthesis combined with excision of the fibrous fibular band part. Results. The achieved amount of lengthening was 5.6±2.6 cm (28.1±4.8 %) on the average for Group I, and 5.4±1.8 cm (27.3±3.9 %) – for Group II. Quick recurrence of angular tibial shaft deformities occurred substantially in Group I during further limb growth despite complete correction in the process of lengthening. There were no shaft deformity recurrences in Group II, or they were not significant. Conclusion. Resection of the fibrous fibular band preferable for leg lengthening in children with congenital fibular ectromelia because it improves the conditions for the ankle formation, and prevents or significantly reduces the degree of tibia and the ankle deformity recurrence in the long-term period.

Purpose. To study the radiomorphological characteristics of leg bones in patients with leg bone congenital pseudoarthrosis using the technique of multispiral computer tomography in order to assess “bone quality”.
Materials and Methods. 20 patients with leg congenital pseudoarthrosis (LCP) at the age of 8-40 years examined by the technique of radiography and computer tomography before and after treatment, and after recurrence including. Results. MSCT demonstrated to allow revealing maximally possible number of the anatomic and structural characteristics of leg bones in patients with congenital pseudoarthrosis which may be of importance for surgical intervention planning.
Conclusion. The intravitally revealed changes in leg bone architectonics coincided with the results of the histological studies made in the same patients, thereby allowing to interpret bone state at different stages of treatment quite accurately. The information obtained confirms the data of bone remodeling defect in the zone of pseudoarthrosis, reducing osteoblastic potential, in connection with which the problems of treatment of such patients appear.

Purpose. To determine the angle of femoral block opening in children of different age in order to reveal the hip dysplasia.
Materials and Methods. The knee ultrasonography performed in 118 children at the age from three to ten years. The knee transverse scanning made in the position of flexion up to 120º. The femoral block preferentially studied as the most available and informative structure for joint dysplasiae. The angle of opening calculated according to an orthopedic pro-gram.
Results. The angle of femoral block opening amounted to 150±0.4° in 38 six-year children, and it was 132±0.9º in 51 seventen-year children. The total number of examined children at the age of six years and those at the age of seven-ten years allowed us to consider the amounts of the angle of femoral block opening to be normal. In case the angle amount deviates from the data it should be consider the knee dysplasia in a child.
Conclusion. Deviation of the opening angle from the norm, even in the absence of dysplasia clinical manifestations, should alert the physician to the possible development of patellar dislocation or chondropathy, or patellar chondropathy with the transition to femoropatellar osteoarthrosis. It’s desirable to determine the angle of femoral block opening by ultrasonoraphy in all children from the age of six years in order to reveal dysplastic changes in the knee.

Purpose. To determine the features of reparative osteogenesis in 6-9-year-old patients with achondroplasia during tibial distraction.
Materials and Methods. Complex dynamic ultrasound examination (Voluson - 730 PRO, Austria) performed in 25 patients at the age of 6-9 years with achondroplasia after 10, 20, 30, 60 days of distraction. Qualitative and quantitative criteria presented which reflects a rapid course of osteogenesis in children. Vascularization features in the zone of lengthening demonstrated in CDS and ED modes.
Results. Reparative osteogenesis of high level established to be characteristic of children at the age of 6-9 years with achondroplasia requiring to perform dynamic USE and timely adjustments of distraction rate.
Conclusion. USE technique in patients at the age of 6-9 years with achondroplasia allows timely identification of qualitative and quantitative echo-signs of rapid osteogenesis throughout the period of distraction and adjusting treatment tactics thereby promoting favorable osteogenesis process and achievement of required lengthening amount.

Purpose. To evaluate the effectiveness of using transosseous osteosynthesis method according to Ilizarov for treatment of primary leg bone tumors in children.
Material and Methods. The results of treatment of 22 children with primary leg bone tumors using transosseous osteosynthesis with the Ilizarov fixator analyzed. In patients with bone sarcoma transosseous osteosynthesis technologies used after the preliminary medical measures including tumor radical and ablastic resection with appropriate complex of neo-adjuvant therapy. As for patients with benign tumors, the rehabilitative procedures for anatomic-and-functional recovery of the operated limb performed by a single stage.
Results. There were no recurrences in the group of patients (12) with benign tumors. The survivability of patients (10) with malignant tumors conformed to the average statistics of the world literature, being 73.6% for three years, it was five-year in 52.6% of those treated. The evaluation of anatomic-and-functional outcomes of orthopaedic rehabilitation evidenced the fact, that transosseous osteosynthesis technologies according to Ilizarov were effective in 97.5% of patients who completed treatment.
Conclusion. The use of transosseous osteosynthesis technologies according to Ilizarov allowed to fill postresection bone defects, as well as to perform optimal limb reconstruction in all patients of the group studied.

Purpose. To analyze the effectiveness of the technique of intramedullary reinforcement using wires with bioactive coating as hydroxylapatite (GA) of particular design for treatment of fibrous osteodysplasia.
Material and Methods. The early clinical experience (9 children) summarized on surgical treatment of long bone fibrous dysplasia by the technique of intramedullary inducing bone tissue using wires with hydroxylapatite coating. The surgery technology described for the disease focal form and diffuse bone involvement complicated by a pathologic fracture.
Results. A positive outcome of treatment achieved in all the patients without deformity recurrence with 5-year follow-up.
Conclusion. Osteogenesis induction in the zone of fibrous dysplasia is the most rational stage of orthopaedics development. There is no need of pathologic focus radical resection – it’s enough to remove most of pathologic fibromatous tissue partially filling the cavity with bone autograft. The inducing coating of wires accelerates bone formation due to both the autograft and the changes in functioning osteogenic cells of immature bone tissue of which thin plates form in the cavities thereby bringing the ossification process to complete maturity.

Purpose. Study vertebral syndrome course and results for different neurogenic spine deformities.
Material and Methods. Retrospective analysis of results made in 23 patients (1,5-28-year old) with spine neurogenic deformities («high risk» group – severe deformity), and progressive deficit of internal organ function. Patients divided into 3 groups by vertebral syndrome nosology and regularities: Group I – patients with myelocele consequences (6), II – spineand- spinal cord injury consequences at cervical and thoracic levels (2), III – neuromuscular diseases (15). Vertebral syndrome special features, dynamics of neurologic status and functional disorders were the study subject. Clinical, radial, functional and statistical methods used.
Results. Techniques of posterior instrumental bi-cortical fixation (PIBCF) with connector system, correcting vertebrotomy at kyphosis apex with PIBCF used in Group I. Mean correction – 68%. For Groups II-III patients extended PIBCF preferred with segment-by-segment step and sacrum-pelvis support platform combined with posterior osteoplastic spondylodesis. The main treatment method was deformity correction and stabilization with CDI segmental instrumentation, posterior spondylodesis with autobone or combined with “Chronos” osteoinductive material. Mean correction in Group II – 60%, in Group III – 57%.
Conclusion. Neurogenic spine deformities require early surgical treatment with maintaining adequate pulmonary ventilation parameters. Surgical treatment is a stage of general treatment strategy. Plan of treatment including surgery can realize only with possible multidisciplinary examination, status monitoring and consulting panel opinion in view of recommendations by an orthopedist, pediatrist, neurologist, anesthesiologist-resuscitator, radial diagnostician, physiologist, physiotherapist. It’s also necessary to create a unified registry of neuroorthopedical patients.

Purpose. The goal of treatment was to determine radiological specificity of the hip joint in children with spina bifida.
Methods and Methods. In our clinic 137 patients with spina bifida were examined and treated in the period of 2006 – 2012 years. Instability of hip joint revealed in 123 patients (89 %).
Results. Based on the results analysis we made a conclusion that there is a dependent between neck-shaft angle (NSA) and neurological level of lesion (r=-0,7917, p kess 0,05): decreasing of neurological level of lesion are accompanied with decreasing of NSA. In 13 From 58 patients the progressive subluxation of the hip were revealed (16 hip joints) and it resulted in dislocation in 9 children (11 hip joints). In the follow up study on radiographs showed improvement (in 22,4%) and degradation (in 8,6%) of radiological points and it depended on level of neurological lesion.
Conclusion. Radiological changes in the hip joint depend on neurological level of lesion. The hip joint x-ray of the patients with spina bifida should be done 1 time a year for evaluation hip joint changes and for treatment selection.

Purpose. To improve the results of funnel chest surgical treatment in children by developing little invasive thoracoplasty.
Materials and Methods. 122 patients (3-17 years) with funnel chest examined and treated. Surgical treatment performed in all cases. Little invasive thoracoplasty by D. Nuss performed in 29 patients. Surgery by the authors’ original technique performed in 93 cases. A new technique of funnel chest surgery described, as well as a correcting plate for the sternocostal complex osteosynthesis. Periods of observation after thoracoplasty were 4 years.
Results. The results of modified thoracoplasty in the first year after the surgery traced in 93 patients. No migrations of metal frameworks, damages of mediastinum organs, large vessels, massive hemorrhages, and no lethal outcomes observed. The mean duration of postoperative hospitalization was 8 days. Marked pain syndrome persisted 5-7 days. Verticalization periods in patients were individual and depended on somatic status, pain syndrome severity. Good results observed in 39 cases, satisfactory – in 6, and unsatisfactory – in 2 cases among 47 patients underwent plate removal. Deformity recurrence noted in 2 patients operated at the age of 4 and 5 years, respectively.
Conclusion. Effectiveness of proposed technique achieves due to creating strong pressure on the correcting plate in stiffening rib zone because of sternum intention to return to the initial position. Secure jamming of the correcting plate in sternocostal complex zone takes place. As a result of surgery, more secure stabilization of the sternocostal complex creates due to more rigid correcting plate using.

Purpose. To analyze different approaches to optimization of funnel chest surgical treatment using internal fixators in children, adolescents and young subjects.
Materials and Methods. The experience of using internal fixators for correction of funnel chest presented in 68 patients at the age of 3-28 years. A frame-like fixator proposed, allowing to perform simultaneous fixation of up to 5-6 adjacent osteotomized ribs and sternum in patients with severe forms of the deformity and a large area of retraction. Patients had Degrees II, III, IV according to Giżycko index. Chondrotomies, radical cartilage resections, costotomies and sternotomy performed during thoracoplasty procedure depending on patient’s age, severity of the deformity.
Results. The use of thoracoplasty techniques selected and an individual approach to postoperative management allowed to achieve good immediate and long-term results in 80.8 % of patients. Satisfactory results obtained in 7 (14.8 %) patients, the results were unsatisfactory in 2 (4.2 %) cases.
Conclusion. In patients below 10 years with Degree II-III deformity KNIIO fixators are acceptable, in those above 10 years T-shaped fixators are effective, and in cases of Degree III-IV rigid deformities with a large retraction area frame-like titanium plates allowing to fix the whole costosternal complex appear to be more effective.

Purpose. To study the results of treating patients operated using the plate developed for funnel chest of different degree.
Materials and Methods. The study performed on the basis of analyzing treatment results in 25 children and adolescents with funnel chest operated in the department of children’s traumatology, chest deformities and pathology of the spine of SRITO of the Republic of Uzbekistan Ministry of Health within the period of 2011-2012. The surgery made according to the Nuss method without sternotomy and chondroresection in all patients. Developed in the authors’ clinic plate used to stabilize the sternocostal complex.
Results. The use of the Nuss modified plate provided significantly better results in the immediate and long-term postoperative periods in comparison with using the original plate.
Conclusion. Thoracoplasty by the Nuss method for funnel chest is the most optimal technique of correction in children and adolescents. The additional stabilizers of the original plate allow to achieve its stable fixation thereby reducing the risk of plate overturning and the development of secondary deformities of the chest front wall.

Purpose. To analyze the results of surgical treatment of patients with congenital chest deformities using «Matrix rib» instrumentation.
Material and Methods. The study group included 21 patients at the age of 12-18 years. There were 2 patients with funnel chest, 19 patients with keeled chest. The clinical material characterized by degree and type of chest deformity. Thoracoplasty performed in all the cases. The volume of surgery depended on deformity degree and type. Osteosynthesis performed using «Matrix rib» plates and locking screws.
Results. There were no metalwork migrations. Treatment results followed within the period from 6 months to 2 years. Evaluation criteria: correct chest shape, formation of the osteochondral model of the sternocostal complex. Good cosmetic results achieved in all the patients. The plates removed after 1-2 years.
Conclusion. The results allow to judge the appropriateness of using, as well as the high effectiveness of surgical treatment of congenital chest deformities using «Matrix rib» instrumentation which allows to perform stable osteosynthesis and maintain the correction for a long time.

Purpose. Substantiation of “CollapAn” implant use for treatment of chronic osteomyelitis in children.
Material and Methods. “CollapAn” granules implanted intraoperatively into a pre-debrided focus. "CollapAn” gel introduced by puncture using computer tomography control. Patients underwent monitoring of immune status laboratory parameters with medicamental correction pre- and postoperatively. Associated chronic diseases treated.
Results. Good result obtained in most patients, repeat surgical intervention not required. “CollapAn” use combined with directed immune correction provides persistent remission for 5 years and more.
Conclusion. Not only pathological focus debridement with further defect filling is important in treatment of chronic osteomyelitis, but medicamental therapy of associated diseases as well with subsequent prolonged systematic monitoring of laboratory blood parameters for timely prevention of recurrence.

The review of the foreign literature and that of our country regarding clubfoot treatment in children with arthrogryposis presents in the article. Current conservative and surgical methods represent, as well as the main problems of arthrogrypotic clubfoot treatment. State of the problem and modern tendencies of developing the techniques of equino-cavo-varus deformity correction introduce based on the examples of last decade literature.

The authors present a clinical case of using «Pedicle subtraction osteotomy» (PSO) technique for treatment of congenital Type III kyphosis according to Winter in 10-year-old child. They note the advantage of this technique for treatment of the most complex and rapidly progressive combination of defects which allows performing acute radical correction with minimal risk of neurological and intraoperative complications.

A clinical case presented on treatment of a child with congenital bilateral recurring clubfoot using transosseous osteosynthesis method according to G.A. Ilizarov. After treatment feet deformity corrected completely, weight-bearing of both lower limbs recovered.

Purpose. To demonstrate the changes in X-ray picture and regional hemodynamics at the stage of treating the patient using the Ilizarov fixator.
Materials and Methods. The changes in hemodynamics of acetabular roof and femoral head demonstrated at the stages of Perthes disease treatment using the Ilizarov fixator. The results showed a favourable treatment outcome.
Results. Reparative processes became dominating in the femoral epiphysis under the treatment influence, and its recovery started. The changes occurred with the enhancement of regional circulation both in bone and in paraosseous tissues, which provided the increase of blood inflow to the magistral arteries.
Conclusion. Combining the techniques of transosseous osteosynthesis, tunneling and autologous blood infusion into the problem areas for Perthes disease is rather effective by providing regional circulation improvement and stimulating restorative processes.