Zyma A. Structural and functional state of bone and orthopedic treatment of osteogenesis imperfecta

The thesis decides a scientific problem, which is related to the diagnosis and orthopedic treatment of patients with osteogenesis imperfecta by comprehensive research of features of clinical course, structural-functional state of bone for the development and implementation of complex system treatment of pathologies of the musculoskeletal system among these patients. The paper has analyzed the results of examination and treatment among 126 patients with different types of osteogenesis imperfecta. Based on clinical, radiographic, x-ray densitometric, histomorphometrical and statistical research it has studied the development and course of orthopedic manifestations of disease, specified basic and additional diagnostic symptoms, changed some idea of the pathogenesis of osteogenesis by investigating disturbances of bone remodeling, metabolism changes brought differing vectors of bone formation, strengthening bone resorption and acceleration remodeling of different types of diseases, which created the foundation for the development of effective medical rehabilitation of patients with osteogenesis imperfecta. It has developed and tested system of complex orthopedic trearment patients with osteogenesis imperfecta, that includes the correction of violations of structural and functional state of bone tissue; it has improved surgical techniques with modern intramedullary designs depending on the type of disease, changes in the structural state of the bone, the type and severity of orthopedic pathology, patient's age. The research has proved the efficiency of the proposed system of orthopedic treatment through clinical (reducing the number of fractures, restoring and improving gait in patients) and paraclinical (increased bone mineral density, reduced bone resorption marker, increase bone capacity) studies in dynamics.