Peculiarities of diagnostics and treatment in the superior congenital radiocubital synostosis in children
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StatusThe thesis was presented on the 27 June, 2007Approved by NCAA on the 20 September, 2007 Abstract – 0.31 Mb / in romanianThesisCZU 616.718-007-053.1-053.2
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Keywords
congenital radiocubital synostosis, children, diagnostics, surgical treatmentSummary
The work is based on a complex analysis of the clinical, imagistic, electrophysiologic and laboratory observation experience and the results of the surgical treatment in 38 children with proximal congenital radiocubital synostosis at the age of 10 months till 14 years old, having been examined and treated in the pediatric orthopaedics and traumatology clinic of the National Scientific – practical Centre of the pediatric surgery „Natalia Gheorghiu” of the Institute of the Scientific Researches in the field of Mother and Child Health Protection (the department of surgical correction of the congenital pathological formation) of the Health Ministry of the Republic of Moldova.The researches have been done on the basis of the clinical, paraclinical, electrophysiological, dopplerographic, biochemical, immunological, genetical examinations and the findings from distance of the operated patients for the deformity correction in congenital radiocubital synostosis in children. The diagnosis is done on the basis of the clinical signs of the absence of the su- pination and pronation movements, determining three degrees of the pathological position of pronation. The confirmation of the diagnosis is possible by means of X-ray of the whole forearm, establishing the localization of synostosis, the area size of the bone welding, the position of the radial head, the trajectory of the forearm bones crossing. The biochemical examination of 18 indices in 12 patients with congenital radiocubital synostosis have established that in 50% of cases the deviation from the norm were revealed. The electromyographic examinations have shown that the tested musches-the pronator teres and the supinator one present a diminished amplitude in the bilateral pathology and asymmetric one in the unilateral pathology. The immunologic examinations allow us to consider that the disturbance of the immune homeostasis in children has a big importance in the appearance of congenital radiocubital synostosis. The growth of the proinflamatory cytokines of IL-1B, IL-8 serum and of the immunoregulating cytokines IL-2 which is accompanied by the immunoregulating lach of poise may be considered one of the risk criteria of the congenital pathology appearance that is congenital radiocubital synostosis. Prof. P.Moroz’s method of correction of the deformity through the derotative osteotomy of the proximal from ulna and the distal from radius, the delicate osteosynthesis and fixation with crossing brooches. The distant findings after 1-23 years after operation have been studied at 29 children and assessed as being good at 26 children, satisfactory in 1 patient, unsatisfactory-2 patients.
Oficial Reviewers
- Gheorghe Croitor
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova - Goţia Dan
Doctor în medicină, profesor universitar, Iaşi, România
Theses
