Correction of radius deformity using guided-growth technology in children with multiple hereditary exostoses
Notice bibliographique
Résumé
Introduction. Multiple hereditary exostoses (MHE) is a disease that progresses as a child grows, which leads to severe deformities of the skeleton. In 30–60% of MHE cases, the bones of the forearms are affected with the development of radius deformity. In addition to resection of bone and cartilage formations, surgical treatment may include various types of osteotomies using submersible metal fixators and external fixation devices. The development of guided-growth technology dictates the need to expand the scope of minimally invasive surgery. The possibilities of using this technology for deformities of the upper extremities have not yet been sufficiently studied. Objective. To evaluate the effectiveness of the method of controlled bone growth in the surgical treatment of ulnar deformity against the background of multiple hereditary exostoses. Materials and methods. In the period from 2021–2024, thirty three 5 to 17 years children (55 segments/forearms) were hospitalized at the National Medical Research Center for Children’s Health. The study group consisted of 13 children (15 segments) diagnosed with: Distal radius deformiry on the background of multiple hereditary exostoses. A control group of 20 (40 segments) children were diagnosed with juvenile idiopathic arthritis. Patients from the study group underwent surgical treatment of radius deformity using temporary arrest of the growth zone (hemiepiphysiodesis) of the radius. All the studied patients were assessed the angle of the ulnar tilt (UT) and of the lunate subsidence (LS) on X-rays of the forearm in direct projection, patients from the study group were radiographed in the preoperative period and 12–20 months after surgery. The statistical analysis of the studied parameters is based on the search for statistical differences in groups and was performed in the Stattech program. Results. The preoperative value of the elbow angle UT was 35° (33.40), after surgical treatment, UT was 27° (24.32) at p = 0.0002. The value of the LS before surgery was 8.73 ± 3.33 mm, after surgical correction LS was 7.48 ± 3.36 mm at p = 0.005. The achieved level of correction of UT and LS in the study group did not statistically differ from that of the control group, which indicates that the target values were achieved. The average angle of correction of the UT parameter was 8°/year, the trend in postoperative LS values was 1.25 mm/year. Conclusion. The technology of guided-growth effectively corrects the axis of the radius deformity in MHE children during growth. The timely application of this technology makes it possible to prevent the development of severe deformity of the radius and to abandon the performance of corrective osteotomies in the future
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».