FEATURES OF THE AGE-RELATED STRUCTURE OF ORTHOPEDIC PATHOLOGY IN CHILDREN
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i1.15260Keywords:
child, orthopedic diseases, structure, рattern, musculoskeletal systemAbstract
SUMMARY. Pediatric orthopedics has its own characteristics. At present, there is an alarming trend towards an uncontrollable increase in the number of orthopedic pathology among the child population. According to our data, and the results of studies by other authors, in children under one year of age, the dominant diseases are hip dysplasia, congenital hip dislocation, clubfoot, and muscular torticollis. Starting from 4-5 years of age, the number of static deformities gradually increases in children. Spinal malformation, scoliosis, kyphosis, kyphoscoliosis, occur in almost every second, third child. In young men, the number of static deformities of the feet is increasing – flat feet, flat-valgus deformities of the feet, adducted foot. In the age period of 5 to 12 years, the number of orthopedic diseases inherent only in children increases – Osgood-Schlatter's disease, Legg-Calve-Perthes, Scheuermann-Mau, Schintz. Our analysis showed that many diagnostic errors are made during an inattentive initial examination of children, which causes untimely therapy of these diseases with negative functional and anatomical changes in the process of intensive growth of the child's body.
The aim – to study the features of the structure of orthopedic pathology in children and young men of military age in the region and to draw the attention of practitioners to the main orthopedic diseases that occur most often in order to diagnose and treat them in a timely manner.
Material and Мethods. An in-depth analysis of the 250532 results of the examination of orthopedic pathology of conscripts in our region for seven years from 2012 to 2018 was carried out in accordance with Articles 62 and 64. The dispensary documentation of the children's population of the region – 20 283 children – was carefully studied. The examination of children was carried out in accordance with the Order No. 343 of 11.08.2006 "On the implementation of the Protocols for the diagnosis and treatment of diseases and injuries of the musculoskeletal system in children" and in accordance with the Order No. 149 of 20.03.2008 "Clinical protocol of medical examination for a healthy child under 3 years of age".
Results. The structure of orthopedic pathology largely depends on age, so up to a year the dominant diseases are hip dysplasia, congenital hip dislocation, clubfoot, muscular torticollis. In the process of children's growth, the number of static deformities of the spine (scoliosis), feet (flat feet), and diseases that are inherent only in children – osteochondropathy (Perthes, Osgood-Schlatter, Scheuermann-Mau disease) increases. Each nosological unit of the disease has its own characteristics of diagnosis and treatment, which must be taken into account when examining children and young people.
Conclusions. 1. There is a clear age dependence of the structure of orthopedic pathology of the child population.
- In children under one year of age, the dominant diseases are hip dysplasia, congenital hip dislocation, clubfoot, muscular torticollis.
- Starting from 4–5 years of age, the number of static deformities gradually increases in children. Spinal malformation, scoliosis, kyphosis, kyphoscoliosis, occur in almost every second, third child.
- In young men, the number of static deformities of the feet is increasing – flat feet, flat-valgus deformities of the feet, adducted foot. In the age period of 5–12 years, the number of orthopedic diseases inherent only in children increases – Osgood-Schlatter's disease, Legg-Calve-Perthes, Scheuermann-Mau, Schintz.
References
Protsailo M, Dzhyvak V, Krytcky I. et al. Multiple malformations due to dysplastic changes in connective tissue in children. Deka in Medicine. 2024. URL: https://doi.org/10.69863/dim.2024.e275. DOI: https://doi.org/10.69863/dim.2024.e275
Protsailo MD, Dzhivak VG, HorishnyiI M. et al. Ortopedychni proiavy deheneratyvnoho melanozu (klinichnyi vypadok) [Orthopedic manifestations of degenerative melanosis (clinical case)]. Health of man. 2024; 2(89): 45-8. Ukrainian. DOI: https://doi.org/10.30841/2786-7323.2.2024.310019
Vakulenko O, Zhalilo L, Komarova N. Stan zdorov'ya ditey i molodi Ukrayiny [State of health of children and youth of Ukraine]. URL: https:www.health.gov.ua>Publ>conf.nsf> OpenDoc. Ukrainian.
Parkhomenko LK. Yuvenolohiya. Praktikum z pidlitkovoyi medycyny [Juvenology. Workshop on adolescent medicine] Kh.: Fakt; 2007. 720 p. Ukrainian.
Karpins'ka TH, Hrabovs'ka TV, Sereda SV, Korotok VV. Pokaznyky stanu zdorov'ya suchasnykh pidlitkiv, yak odna iz skladovykh zdorov'ya naselennya derzhavy [Indicators of the state of health of modern teenagers, as one of the components of the health of the population of the state]. Ukrainian medical journal. 2021; 3(143)-V/VI. DOI: 10.32471/umg.1680-3051.143.209478. Ukrainian. DOI: https://doi.org/10.32471/umj.1680-3051.143.209478
Analitychna zapyska pro osnovni tendentsiyi zminy znachen' pokaznykiv, shcho zastosovuyut'sya dlya rozrakhunku indeksu rehional'noho lyuds'koho rozvytku vykonavchyy orhan Kyyivs'koyi mis'koyi rady (Kyyivs'ka mis'ka derzhavna administratsiya) [Analytical note on the main trends of changes in the values of indicators used to calculate the index of regional human development by the executive body of the Kyiv City Council (Kyiv City State Administration)]. 2021. URL: https:www.minregion.gov.ua/wp-content/uploads/2021/09/kmda-analitychna-zapyska.pdf. Ukrainian.
Nakaz № 402 vid 14.08. 2008. Pro zatverdzhennya Polozhennya pro viys'kovo-likars'ku ekspertyzu v Zbroynykh Sylakh Ukrayiny [Order No.402 dated August 14. On the approval of the Regulation on military medical examination in the Armed Forces of Ukraine]. URL: https://zakononline.com.ua /documents/show/285914_672324. Ukrainian.
Nakaz № 521 MOU. 2006. “Pro zatverdjennia protokoliv diagnostyky ta likuvannia zachvoruvan ta traum oporno-ruchovogo aparatu u ditei” [Order No 521. 25.07. Ministry of Health of Ukraine. "On the Confirmation of the Protocol of Diagnostics and Treatment of Illness and Injuries of the Musculoskeletal Apparatus in Children"]. Ukrainian.
Hefti F, BrunnerR, Hasler C, Jundt G. Pediatric Orthopedics in Practice. Springer-Verlag Berlin Heidelberg. 2007. 781 p.
Mykytenko DO. Phormuvannia systemy derzavnogo control ta vprovadzennia monitoryngu vagitnych grup ryzyku [Formation of the system of state control and implementation of monitoring of pregnant risk groups]. Public administration: improvement and development. URL: htth:www.dy.nayka.com.ua>op=1 monitoring of pregnant women at risk. November 13. 2009. Ukrainian.
Instytut Traumatologii ta Ortopedii Nazionalnoi Akademii Nauk. [Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine]. Dysplaziya kul'shovykh suhlobiv u novonarodzhenykh Hip [Dysplasia in newborns]. 2021. URL: https:/ito.gov.ua. Ukrainian.
Levytskyi AF, Holovatyuk DV, Karabenyuk OV, Vityaz VM. Dignostyka ta licuvannia dysplazii kulchovogo sugloba ta vrodzhenogo zvychu stegna u ditei. [Diagnostics and treatment of hip dysplasia and congenital hip dislocation in children]. Pediatric Surgery. Ukraine. 2019; 1(62):90-8. DOI: 10.25574/ PS.2019.62.90. Ukrainian.
Guandrathi J. Primary treatment modalities for torticollis include conservative measures such as stretching exercises and physical therapy. National Institutes of Health (NIH). 2024. URL: https://www.ncbi.nim.nih.gov
Hoiness PR, Medboe A. Surgical Treatment of Congenital Muscular Torticolls: Significant Improvement in Health-Related Guality of Life Among a 2-year Follow-up Cohort of Children, Adolescentr, and Young Adults. J. Pediatr Orthop. 2023; 43(9):769-774. DOI: 10.1097 /BPO. 0000000000002480. DOI: https://doi.org/10.1097/BPO.0000000000002480
Matar HE, Beirne P, Bruce C et al. Treatment of complex idiopathic clubfoot using the modified Ponceti method: up to 11 years follow-up. J. Pediatr Orthop. 2017; 26(2):137-142. DOI: 10.1097/BPB. 0000000000000321. DOI: https://doi.org/10.1097/BPB.0000000000000321
Allende V, Paz M, Sanchez S et al. Complex clubfoot treatment with ponseti method: a Latin American multicentric stude. Journal of Pediatric Orthopedics. 2020; 40(5):241-5. DOI: 10.1097/ BPO. 0000000000001469. DOI: https://doi.org/10.1097/BPO.0000000000001469
Alam N, Addas M, Siddqui Y et al. Effectiveness of Ponseti Technique in management of arthrogrypotic clubfeet - a prospective study. International Journal of Burns and Trauma. 2023; 13(2):33-43/eCollection.202
Rangasamy K, Baduraj V, Gopinathan N et al. Correction results atypical clubfeet managed with modified Ponseti Technique: A meta-analisis of 354 feet. Journal of Clinical Orthopaedics & Trauma. 2022; 25,31:101939. DOI:10.1016/j.jcot.101939eCollection 2022. DOI: https://doi.org/10.1016/j.jcot.2022.101939
Tao L, Zhou S, Tao Z, Wen K, Da W, Meng Y. The publication trends and hot spots of scoliosis research from 2009 to 2018; a 10 year bibliometric analisis. Hom. 2020; 8(3). DOI: https://doi.org/10.21037/atm.2020.02.67
Serdyuk VV. Novyy vzhlyad na etiolohiyyu y hatohenez ydyyopatycheskoho skolyoza [New look at the etiology and pathogenesis of idiopathic scoliosis] Collection of science Proceedings of the XV Congress of Orthopedic Traumatologists of Ukraine. - Dnipropetrovsk. 2010. September 16-18: 295. Ukrainian.
Protsenko VN. K voprosu o roly funktsyonal’noho neravenstva dlyny nyzhnykh konechnosteyv formirovanyy deheneratyvno-dystrofycheskoy patolohyy poyasnychnoho otdela pozvonochnyka [To the question of the role of the functional inequality of the length of the lower limbs in the formation of degenerative-dystrophic pathology of the lumbar spine] Collection of science Proceedings of the XV Congress of Orthopedic Traumatologists of Ukraine. - Dnipropetrovsk. 2020. September 16-18: 315. Ukrainian.
Markdante KD, Kligman RM. Osnovy pediatriyi za Nelsonom u 2-kh tomakh. Pereclad 8-ho anhliys’kogo vydannya - Medytsyna [Fundamentals of pediatrics according to Nelson in 2 volumes. Translation of the 8th English edition - Medicine] Shifter Berezenko VS, Pochinok TV. 2019.378. Ukrainian.
Golky HG, Bur'yanov OA, Klymovytskoho VG. Travmatilogiya ta ortopediya: pidruchnyk dlya stud. vychchykh med. zakladiv [Traumatology and orthopedics: textbook for students. higher med. education institutions] New book. 2014. 416 p. Ukrainian.
Protsaylo MD, Krytskyi IO. Simeinyi vupadok chvoroby Legg-Calve-Perthesa [Family case of Legg-Calvet-Perthes disease] Pediatric surgery. 2019; 2(63):104-8. DOI:10.15574/PS.2019.63.104.Ukrainian.
Protsaylo MD, Dzhyvak VH, Krytskyi IO. et al. The Knee joint is the Achilles’heel of a child’s body. East Ucr. Med J. 2023; 11(3):260-270. DOI:10.21272/eumj.2023; 11(3):260-270. Ukrainian. DOI: https://doi.org/10.21272/eumj.2023;11(3):260-270
