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Introduction Acetabular dysplasia associated with ischemic deformity of the proximal femur leads to significant functional limitations and progressive hip osteoarthritis (OA). The best surgical approach, the timing and the volume of surgery are still controversial. Material and methods Outcomes of 32 patients with ischemic hip deformity were reviewed. The mean age at the time of surgery was 15.8 ± 0.7 (range, 12–24) years. The mean follow-up period was 4.2 ± 0.4 years. Clinical outcomes were measured using the Merle d'Aubigné-Postel, Tönnis, Severin scoring scales and the grading system developed at the National Ilizarov Medical Research Center for Trauma and Orthopedics (NIMRC TO). Extra-articular (n = 24) and intra-articular (n = 8) procedures were produced for hip reconstructions. Results The hip function score was 5.2 ± 0.1 after extra-articular interventions and 4.3 ± 0.14 after intra-articular procedures. Postoperatively, hip joints were+ graded as Severin IIa (n = 18), Severin IIb (n = 10) and Severin III (n = 4). No arthritic changes occurred in 25 hips. In the remaining cases, OA either progressed (n = 4) or improved (n = 3). Outcomes were rated as good with 2.6 ± 0.03 scores (n = 17), fair with 2 ± 0.1 scores (n = 13) and poor with 1.41 ± 0.05 scores (n = 2) measured on the NIMRC TO scale. Conclusion The technologies offered for the reconstruction of both articular components have been shown to be effective in treatment of patients with ischemic hip deformity and associated acetabular dysplasia.

Objective Improve the effectiveness of pediatric treatment of chronic radial head dislocations (CRHD). Material and methods The review included 100 pediatric patients aged 2–18 years treated for CRHD between 2005 and 2019. Patients underwent physical examination, radiological (conventional radiography, US, MRI, MSCT) evaluation and statistical analysis was performed. Patients were divided into two groups. A major group consisted of 33 (33%) patients who were treated with new bone and plasty procedures including open reduction of the radial head (ORRH), plasty of the annular ligament with m. anconeus flap and fixation with the plaster cast; osteotomy of the proximal ulna and ulnar realignment with the Ilizarov external fixation. Outcomes were retrospectively compared with 67 (67.0 %) control patients treated with different classical techniques including ORRH, radial head fixation with wires, polyethyleneterephthalate band or the remnants of the annular ligament, with/without ulnar osteotomy. Anatomical and functional results of treatment were evaluated at a short (up to one year) and long term (over one year) after frame removal using modified Mattis-Lyuboshitz-Shwarzberg grading scale. Results Comparative analysis of outcomes of surgical management at a short- and long term in both groups showed that the percentage of good results was 1.5 times higher in the major group. A table of differentiated indications to pediatric treatment of CRHD was devised based on the findings. Conclusion Biomechanical articular parameters appear to deteriorate over time following radial head dislocation and can result in radial head deformity, malaligned and shortened ulna. Pediatric treatment is supposed to be differentiated depending on time of injury, patient's age, anatomical and radiological manifestations of the joint. Operative pediatric treatment of CRHD involving bone and plasty procedures can provide good internal fixation preventing recurrence.

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