Martsynyak S. Comprehensive orthopedic treatment of patients with vitamin D-dependent and vitamin D-resistant rickets

The dissertation is devoted to improving of the results of diagnosis and treatment of patients with orthopedic manifestations of rickets (D-dependent rickets and D-resistant rickets) by studying the clinical and radiological manifestations of the disease, their systematization, study of bone metabolism, development and analysis of conservative treatment. The results of diagnosis and treatment of 236 patients with rickets-like diseases are analyzed, the sequence of diagnostic and treatment measures depending on the type of vitamin-D-dependent and vitamin-D-resistant rickets is developed. The list of pathognomonic clinical and radiological signs of rickets depending on the type of rickets is specified. A study of bone metabolism in patients with vitamin D-dependent and vitamin Dresistant rickets is presented. The principles of pathogenetically-directed conservative therapy are offered, which in 88.6% of cases allowed to avoid surgical correction of deformities of the lower extremities in vitamin-D-dependent rickets; and the principles of conservative therapy of orthopedic manifestations of vitamin D-resistant rickets, which significantly improved the condition of bone tissue in the pre- and postoperative period (improving the timing and quality of consolidation, normalization of growth zones). The author analyzes the existing and proposes a modern approach to the surgical treatment of multiplanar deformities of the lower extremities in children with vitamin D-dependent and vitamin D-resistant rickets. A sequence of diagnostic and treatment measures depending on the type of vitamin-dependent and vitamin-resistant rickets is proposed.