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Year 2012 Vol. 20 No 5
TRAUMATOLOGY AND ORTHOPEDICS
V.P. MOROZOV, E.G.PETROVA
SURGICAL TREATMENT OF CHILDREN WITH BENIGN TUMORS AND TUMOR-LIKE DISEASES OF LONG TUBULAR BONES
State Budgetary Educational Establishment OF HIGHER Professional Education “Saratov State Medical University named after V.I.Rasumovsky”, Saratov,
The Russian Federation
Objectives. To develop an algorithm of surgical treatment tactics of benign tumors and tumor-like processes of long bones permitting to restore the integrity of a bone and limb function.
Methods. 184 children with benign tumors and tumor-like diseases were under observation; they were subjected to different types of resection within healthy tissues. Various types of osteoplastic material in combination with fixation of the damaged segment in different ways were used. In addition, computer simulation of the axial load on the long tubular bone defects with different localization and size was carried out.
Results. The performed computer simulation shows that presence of the bone defect in its size 1/3 larger than the length of the diaphysis circle and 25% bigger than the bone length weakens the bone toughness so that at usual physiological load on a limb, a pathological break in the defect zone may occur.
On the basis of analysis results, we developed an algorithm for treatment tactics selection, taking into account the nature of the pathological process, the size and location of the resulting bone defect. It was determined that patients operated on using the developed algorithm, in spite of the greater volume of the present defect, rehabilitation period was 15-18% shorter if compared with patients in whom continuous external plaster immobilization was applied and early motor load was not realized.
Conclusions. Differential use in children with post-resection bone defects of osteoplastic materials and preventive osteosynthesis gives the most favorable clinical results with maximally early activation of patients and preservation of a usual life style of a patient during treatment.
1. Grigorovskii VV, Luchko RV, Zotikov LA. Patomorfologicheskie izmeneniia, otrazhaiushchie biologicheskieprotsessy v kal'tsii-fosfatnykh implantatakh, pri plastike ostatochnykh polostei v kostiakh cheloveka. [Pathological changes reflecting biological processes in calcium phosphate implants for plastic residual cavities in human bones]. Vestn Travmatol Ortoped im NN Priorova. 2008;(1):82–88.
2. Seinian S. G., Aivazian V. P., Khanamirian T. V. Khirurgicheskoe lechenie dobrokachestvennykh opukholei i opukholepodobnykh porazhenii kostei s primeneniem alloplastiki demineralizovannymi kostnymi transplantatami. [Surgical treatment of benign tumors and tumor-like lesions of bone with the use of alloplastic demineralized bone grafts]. Vestn Travmatol Ortoped im NN Priorova. 1996;(2):18–20.
3. Lekishvili MV, Balberkin AV, Vasil'ev MG, Kolondaev AF, Baranetskii AL, Buklemishev IuV. Pervyi opyt primeneniia v klinike kostnoi patologii biokompozitsionnogo materiala "Osteomatriks" [The first experience of application of biocomposite material "Osteomatrix" in the clinic of bone disease]. Vestn Travmatologii i Ortopedii. 2002;(4):80–83.
4. Malakhov OL, Belykh SI, Berchenko GN, Kozhevnikov OV, Saltykova VG., Ivanov AV, Malakhov OO, Krasnoiarov GA. Primenenie «materiala dlia osteoplastiki» v detskoi ortopedii: otsenka effektivnosti i izuchenie protsessov biotransformatsii [The use of "material for osteoplasty" in pediatric orthopedics: efficacy and learning processes of biotransformation]. Vestn Travmatol Ortoped im NN Priorova. 2004;(2):49–53.
5. Yanagawa T, Watanabe H, Shinozaki T, Takagishi K. Curettage of benign bone tumors without grafts gives sufficient bone strength. Acta Orthop. 2009 Feb;80(1):9–13.
6. Knetes IV, Pfafrod GO, Saulgozis IuZh. Deformirovanie i razrushenie tverdykh biologicheskikh tkanei. [Deformation and fracture of solid biological tissue]. Riga, SSSR: Zinatne; 1980. 319 p.
7. Petrova EG, Rubashkin SA, Kurkin SA. Meditsinskii instrument dlia izmereniia vnutrennego ob"ema organov [Medical instrument for the measurement of the internal volume of organs]: pat. RF ¹78056; patentoobladatel': FGU SarNIITO Rosmedtekhnologii. ¹2008128088/22; zaiavl. 09.07.2008; opubl. 20.11.2008. Ofitsial'nyi Biul Rospatenta Izobreteniia i Poleznye Modeli. 2008;(32).
8. Ianson KhA. Biomekhanika nizhnei konechnosti cheloveka [Biomechanics of human lower extrimity]. Riga, SSSR: Zinatne; 1975. 324 p.
410002, Rossiyskaya Federatsiya, g. Saratov, ul. Chernyishevskogo, d. 148, FGU «Saratovskiy NII travmatologii i ortopedii Rosmedtehnologiy», kafedra travmatologii i ortopedii,
e-mail: petrovagirl@mail.ru,
Petrova Ekaterina Gennadievna
Morozov V.P. Doctor of Medical Sciences, Professor of Traumatology and Orthopedics Chair of SBEE HPE “Saratov State Medical University named after V.I.Rasumovsky”
Petrova E.G. Post-Graduate Student of Traumatology and Orthopedics Chair of SBEE HPE “Saratov State Medical University named after V.I.Rasumovsky”
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