Background. The main orthopedic manifestation of osteogenesis imperfecta is multiple fractures. In severe disease, frequent fractures lead to malunion and deformity, which increases the risk of refracture. Surgical treatment of children with osteogenesis imperfecta is aimed at reducing the risk of complications and improving the quality of life of the child. The Fassier-Duval telescopic intramedullary system has taken the leading place among the growing metal fixators. In this study, we conduct a comparative analysis of the results of a longitudinal study between patients with osteogenesis imperfecta types I and III, as well as an assessment of motor activity. Aim. To evaluate the efficiency of using the telescopic intramedullary system depending on the type of osteogenesis imperfecta. Materials and methods. A prospective analysis of surgical treatment of 20 children with types I and III was carried out. Group I included 8 patients with type I NO, group II included 12 with type III. The average age of patients was 8.2 years. Surgical treatment was carried out on the basis of the neuroorthopedic department with orthopedics of the National Medical Research Center for Children's Health. A total of 48 intramedullary telescopic pins were installed. The average period of postoperative dynamic follow-up was 42 months. The analysis of the results of surgical treatment was carried out according to the following criteria: the frequency of migrations of metal structures, the formation of bone deformities, the number of revisions, as well as the number of bone fractures with an installed metal fixator. Evaluation of the results of motor activity was carried out using two scales: Gillette Functional Assesment Questionnaire (Gillette FAQ) and HofferBullock. Results. There were no statistical differences in the number of complications in the two groups. Fractures among patients with type I occurred more often than in patients with type III by 19.3%. The frequency of migrations in the I study group was 7.1% (1 segment), in the II group 35.3% (12 segments). The formation of deformation was the main factor in the revision intervention, which in our case amounted to 83.3%. In the group of patients with type I, the number of repeated operations was 7.1% (1 segment in 1 patient), in the group of patients with type III 17.6% (6 segments in 4 patients). All patients in the postoperative period had II or I level of motor capabilities on the HofferBullock scale. According to the Gillette FAQ scale in the postoperative period, the subjects showed a result above 4 points. Conclusion. The Fassier-Duval telescopic rod is a modern and reliable metal fixator. Despite the absence of statistical differences in the two study groups (p-value20.005), there was an increase in the tendency to complications in severe course with NO. Correction of varus deformation when restoring normal values of DN125 and HEA within 2538 is the prevention of the re-formation of the truth of Coxa Vara. The motor activity of children with severe course did not statistically differ from children with mild course (p-value20.005) in the postoperative period with an average follow-up period of 42 months, regardless of the initial low motor capabilities in children with type III.

Objective of the study: to evaluate the effectiveness of layered alloplasty in the surgical treatment of active aneurysmal bone cysts (ABCs) in children. Materials and methods of research: from 2007 to 2020 56 patients with ABCs were treated in the Neuroortopedic Department with orthopedics of the National Medical Research Center for Children’s Health (Moscow, Russia). All patients have underwent a comprehensive clinical and radiological examination, including the determination of intraosseous pressure (IOP) to determine the activity of the pathological process. Surgical treatment of 19 patients with ABCs was performed through layered alloplastic method of the cyst cavity with the enhancing of the bone growth zone with alloimplants based on sea coral. Results: the results of treatment were evaluated on the basis of an analysis of the radiographic picture of reconstruction of bone implants and restoration of bone tissue structure, as well as analysis of the quality of life of patients in the 1st and 2nd module of the PedsQL Generic Core scale questionnaire before and after surgical treatment. Conclusion: the use of layered plasticity of a bone defect in the surgical treatment of ABCs can be considered as effective method for preventing recurrence of the disease.

Osteogenesis imperfecta (OI) is a heterogeneous group of diseases with different types of inheritance, characterized by frequent fractures and deformities of the bone skeleton. Conservative and surgical treatment of children with this pathology is an integral part of a multidisciplinary approach. In the surgical treatment of bone deformities in children with OI, the method of choice is corrective osteotomies, and an effective method of fixation is intramedullary osteosynthesis. Surgical treatment of children with OI is aimed at reducing the number of fractures, correcting deformities and increasing motor activity. Aim of the study to determine the indications for intramedullary osteosynthesis of long tubular bones in children with the disease. To review the studies concerning treatment of children with OI. Consider the different types of metal fixers, their advantages and disadvantages. Today the technique of intramedullary fixation is the "gold" standard in the surgical treatment of children with OI. There is a clear advantage of telescopic rods in terms of the frequency of reoperations, but their use does not exclude the presence of postoperative complications.

Aim. To carry out a comparative analysis of approaches to the surgical correction of equinoplonal valgus deformity of the feet in children with infantile cerebral palsy. Materials and methods. A retrospective clinical and radiological analysis of the results of surgical treatment of 109 patients (194 feet) with equinoplovalgus deformity of the feet was performed. The patients are divided into four groups according to the method of surgical correction and age periods. Tendon-muscle plastics: in study group 1a, 21 children 4–7 years old and 23 children 8–11 years old in group 1b. Osteoplastic surgery: 28 children 4–7 years old in study group 2a and 34 children in group 2b. The average age of the patients was 8.2±2.8 years. According to the neurological status, patients of I – III levels of motor development (according to the Gross Motor Function Classification System – GMFCS) with hemiparesis, diplegia and tetraparesis were examined. Comparative analysis was carried out with a reference group consisting of 40 children (71 feet) with exostotic chondrodysplasia or injury to the ligamentous apparatus of one foot at the age of 4–11 years without neurological pathology and foot deformities. Results. A significant improvement in clinical and radiological parameters was determined in all study groups 14±2 months after surgical treatment in comparison with preoperative parameters. Most of the values approached the established reference intervals. Assessment 34±3 months after surgical treatment in study groups 1a and 1b showed a decrease in the studied clinical and radiological parameters. The results after 34±3 months in study groups 2a and 2b with performed osteoplastic interventions did not reveal significant differences from the parameters after 14±2 months. Such results indicate the preservation of early results of surgical treatment when using osteoplastic methods for correcting foot deformities in children 4–11 years old. The results obtained with the use of soft tissue surgical techniques in children 8–11 years old indicate a high recurrence rate in the long term. Conclusion. The study of functional status parameters according to the Gillette Functional Assessment Questionnaire 22±4 months after surgery revealed an increase in functional status in 42.85% of children in group 1a and 71.43% in group 2a. In group 1b, an increase in functional status was noted in 30.45% of children, in group 2b – in 67.65% of children. In 4.33% of children of the primary school group, tendon-muscle plastic showed negative dynamics in the functional status. The data obtained in general indicate that there are great prospects for long-term correction of foot deformity by means of osteoplastic operations in comparison with surgery of soft tissue structures.

Materials and methods. The data of 4 groups with patients from 4 to 14 years old were studied. Group 1: 22 patients (34 knees), with angular deformities about the knee. Group 2: 38 patients (38 knees) with leg length discrepancies. Group 3: 15 patients (27 knees) with knee flexion contracture and cerebral palsy. Patients of 1–3 groups were operated by guided growth. The reference group (40 patients, 60 knees) was formed to determine the normal knee extension values in children according to X-ray and goniometry data. Results. The mean angle of deformity before and after surgical treatment in group 1 were: 15.3 and 1.6o; in group 3: 160 and 4o recurrence, respectively, ( p <0.05). The mean leg length discrepancy before and after surgery in group 2 were: 30 and 8 mm ( p <0.05). The mean correction rate in group 1 was 0.6o per month, in group 2 – 0.9 mm per month, in group 3 – 2.9o per month. The mean score on the Gillette FAQ in group 3 increased after surgical treatment from 3.63 to 4.13. In reference group the mean angle of passive extension was 5o recurrence with goniometry lying on back, and 15o recurrence on X-ray. The mean active extension in a standing position was 4o recurrence. Smaller values of the tibiofemoral angle with goniometry in the standing position and passive extension with X-ray and goniometry can serve as clinical and radiological criteria for knee flexion contracture. Conclusion. Guided growth is an effective technique for correcting leg length discrepancy and angular deformities about the knee in children. Close outpatient observation allows to not only timely identify orthopedic pathology, but also to effectively correct it without major reconstructive operation.