[Spinal tuberculosis in young children (organization of early detection and treatment)].
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Biomedical subjects
Publications and source records attributed to K N Kovalenko.
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Long-term results of reconstructive osteoplastic operations on the vertebral column performed for tuberculous spondylitis in 116 children, aged from 1 year and 4 months to 6 years, are presented. All of them were practically cured, thus having a complete recovery of their vertebral column supporting function; in 65.5% of these patients, there was a reduction of a cyphotic deformity with age; 18.7% of the operated persons, including merely 13% of the disabled in their childhood, had resumed their work and 23% of the patients were taken off the dispensary record upon their recovery. Osteoplastic reconstructions for tuberculous spondylitis performed in early childhood failed to affect a future growth of the vertebral column. Besides, they ensure a complete recovery of a child and should have the lead in the whole system of the up-to-date management of spondylitis in children.
Results of reconstructive bone-plastic operations are presented which were performed on 170 children of younger age with tuberculous spondylitis. The method of operative procedures is described followed by an assessment of the results obtained.
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The authors make an analysis of their many-years experience with the surgical treatment of tuberculosis of bones and joints (1380 operations in children aged from 8 months to 14 years with different manifestations of bone--joint tuberculosis). The context and principles of the surgery of tuberculosis of bones and joints in children as an independent scientific branch are determined. The priority of surgical methods in the treatment of the disease is confirmed and further trends of its development are shown.
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On the grounds of the experience with the surgical treatment of 268 children of different age with tuberculosis of the spine and big joints the types of surgical interventions, aimed at the correction, prevention or elimination of marked skeletal deformities concomitant with the main disease are defined. A high effectiveness of early necrotomies in the prophylaxis of such deformities is emphasized. A critical assessment of resection of the main joints in children of the first 7 to 9 years of age is given, and the indications for this operation are restricted.
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