Backgrоund. In most cases, haematogenic osteomyelitis affects the long bones of the skeleton. Predominantly, the centers of destruction are located in the lower extremities. The orthopedic complications of haematogenic osteomyelitis were observed (according to different data) in 22%71.2% of childhood cases. In 16.2%53.7% of cases, the complications can lead to childhood (nascent) disability. Aim. The purpose of the research is to conduct a retrospective analysis of femoral deformity correction results in children with haematogenic osteomyelitis consequences by applying both an Ortho-SUV Frame (based on passive computer navigation) and following the Ilizarov method. Materials and methods. The study examined 76 patients of both genders aged between 8 and 17 years old who were experiencing the consequences of haematogenic osteomyelitis in the long bones of the lower extremities. A comparative assessment of the parameters reflecting the effectiveness of circular external fixation in combination with an Ortho-SUV Frame and the Ilizarov method was conducted. Reference lines and angles before and after surgery, elongation size, distraction time, deformity correction period, external fixation index, number of complications, and the functional result were all considered. Results. All the children underwent deformity correction surgery, and the length of the afflicted lower extremity segment was reconstructed (restored). The use of the repositioning unit enabled a higher correction accuracy (94.45%) of the femur in comparison with the Ilizarov frame (30%). The frequency of excellent functional results in the first group of patients was more than 1.5 times higher than in the second group, whereas the satisfactory results turned out to be almost twice as low. Fewer complications were observed while using the Ortho-SUV hexapod. Conclusions. The application of the Ortho-SUV Frame at the long-bone-deformity-correction stage facilitates an increase in the efficiency of the circular external fixation method.

Введение. Врожденная контрактура подвздошно-большеберцового тракта -достаточно редкая патология, вызывающая трудности диагностики и планирования лечебных мероприятий. Отсутствие четкого представ-ления о причинах заболевания вызывает разногласия в трактовке диагноза у пациентов с данной патологией. В русскоязычной литературе это заболевание обозначается как идиопатическая разгибательно-отводящая кон-трактура тазобедренного сустава или идиопатическая контрактура большой ягодичной мышцы, врожденная контрактура сухожилий больших ягодичных мышц. В англоязычной литературе чаще говорится о врожденной или идиопатической контрактуре больших ягодичных мышц. Клиническое наблюдение. Представлен результат лечения ребенка 6 лет с врожденной контрактурой под-вздошно-большеберцового тракта. На хромоту было обращено внимание с началом его ходьбы, но правиль-ный диагноз не был установлен. В клинической картине, наряду с ограничением приведения и разгибания в тазобедренном суставе, уплотнением мягких тканей по наружной поверхности правого бедра в виде лампаса, имелись перекос таза, укорочение правой нижней конечности и вальгусная деформация диафиза правой бе-дренной кости. Ультрасонография и магнитно-резонансная томография показали наличие фиброзного тяжа по наружной поверхности правого бедра. Фиброзный тяж иссечен на протяжении 15 см, выполнен временный гемиэпифизеодез медиальной порции дистальной зоны роста правой бедренной кости. Результаты и обсуждение. При контрольном обследовании через 1 год пациент жалоб не предъявлял. Реци-дива контрактуры не отмечено. По данным рентгенологического исследования достигнута коррекция валь-гусной деформации правой бедренной кости, металлические конструкции из которой удалены. Несмотря на чаще встречающуюся разгибательно-отводящую направленность контрактуры подвздошно-большеберцового тракта, на что указывают большинство авторов, направленность и выраженность ее, по-видимому, может за-висеть от преобладающей зоны фиброзного перерождения мышечных групп. И при преобладающем пораже-нии большой ягодичной мышцы можно ожидать более выраженный разгибательный компонент, в то время как при преобладающем поражении мышцы, напрягающей широкую фасцию бедра, -сгибательный. Что мы и наблюдали у нашего пациента.Ключевые слова: дети; врожденный; контрактура; подвздошно-большеберцовый тракт.

BACKGROUND: The use of a vascularized fibular graft during reconstructive interventions on the limbs in children is a promising direction in the replacement of extensive bone defects in children. AIM: This study aimed to conduct a systematic review of the literature on microsurgical transplantation of a fragment of the fibula in the replacement of long bone defects in children. MATERIALS AND METHODS: Articles were searched in systems such as eLibrary, PubMed, and Google Scholar, with a search time range of 10 years (from 20122022, last query 11/08/2022). The following keywords were used for searching in Russian-language search engines: replacement of bone defects in children and fibula transplantation in children, and in the English-language search engines, microsurgical and fibula, microvascular and fibula, and bone and defect were used. After sorting the published studies, 17 publications were analyzed. RESULTS: The study analyzed a total of 690 patients (mean age 12 2.6 years). The predominant cause of the defects was malignant tumors in 647 patients (93.7% of all patients). Benign processes were also noted, which accounted for 0.87% of all patients: osteomyelitis, 2.0%; congenital pathology, 2.17%, and trauma, 1.45%. The mean follow-up period was 4.8 2.4 years. The survival rate of patients with cancer was 78.4%. Donor-side complications accounted for 14.7% of all complications. Recipient-zone complications were frequent and accounted for 85.3% of all complications (n = 457 cases). The main type of complications reported in the studies was graft fracture or fracture at the graft-bone level (35.7% of all complications). CONCLUSIONS: The use of a fragment of the vascularized fibula in the replacement of extensive bone defects enables a one-stage reconstruction of the limb with good long-term results in large segmental defects of various features. Despite the complications, this technique is one of the few that enables simultaneous limb reconstruction. The decision to use microsurgical fibula autotransplantation is based on the preference and surgical experience of the surgeon.

BACKGROUND: The surgical treatment of children with pectus excavatum is regarded as an urgent problem still demanding solution despite the multitudes of surgical correction methods available nowadays. The currently available well-known techniques cannot be considered perfect because they are not proper enough for solving all the tasks, not to mention the problem of asymmetric forms of pectus excavatum treatment. AIM: To analyze publications containing information on the methods of surgical treatment used for children with pectus excavatum. MATERIALS AND METHODS: The study presents the results of literature review on the methods of surgical correction of pectus excavatum. Information was retrieved in PubMed, Google Scholar, and eLibrary scientific databases using keywords. Consequently, 63 foreign and domestic scientific sources over the period from 1609 to 2022 were identified. Among them, 29 publications refer to the latest decade. RESULTS: Given the variety of methods used for chest deformity correction, thoracoplasty by D. Nuss has become the gold standard for the treatment of pectus excavatum. However, according to the search results, it is impossible to name one universal method of surgical intervention that could solve all the urgent problems at present. Modern surgery methods used for pectus excavatum correction can be considered only as modifications of treatment methods having been used before. CONCLUSIONS: The shortcomings of modern thoracoplasty determine the necessity to keep searching for new techniques and improve those available at present. Besides, the standard suitable for both surgeons and patients should be elaborated.