- Klíčová slova
- Köhlerova nemoc,
- MeSH
- bolest * etiologie prevence a kontrola MeSH
- člunkovitá kost * patologie MeSH
- lidé MeSH
- osteochondróza * diagnóza etiologie terapie MeSH
- předškolní dítě MeSH
- rentgendiagnostika metody využití MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- Publikační typ
- kazuistiky MeSH
Autoři předkládají základní popis nové diagnostické jednotky Laboratoře chůze, založené na 3-D (trojrozměrné) optické dokumentaci pohybu, umožňující sofistikovaným způsobem „motion analysis“ (instrumentální analýzu pohybu) dynamický záznam rozsahu pohybů v jednotlivých kloubech dolních končetin ve třech rovinách v celém krokovém cyklu v reálném čase. Cílem jsou kineziologické studie hlavně u pacientů s dětskou mozkovou obrnou, ale i u dětí se závažnými vrozenými nebo získanými vadami pohybového aparátu. Návrh nového výkonu pod názvem „Komplexní analýza pohybových poruch u dětí a mladistvých do 18 let“ byl již komisí MZ ČR schválen.
The authors present the basic description of a new diagnostic unit, the Gait Laboratory, based on 3-D (three-dimensional) optic documentation of motion allowing, in a sophisticated „motion analysis“ manner, for a dynamic recording of the ranges of motion in the individual joints of the lower limbs in three planes throughout the gait cycle in real time. The aim is to conduct kinesiologic studies particularly in paediatric patients with cerebral palsy as well as in children with severe congenital or acquired locomotor disorders. The proposal of a new procedure entitled „Comprehensive analysis of locomotor disorders in children and adolescents under 18 years of age“ has already been approved by the Committee of the Czech Ministry of Health.
- Klíčová slova
- dětská mozková obrna, instrumentální analýza chůze,
- MeSH
- audiovizuální záznam MeSH
- biomechanika MeSH
- chůze (způsob) fyziologie MeSH
- dítě MeSH
- dolní končetina patofyziologie MeSH
- financování organizované MeSH
- kineziologie aplikovaná metody přístrojové vybavení využití MeSH
- kolenní kloub patofyziologie MeSH
- kyčelní kloub patofyziologie MeSH
- lidé MeSH
- lokomoce MeSH
- metody pro podporu rozhodování MeSH
- mladiství MeSH
- mozková obrna diagnóza patofyziologie MeSH
- plánování péče o pacienty MeSH
- pohybové poruchy diagnóza patofyziologie MeSH
- předškolní dítě MeSH
- rozsah kloubních pohybů MeSH
- zobrazování trojrozměrné využití MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- předškolní dítě MeSH
PURPOSE OF THE STUDY: To evaluate our experience with indications for surgery based on instrumental gait analysis in cerebral palsy children, and to compare them with those drawn from the results of clinical examination. MATERIAL AND METHODS: The gait analysis laboratory was built in the Paediatric Hospital of the Faculty of Medicine in Brno in the 2008/09 period with support of the Norwegian funds. It is equipped with eight optical cameras, two auxiliary motion-picture video came- ras, two force platforms and a telemetry system for electromyography. Between June 2009 and March 2010 a total of 297 children with spastic cerebral palsy, 66 with hemiparesis and 231 with diparesis were examined. RESULTS: On the basis of instrumental gait analysis, indications for surgery were established in 19 hemiparetic and 88 diparetic patients, which meant a new indication in 107 children. In 14 children, the results of gait analysis led to abandoning former indications for surgery based on clinical examination only while, in 13 children, they backed up the surgical indications in spite of the negative results of clinical examination. In six children a so-called superclinical decision was made, i.e., the results of repeated clinical examinations over-weighed those of instrumental gait analysis either in favour of or against surgery. DISCUSSION: Based on the gait analysis results, a change in treatment plans was made in 27 out of 297 children (9 %). This is in contrast with the findings of other authors who report a much higher rate of treatment planning changes (52-70 %) In our stu- dy the use of instrumental gait analysis allowed us to decrease the frequency of surgical indications by 4.7 %. Other authors have achieved a higher value, up to 13 %. Unlike other studies, ours did not confirm the effect of gait analysis outcomes on an increase in the number of one-stage multi-level surgical procedures. CONCLUSIONS: Instrumental gait analysis is a great contribution to the diagnosis of movement disorders in children with cerebral palsy.
To test the hypothesis that the application of tricalcium phosphate (TCP) mixed with autologous bone marrow can achieve better and faster healing of benign bone lesions than the application of tricalcium phosphate granules alone. MATERIAL AND METHODS: The prospective study included two groups, each consisting of 10 patients, treated for benign cystic bone lesions at the Department of Paediatric Surgery, Orthopaedics and Trauma Surgery from July 1, 2008 to June 30, 2010. The bone cysts involved non-ossifying fibroma, enchodroma, fibrous dysplasia, aneurysmal bone cyst and juvenile bone cyst. One group was treated using ChronOS(TM) Beta-Tricalcium Phosphate (Synthes GmbH, Switzerland) granules mixed with autologous bone marrow harvested during surgery (BM group). The other (CH group) received treatment with ChronOS granules alone. Relevant clinical data were obtained from all 20 patients treated for one of the bone cyst forms mentioned above. The patients were followed up till the end of 2010. RESULTS: TCP application was a one-step procedure in both groups. In the BM group, bone regeneration ad integrum (Neer 1) was achieved, with only an occasional very small residue of the cyst seen on radiographs (Neer 2). None of the patients reported any problems, not even at 6 months after surgery. In the CH group, two patients required further surgical treatment because of insufficient bone healing (Neer 3) and two other patients reported pain persisting at the site of the lesion at 6 months post-operatively. In these patients TCP was used to fill a defect after excochleation of an aneurysmal bone cyst or fibrous dysplasia. The rest of the patients showed satisfactory healing. DISCUSSION: The main objective of the use of synthetic biocompatible materials in surgical treatment of benign bone cysts requiring filling of the lesion is to reduce the post-operative stress of paediatric patients as much as possible. Although our first results were not statistically significant to give unambiguous support to our hypothesis that lesions would heal better with the use of synthetic tricalcium phosphate mixed with autologous bone marrow, there is plenty of evidence that further development of cell technologies will result in a more exact definition of bone substitute materials in both their components, i.e., well-defined cells and non-biological scaffolds close in structure to inorganic compounds of bone, i.e., biodegradable osteoinductive materials. CONCLUSIONS: The patients with benign bone lesions treated by TCP mixed with autologous bone marrow showed neither recurrent disease nor complications. The group treated with TCP alone had recurrent lesions in two and persisting pain also in two patients. Other complications were not recorded.
- MeSH
- autologní transplantace MeSH
- dítě MeSH
- financování organizované MeSH
- fosfáty terapeutické užití MeSH
- interpretace statistických dat MeSH
- kostní cysty chirurgie MeSH
- kostní náhrady terapeutické užití MeSH
- lidé MeSH
- prospektivní studie MeSH
- statistika jako téma MeSH
- transplantace kostní dřeně MeSH
- výsledek terapie MeSH
- výsledky a postupy - zhodnocení (zdravotní péče) MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Klíčová slova
- analýza pohybu,
- MeSH
- chůze MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- financování organizované MeSH
- laboratoře nemocniční využití MeSH
- lidé MeSH
- mozková obrna rehabilitace MeSH
- technologie metody MeSH
- zdravotnické prostředky MeSH
- zobrazování trojrozměrné metody využití MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
The aim of the study was to present the results of video-assisted fractional lengthening of the triceps surae muscle and the hamstrings in children with spastic cerebral palsy. In the period from September 2003 to December 2004, triceps surae muscle contractures were treated in 35 lower extremities (22 patients) and hamstring lengthening was performed in 12 knees (eight patients). The patients were between 4 and 10 years of age. Lengthening of the gastrocnemius-soleus was sufficient for achieving 10 degrees dorsiflexion of the foot in 31 of the 35 extremities. The short-term follow-up, at least 1 year after operation, did not reveal any complications. The hamstring lengthening resulted in full correction in nine knees; one endoscopic procedure required conversion to open surgery owing to bleeding. In one case, incomplete sciatic nerve palsy developed. Video-assisted gastrocnemius-soleus recession as well as video-assisted lengthening of the hamstrings proved to be fully efficient in the group reported here.
- MeSH
- Achillova šlacha chirurgie MeSH
- dítě MeSH
- dolní končetina chirurgie patofyziologie MeSH
- endoskopie MeSH
- kontraktura chirurgie patofyziologie MeSH
- kosterní svaly chirurgie patofyziologie MeSH
- lidé MeSH
- mozková obrna patofyziologie MeSH
- následné studie MeSH
- nemoci sedacího nervu etiologie MeSH
- pooperační komplikace MeSH
- předškolní dítě MeSH
- prospektivní studie MeSH
- video-asistovaná chirurgie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- předškolní dítě MeSH
- Publikační typ
- práce podpořená grantem MeSH
Závěrečná zpráva o řešení grantu Interní grantové agentury MZ ČR
Přeruš. str. : il., tab. ; 30 cm
Video-assisted talo-calcaneal arthrodesis using a synthetic bone substitute (beta-tricalcium-phosphate) in conjunction with mini-invasive talo-calcaneal stabilisation by a cannulated screw.
Video-asistovaná artrodéza talo-kalkaneální s užitím syntetické kostní náhrady- beta-tricalcium-fosfátu, doplněná miniinvazívní stabilizací talu a kalkanea kanalizovaným šroubem.
- MeSH
- artrodéza metody MeSH
- dítě MeSH
- equinózní deformity nohy (od hlezna dolů) chirurgie MeSH
- fosfáty terapeutické užití MeSH
- mozková obrna MeSH
- paralýza MeSH
- patní kost chirurgie MeSH
- pes equinovarus chirurgie MeSH
- protézy a implantáty MeSH
- transplantace kostí MeSH
- video-asistovaná chirurgie MeSH
- Check Tag
- dítě MeSH
- Konspekt
- Ortopedie. Chirurgie. Oftalmologie
- NLK Obory
- pediatrie
- ortopedie
- NLK Publikační typ
- závěrečné zprávy o řešení grantu IGA MZ ČR
