The aspects of minimally invasive surgery of forefoot static deformities

The review illustrates various approaches to the potential of minimally invasive surgery in forefoot static deformities treatment. We demonstrated that methods aimed at the performance of nonlocking wedge osteotomy of first metatarsal bone and of proximal phalanx of big toe with preservation of cortex wedge contralateral to the base as well as of central metatarsal, extending tenotomies of flexors without tendon suture are the base for minimally invasive correction of forefoot static deformities providing orthopedically correct orientation of metatarsal heads under the early full postoperative load on the foot and preventing excessive dislocation of tendon ends.</p

Comparative analysis of morphological and topometric parameters of lumbar spine in normal state and in degenerative-dystrophic changes

Objective: to carry out comparative analysis and identify patterns of topographic variation patterns of lumbar spine in normal and degenerative changes. Material and methods. CT- and MRT-grams for men and women I (M1-22-35 years; W — 21-35 years) and II (M2-36-60 years; W2-36-55 years) periods of mature age with no signs of trauma, scoliosis and systemic diseases of the spine (n=140) and CT- and MRT-grams in patients with revealed degenerative changes in the lumbar spine degree II-III (n=120). The pictures with digital PACS system measure the height of the vertebral body, intervertebral disc height, vertical, horizontal diameter and the area of intervertebral foramen. Results. The height of the lumbar vertebral bodies normally increased from27,90±0,38mmatthe level of L, to 29,93±0,33 mm Lm, and then decreased to 24,35±0,27 mm at level L^, in osteochondrosis it is statistically significantly lower at all levels on average by 20%. The height of the intervertebral disc with osteochondrosis below at all levels by an average of 25% of its value in the range 5,27±0,19 to 6,13±0,17mm, while the normal disc height varies from 6,88±030 to 9,36±0,28mm. The area of intervertebral holes normally ranging from 103,29±5,78 to 127,99±5,92mm2, with osteochondrosis aperture area is reduced to a greater extent by decreasing the vertical diameter in comparison with the horizontal. Conclusion. For the studied parameters characteristic topographic variability has been determined. The maximum values parameters are marked at the top of the lumbar lordosis, at chest height, lumbar and lumbosacral junctions sizes are reduced. In osteochondrosis the intervertebral disc height and the height of lumbar vertebral bodies are reduced; intervertebral foramina area is also reduced to a greater extent by reducing the vertical diameter than the horizontal one