Background. Мeningococcal infection with damage to various organs and systems, including the musculoskeletal system, causes growth plate dysfunction, which usually leads to the formation of orthopedic consequences, including axis deviation and/or limb length discrepancy. Aim. This study aimed to analyze the features of limb deformities and methods for their correction in children with consequences of meningococcemia. Materials and methods. The retrospective analysis was performed on patients with consequences of meningococcemia who were examined and surgically treated in the clinic between 2012 and 2018. A total of 12 patients (six boys and six girls) were included, with an age range of 215 years. The examination included clinical, X-ray, and physiological methods. Treatment methods consisted of a combination of angular deformity correction and limb lengthening. Results. In 12 patients, 76 growth plate arrests of long bones were found. Most frequently (17.1%), growth plate arrests of the distal femur and proximal tibia were observed, which resulted in limb shortening and/or axis deviation. For restoration of limb alignment in 10 (83.3%) patients, transosseous compression-distraction osteosynthesis was performed. For limb deformity correction, guided growth technique was applied by using eight-plate for temporary epiphysiodesis of active functioning part of the growth plate in four (33.3%) patients, whereas partial growth plate arrest resection with following epiphysiodesis was achieved in two (16.6%). Conclusions. Meningococcal septicemia leads to long bone growth plate dysfunction. The main complaints in this patient are limb shortening and their deformity. Along with the transosseous compression-distraction osteosynthesis technique, using the guided growth method by carrying out temporary epiphysiodesis of the remaining functioning part of the growth plate of damaged bone was appropriate.

BACKGROUND: Congenital malformations of the spine and spinal cord can be combined with various clinical manifestations of the spine, spinal cord, and lower extremities. Children with these neurological disorders often lack sensitivity and motor activity of their lower extremities and, in most cases, have bladder infections and incontinence (lack of bladder and bowel control). AIM: This study aims to analyze publications with the diagnostic and treatment results of patients with neurological, orthopedic, neurological, and ophthalmological problems with spina bifida. MATERIALS AND METHODS: We searched PubMed, Web of Science, Scopus, MEDLINE, eLibrary, and RSCI databases and found about 2000 references and 374 articles. We selected 60 articles for review in orthopedics, neurosurgery, urology, and ophthalmology. RESULTS: Neural tube defects are a wide range of congenital malformations, including skull defects and open or closed spinal dysraphism. The incidence of spine and spinal cord malformations in different countries is quite broad and amounts to 0.3199.4 cases per 10,000 births worldwide. Spinal cord malformations often occur in combination with bladder infections and incontinence, limb deformities, and other central nervous system developmental anomalies. Among the orthopedic problems leading to impaired support function, the most common are foot deformities and hip joint instability. Orthopedic monitoring of a patient with spina bifida consists of mainly preventing or correcting deformities according to the rehabilitation potential of the child. The timely completion of treatment allows the child to maintain mobility and independence of movement daily activities. At the same time, such treatment must pursue realistic goals according to the potential motor level of the child. In addition to neurosurgical and orthopedic problems, most children with spina bifida (88%94%) suffer from pelvic disorders. A urologist should observe a patient with spina bifida to perform ultrasound and laboratory monitoring of both the lower and upper urinary tract conditions from an early age. Timely procedures to eliminate urinary retention and sanitation can maintain normal kidney function and contribute to the adequate conduct of motor and neurological rehabilitation of the child. The most common complication of spina bifida is the Chiari II malformation, which is manifested by damage to brain stem structures and internal occlusal hydrocephalus with various symptoms, including neuroophthalmological signs. CONCLUSIONS: A multidisciplinary team of specialists comprising a neurologist, neurosurgeon, urologist, orthopedic surgeon, ophthalmologist, orthosis specialist, and psychologist should be involved in treating the children with the above presented problems. The use of an integrated approach to treat this group is absolutely justified and enabled the maximum rehabilitation potential of the child to be achieved.

Background. Тraumatic hematomas in the posterior fossa rarely occur, which account for 0.01%0.6% of brain injury cases. Retroclival location for such hematomas is uncommon, as they are mostly epidural and diagnosed almost exclusively in the pediatric population. Clinical cases. Herein, we report two pediatric cases of traumatic epidural and traumatic subdural retroclival hematomas that developed after high-energy trauma in motor-vehicle accidents. Discussion. Related studies were reviewed, and anatomical features and neuroimaging findings associated with various compartments of the retroclival hemorrhage in children were discussed. Conclusion. Considering the nonspecific clinical features and special topographic correlation of anatomical structures in this region, neuroimaging is regarded as the most reliable method to diagnose and correctly classify this pathology, which is essential for further treatment.

BACKGROUND: Sacral neuromodulation is a neurosurgical method for the correction of bladder and bowel dysfunctions of various origins that are refractory to conservative treatment. AIM: To analyze chronic sacral neurostimulation results as a correction method for pediatric bladder and bowel dysfunction of various origins. MATERIALS AND METHODS: The results of chronic sacral neurostimulation for treating urination and defecation disorders of various origins in children reported in the world literature were analyzed. The literature search was performed in the open electronic scientific databases eLIBRARY, PubMed, and Cochrane Library. The source selection was limited by 20022022. RESULTS: Most authors report good and satisfactory results in the treatment of bladder and bowel dysfunction by sacral neurostimulation. However, the level of evidence on the effectiveness of sacral neurostimulation remains low because data were obtained from small and heterogeneous groups of patients and studies employed different criteria for inclusion and methods for analyzing the results. CONCLUSIONS: Conducting randomized trials will allow for the assessment of the efficacy and safety of sacral neuromodulation in children with bladder and bowel dysfunctions of various origins that are refractory to standard conservative treatment.