Fractures of lower limbs in children with spina bifida
| Autor: | Aleksandra S. Fedoseyeva, Milana A. Ugurchieva, Stanislav V. Ivanov, Vladimir Kenis, Tatyana N. Prokopenko |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
congenital hereditary and neonatal diseases and abnormalities Radiography Osteoporosis Periosteal reaction fracture of the femur and the tibia 03 medical and health sciences 0302 clinical medicine medicine Orthopedics and Sports Medicine Displacement (orthopedic surgery) osteoporosis in children 030222 orthopedics business.industry Spina bifida lcsh:RJ1-570 lcsh:Pediatrics medicine.disease Spinal cord Surgery nervous system diseases spina bifida medicine.anatomical_structure Radiological weapon Pediatrics Perinatology and Child Health Orthopedic surgery business 030217 neurology & neurosurgery |
| Zdroj: | Ortopediâ, Travmatologiâ i Vosstanovitelʹnaâ Hirurgiâ Detskogo Vozrasta, Vol 6, Iss 3, Pp 25-31 (2018) |
| ISSN: | 2410-8731 2309-3994 |
| Popis: | Background. Spina bifida is a serious defect in the development of the spine and spinal cord. It is accompanied by several orthopedic disorders of the spine and lower limbs, including fractures of long tubular bones. In spina bifida, osteoporosis plays an important role in the pathogenesis of motor disorders. Aim. The objective was to determine the patterns of occurrence and the clinical and radiological features of fractures of the long tubular bones of the lower limbs in children with sequelae of spina bifida. Materials and methods. From 2006 to 2017, 544 patients with spina bifida were examined and treated at the Turner Research Institute for Children’s Orthopedics. Clinical-neurological and radiographic methods were used. The neurosegmental level of spinal cord involvement was determined using the Sharrard classification, and the motor level was assessed according to the method proposed by Melbourne Medical University. Results. The clinical picture of a fracture of a long tubular bone in a child with spina bifida has many characteristics. There was no abnormal mobility in the fracture site in 56% of cases, edema was absent in 88% of children, and pain in the fracture region was observed in only 19% of cases. The radiographic features of the atypical fracture of long tubular bones in children with sequelae of spina bifida included lack of a fracture line, presence of a hypertrophic periosteal reaction, and sclerosis areas at the fracture site. Conclusion. The frequency and localization of fractures of the lower limbs in children with sequelae of spina bifida are determined according to the neurosegmental level. The clinical picture of fracture often differs from usual fractures by the absence of pain syndrome, edema in the fracture region, and displacement of bone fragments, which must be considered for diagnosis. The peculiarities of the clinical and radiological picture are associated with the presence of osteoporosis in this pathology due to a decrease in the motor activity level of the patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|