Iershov D. Experimental and clinical justification of unilateral growth plate blocking for pediatric frontal knee deformities treatment.

pediatric frontal epimethaphyseal knee deformities. The aim: to improve the results of pediatric frontal knee deformities surgical treatment by study, elaboration and clinical implementation of unilateral growth plate blocking method. Methods: clinical, X-ray, computed tomography, histology, mathematical modeling, finite element modeling, analytic, statistical. Morphological analysis of the growth plate structural changes under unilateral blocking using different types of fixators allowed to obtain additional information. Morphological analysis of the proximal tibial growth plate of the rabbits at 3rd, 5th and 7th weeks after the temporal medial growth plate blocking using different types of fixators (locking and non-locking plate, staples Blount) showed no severe violations of the structure of mentioned zones and primary osteogenesis zone were noted. Radiometric comparative study has shown that temporal medial blocking of the proximal tibial growth plate in rabbits using both the locking and non-locking plate leads to progressive tibial varus deformity formation which was significantly faster in the locking plate group from the second to the fifth weeks in postoperative period. 3D mathematical models of the child's proximal tibia allowed to determine the features of the stress strain state in the proximal epimethaphysis and various types of fixators (non-locking and locking plate, Blount staples). It was shown that the use of Blount staples and locking plates Blount allow to achieve rigid fixation immediately after installation. New fixator for the long bones growth plate was invented (patent 98236 UA), which allows a close fit to the bone and reduces the number of complications of surgical treatment of pediatric frontal knee angular deformities. The differential treatment algorithm for pediatric frontal knee deformities has been developed. It allows to make a choice of surgical treatment options and justifies the use of minimally invasive temporal unilateral growth plate blocking technique for pediatric frontal knee deformities that will increase the effectiveness of the treatment. The results of this research were implemented into clinical work of SI "Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine", the Khаrkiv regional trauma hospital, Ukrainian Institute of Prosthetics, Prosthesis and rehabilitation of the Ministry of Social Policy of Ukraine and to the educational program of Kharkiv Medical Academy of Postgraduate Education Ministry of Health of Ukraine. Traumatology and orthopaedics.