Abstract. Clinical and epidemiological and electrocardiographic features of Wolf Parkinson White syndrome in men of military age were studied. The study was a retrospective study with a solid sample of patients. Of the 1,9056 men residents of St. Petersburg between the ages of 18 and 27, Wolf-Parkinson-White syndrome was identified in 107 (0,56%) people. The disease was asymptomatic in 38 (35,5%) patients. All identified individuals with Wolf Parkinson White syndrome, in addition to asthenic Constitution type, which was observed in 68,2% of cases, were assessed for signs of systemic connective tissue involvement. It was found that flat feet, scoliosis or kyphosis, myopia, as well as mitral valve prolapse and abnormally located chords in the left ventricle of the heart are detected in almost every second man of military age. Due to the inability to assess the presence of all signs of systemic connective tissue involvement, the isolation of specific variants of dysplastic phenotypes in patients with Wolf Parkinson White syndrome was not performed. It was found that in the presence of increased dysplastic stigmatization, the clinical course of Wolf Parkinson White syndrome is characterized by a lower number of asymptomatic cases (6,3 and 16,7%, respectively; p0,05), an increase in the frequency of paroxysmal tachyarrhythmias (81,5 and 63,1%, respectively; p0,05) and a high incidence of vegetative-vascular disorders (82,8 and 15,4%, respectively; p0,05).

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Relevance. For more than a century, many methods of treating Kienböck’s disease have been developed, although none of them could achieve consistently good results. The transposition of the pisiform into the lunate location after removal of the latter, as well as the combination of this operation with a shortening osteotomy of the radius, is considered as one of the promising methods of this disease treatment. The purpose of this publication was to demonstrate the options of the modern reconstructive surgery for the treatment the stage IIIb Kienböck’s disease. Case presentation. A clinical case of a successful non-free transplant of a blood-supplied pisiform in aseptic necrosis of the lunate is described. A patient was a 21 year old military serviceman with stage IIIb Kienböck’s disease complicated by persistent pain syndrome and severe dysfunction of the left wrist. He underwent removing the fragmented lunate with replacing it with a pisiform on the tendon feeding pedicle and performing simultaneous shortening osteotomy of the radius. The displaced bone was fixed with an anchor to the dorsal surface of the distal radial metaepiphysis. In 12 months after the surgery, an improvement of the wrist function was achieved in the form of an increase in the range of motion compared with the preoperative period and a significant decrease in the level of pain syndrome. The radiological examination at the same time showed the preservation of the shape, size and intraarticular localization of the bone autograft. Conclusion. The use of transposition of the blood-supplied pisiform on a permanent tendon feeding pedicle into the region of the removed lunate demonstrated, in our opinion, the favorable possibilities of successful surgical treatment of the late stages of Kienböck’s disease. A favorable outcome of such treatment is possible only in a specialized hospital, where there are trained specialists in the field of hand surgery, and there are also opportunities for employment a modern rehabilitation complex aimed at restoring movements in the hand joints, taking into account the strength and coordination parameters of its anatomical structures.