There is presented a comparative characteristic of the clinical and radiological picture of congenital and neurogenic spastic instability of the hip in children, the peculiarities of surgical treatment of these pathologies have been revealed. The work is based on an analysis of the results of surgical treatment of 115 patients (205 hips) who were divided into 2 groups. The first group included 58 patients (50.4 %) with spastic hip instability. The second group (57 patients, 49.6%)) was consisted of patients with dysplastic instability in. indications for various types of surgeries were pathogenetically substantiated.

Examples of the treatment of pathological hip joints in children with juvenile cerebral palsy (JCP) are presented with reference to severity of locomotor insufficiency, neurologic deficiency and hip pathology. Methods for surgical treatment of various locomotor problems are descried.

An algorithm for the examination of children with the cervical spine instability has been presented and the necessity of a multidisciplinary approach to diagnosis and treatment of these forms of pathology has been evidenced. 194 patients agedfrom 5 to 18 years with complaints of headache, dizziness, neck pain, recurrent subluxations in atlantoaksial joint have been examined. Anamnesis revealed that 73% of children with unstable cervical spine were observed for a long time and treated with a diagnosis of vegetative-vascular dystonia. The importance of X-Rays medical imaging both in the standard and transoral projections and performing function tests, as well as carrying out duplex scanning of the brain vessels and neck with a rotary tests has been established.

32 patients underwent 64 surgical interventions in Orthopedic Department of Research Centre of Children’s Health between 2009 and 2012. For patients of group 1 (n=21, 4 boys and 17 girls aged 4-10 yr) surgery was planned based on the results of X-ray examination. In group 2 (n=11, 1 boy and 10 girls aged 4-8 yr) surgery was planned by the newly proposed method using CT. Diagnosis was based on the analysis of patients ’ complaints, examination, X-ray study with the measurement of hip angular parameters in the direct projection and in the position of hip abduction with maximum internal rotation, CT down to femoral condyles for determining true parameters of the cervical-diaphyseal angle, femoral anteversion. CT yielded data for the level of femoral osteotomy between greater and lesser trochanters, mean diameter of the circumference (arithmetic mean between maximum and minimum diameters). The necessary derotation length was calculated by the formula L = d × pi × c/360 degrees, where L the necessary rotation length in mm, d mean circumference diameter in mm, c derotation angle calculated as the difference between observed proximal femur anteversion and its age norm. The latter were determined as described in [13]. The outcome of surgery was assessed by the following criteria: the degree of conformity to age-specific anteversion of proximal femur in the postoperative period, symmetry of results after bilateral femoral derotation osteotomy.

Traumatic-Orthopedic Department, Research Centre of Children ’s Health, between 2008 and 2011 using the endoprosthetic techniques. The aim of the study was to assess the efficacy of surgery and the patients ’ quality of life. Most patients presented with hip pain and constrained movements, different leg length, lameness, compromised support ability and function of the extremities that prevented walking without additional support in 90% of the cases. Analysis of X-ray images during the follow-up revealed adequate location of endoprosthesis components. Their complete consolidation was documented in patients who underwent autoplastic correction of the cotyloid cavity. The data on the position of the stem of the endoprosthesis were used to restore the limb length and hip slope. No signs of destruction in the knot of endoperosthesis friction were seen on X-ray images. The Harris hip score improved up to 85-90 after surgery. None of the patients complained o fpain in the hip and lower extremity. Good correction of deformation and normal or almost normal functional status of the leg was achieved.

The article presents data on modern techniques for the early identification of degenerative disease of joints in children. 120 adolescents aged 12 to 18 years were examined. All the patients were divided into two groups. The main group included 70 children with various manifestations of osteoarthritis. The control group was made up of 50 healthy children with growing pains. The examination helped determine the diagnostic value of various (X-ray, ultrasonic, magnetic resonance) techniques for the study of joints in children with clinical manifestations of osteoarthritis. Key words: children, osteoarthritis, arthralgia, diagnostics. (Pediatric Pharmacology. – 2010; 7(2):66-72)