Vyderko R. Orthopedic manifestations of congenital vascular malformations of the lower extremities (diagnosis and treatment)

This dissertation is devoted to improving the results of diagnosis and treatment of orthopedic pathology in congenital vascular malformations of the lower extremities. It is planned to improve the results of diagnosis and treatment by studying the features of the clinical course of orthopedic pathology in congenital vascular malformations; study of the structural and functional state and metabolism of bone tissue in the case of regional hemodynamic disorders; assessment of the influence of regional hemodynamics disorders on the formation of the difference in the length of the lower limbs; development of a differential algorithm for the treatment of pathology of the musculoskeletal system in this disease. The scientific novelty of the work is as follows: it was established for the first time that in 70% of patients with arteriovenous malformations, a violation of the structural state of the bone tissue of the affected limb was found; a significant difference between the mineral density of the bone tissue of the limb affected by the malformation in comparison with the healthy one was proved, which is due to the influence of the regional hemodynamic disturbance; the deviation of the level of markers of bone metabolism from the limits of the age norm in the predominance of osteoresorption processes over bone formation was established; for the first time revealed the relationship between regional blood circulation disorders and the difference in the length of the lower limbs in patients with congenital vascular malformations. The practical significance of the work is as follows: a working clinical-orthopedic classification of the functional state of the lower extremities in congenital vascular malformations has been developed, which is an essential basis for improving the system of orthopedic treatment of patients; it has been proven that orthopedic treatment of pathology of the musculoskeletal system should be carried out taking into account hemodynamic disorders of the lower extremities and the form of vascular malformations, the type and degree of orthopedic disorders, the age of the patient and taking into account the developed working clinical and orthopedic classification of the functional state of the lower extremities, specified indications and contraindications for surgical interventions, which allows to effectively correct orthopedic manifestations of the disease and improve the quality of life in patients with congenital vascular malformations.