Surgical treatment of children with extensive bone defects (Literature review)

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Abstract

BACKGROUND: Reconstruction of extensive defects to bone tissue is one of the important problems of orthopedics and traumatology. Especially in acuteis, the problem is associated with the restoration of bone tissue in conditions of its deficiency in pediatric patients.

AIM: The aim of the study is to analyze modern methods of surgical treatment in children with extensive bone tissue injuries based on the published literature.

MATERIALS AND METHODS: Our report presents a review of the literature of methods of surgical treatment of extensive bone defects. The literature search was carried out in several databases such as PubMed, ScienceDirect, E-library, GoogleScholar for the period from 2005 to 2020, using the keywords given below. As a result of the search, 105 foreign and 37 domestic sources were found. After exclusion, 56 articles were analyzed, all presented works were published in the last 15 years.

RESULTS: The gold standard for replacing bone defects is still the use of autografts, including the use of technologies on a vascular pedicle. Various types of xenografts and allografts of bone tissue are increasingly being replaced by various kinds of synthetic implants.

CONCLUSIONS: To date, there is no single generally accepted standard for the surgical treatment of extensive bone defects. The option of surgical treatment of extensive bone tissue defects using tissue-engineered bone implants with axial blood supply seems to be extremely interesting and promising.

About the authors

Anton S. Shabunin

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery; Peter the Great St. Petersburg Polytechnic University

Email: anton-shab@yandex.ru
ORCID iD: 0000-0002-8883-0580
SPIN-code: 1260-5644
Scopus Author ID: 57191623923

Research Associate

Russian Federation, 64–68 Parkovaya str., Pushkin, Saint Petersburg, 196603; Saint Petersburg

Marat S. Asadulaev

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Author for correspondence.
Email: marat.asadulaev@yandex.ru
ORCID iD: 0000-0002-1768-2402
SPIN-code: 3336-8996
Scopus Author ID: 0000-0002-1768-2402

MD, PhD student

Russian Federation, 64–68 Parkovaya str., Pushkin, Saint Petersburg, 196603

Sergei V. Vissarionov

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: vissarionovs@gmail.com
ORCID iD: 0000-0003-4235-5048
SPIN-code: 7125-4930
Scopus Author ID: 6504128319

MD, PhD, D.Sc., Professor, Corresponding Member of RAS

Russian Federation, 64–68 Parkovaya str., Pushkin, Saint Petersburg, 196603

Andrej M. Fedyuk

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery; St. Petersburg State Pediatric Medical University

Email: andrej.fedyuk@gmail.com
ORCID iD: 0000-0002-2378-2813
SPIN-code: 3477-0908

5th year student

Russian Federation, 64–68 Parkovaya str., Pushkin, Saint Petersburg, 196603; Saint Petersburg

Timofey S. Rybinskikh

St. Petersburg State Pediatric Medical University

Email: timofey1999r@gmail.com
ORCID iD: 0000-0002-4180-5353
SPIN-code: 7739-4321

5th year student

Russian Federation, Saint Petersburg

Aleksandr Y. Makarov

St. Petersburg State Pediatric Medical University

Email: makarov.alexandr97@mail.ru
ORCID iD: 0000-0002-1546-8517
SPIN-code: 1039-1096

5th year student

Russian Federation, Saint Petersburg

Daniil A. Pushkarev

St. Petersburg State Pediatric Medical University

Email: dan2402@mail.ru
ORCID iD: 0000-0003-1531-7310

4th year student

Russian Federation, Saint Petersburg

Marina V. Sogoyan

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: sogoyanmarina@mail.ru
ORCID iD: 0000-0001-5723-8851
SPIN-code: 2856-3854

MD, Research Associate

Russian Federation, 64–68 Parkovaya str., Pushkin, Saint Petersburg, 196603

Ekaterina N. Maevskaia

Peter the Great St. Petersburg Polytechnic University

Email: ma.eka@yandex.ru
ORCID iD: 0000-0002-9316-7197
Scopus Author ID: 57203990196

MD, PhD student

Russian Federation, Saint Petersburg

Natalya B. Fomina

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: natal.fomi@gmail.com
ORCID iD: 0000-0001-6779-9740

Research Associate

Russian Federation, 64–68 Parkovaya str., Pushkin, Saint Petersburg, 196603

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2. Fig. 1. Radiographs of a vascularized fibula autograft at the site of the femur defect immediately after surgery and after 9 months (the red arrow indicates the line along which the graft was incorporated) [29]

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3. Fig. 2. Cameras used by Weigand et al. [38]: a, vascularization of the graft from the arteriovenous loop in a completely isolated chamber; b, vascularization of the graft from the arteriovenous loop and from the surrounding tissues in a perforated chamber; c, general view of a continuous Teflon polymer chamber; d, general view of the matrix made of NanoBone material; e, general view of a perforated titanium chamber; f, general view of a continuous chamber with a matrix and an arteriovenous loop located inside (the lid is open); g, general view of a perforated chamber with a matrix and an arteriovenous loop placed inside (the lid is open); h, general view of a continuous polymer chamber with a matrix and an arteriovenous loop located inside (the lid is closed, the chamber is fixed with sutures to the surrounding stitches); and i, general view of a perforated chamber with a matrix and an arteriovenous loop placed inside (the lid is closed, the chamber is fixed with sutures to the surrounding tissues)

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Copyright (c) 2021 Shabunin A.S., Asadulaev M.S., Vissarionov S.V., Fedyuk A.M., Rybinskikh T.S., Makarov A.Y., Pushkarev D.A., Sogoyan M.V., Maevskaia E.N., Fomina N.B.

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