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Papers by Ольга Агранович

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2014

The paper describes the treatment of arthrogryposis, which is a severe congenital pathology. It p... more The paper describes the treatment of arthrogryposis, which is a severe congenital pathology. It provides an overview of the natural history and etiology, as well as the development of a system for assisting patients with arthrogryposis in the Institute n. a. G. I. Turner. We described in detail the variants of upper and lower limb deformities, as well as methods of complex treatment in infants, depending on the nature and degree of severity.

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2018

Introduction. Shoulder internal rotation contracture is the most common deformity affecting the s... more Introduction. Shoulder internal rotation contracture is the most common deformity affecting the shoulder in patients with obstetric brachial plexus palsy because of the subsequent imbalance of the musculature and the abnormal deforming forces that cause dysplasia of the glenohumeral joint. Aim. To assess the effects of tendon transfers in children with shoulder internal rotation deformity due to obstetric brachial plexus palsy. Materials and methods. From 2015 to 2017, we examined and treated 15 patients with shoulder internal rotation deformity caused by obstetric brachial plexus palsy. The children ranged in age from 4 to 17 years. We used clinical and radiographic examination methods, including magnetic resonance imaging, electromyography, and electroneuromyography, of the upper limbs. Results. According to the level of plexus brachialis injury, the patients were divided into 3 groups: level С5–С6 (9 patients), level C5–C7 (5 children), level С5–Th1 (1 patient). All children had ...

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2017

The reported incidence of scoliosis in patients with arthrogryposis varies greatly between 2,5% a... more The reported incidence of scoliosis in patients with arthrogryposis varies greatly between 2,5% and 69%. Curves can progress quickly. The most typical localizations of scoliosis are the thoracic and the thoracolumbar parts of the spine. In some cases, thoracolumbar scoliosis is combined with contractures in the hip and pelvis oblique. Scoliosis in children with arthrogryposis, as opposed to limb abnormalities, is generally rarely diagnosed at birth. The diagnosis is often established at the age of 5 years and can be explained by a period of rapid spine growth. The poor prognostic signs that determine the rapid development of scoliosis include progression at an early age, paralytic deformity, and pelvis oblique. Treatment options include spine casting, bracing, expandable implant surgery, and spinal fusion. The treatment goal is to allow optimal growth and development of the chest and a well-balanced spine. This article analyzes the modern approach to treatment scoliosis in patients ...

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2018

Background. Severe hypoplasia (or aplasia) of the biceps brachii is a primary cause of restrictio... more Background. Severe hypoplasia (or aplasia) of the biceps brachii is a primary cause of restriction in activities of daily living in patients with arthrogryposis. Aim. To estimate the possibility of restoring elbow active flexion via a latissimus dorsii transfer in patients with arthrogryposis. Materials and methods. From 2011 to 2018, we restored active flexion of the elbow via a latissimus dorsi transfer to the biceps brachii in 30 patients with arthrogryposis (44 upper limbs). We used different regimes including clinical examinations, EMG donor and recipient sites, and CT of the chest wall and shoulder. Results. The mean age of the patients was 4.0 ± 2.4 years, and the follow-up period was 3.2 ± 1.9 months. Follow-up results were available for 26 patients (30 upper limbs). The active postoperative elbow motion was 90.5 ± 14.9°. Elbow extension limitation occurred in 51% of cases (12.8 ± 4.3°) without any problems in activities of daily living. In total, 55.6% of patients had good ...

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2017

Poland’s syndrome is a rare congenital condition classically characterized by partial or complete... more Poland’s syndrome is a rare congenital condition classically characterized by partial or complete absence of chest muscles on one side of the body and usually webbing of the fingers of the hand on the same side. There may also be rib (aplasia or hypoplasia) and chest bone abnormalities, which may be noticeable due to less fat under the skin. Breast and nipple abnormalities may also occur, and underarm hair is sometimes sparse or abnormally placed. In most cases, the abnormalities in the chest area do not cause health problems or affect movement. Poland’s syndrome most often affects the right side of the body and occurs more frequently in males than in females. The etiology is unknown; however, interruption of the embryonic blood supply to the arteries that lie under the collarbone (subclavian arteries) is the prevailing theory. There are many methods of operative correction because of the polymorphic clinical features of this syndrome. We gathered data on the etiology, pathogenesis,...

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2016

Introduction: Treatment of wrist contractures in children with arthrogryposis multiplex congenita... more Introduction: Treatment of wrist contractures in children with arthrogryposis multiplex congenita (AMC) is extremely problematic because of the high incidence of recurrence. This study aimed to improve the outcome of wrist contracture treatment in children with AMC.Materials and Methods: A total of 90 patients (162 wrists) were examined and treated. Patients were assessed using a number of clinical, radiological, and electrophysiological examinations. There are several different clinical variants of wrist contracture, including flexion contracture of the wrist, flexion contracture associated with ulnar deviation, and isolated ulnar deviation of the wrist. Patients were divided into three groups according to the level of spinal cord lesion: С6-С7, С5-С8, and С5-Th1. As the number of damaged spinal cord segments increased, the amplitude of passive and active movements, degree of passive correction, muscle power, and wrist function decreased. Surgical treatment involved the following t...

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2015

The article describes the clinical case of an infant with Bruck syndrome. The clinical and radiol... more The article describes the clinical case of an infant with Bruck syndrome. The clinical and radiological analyses showed the presence of systemic osteoporosis with pathological fractures; contractures of the elbow, knee, and ankle joints; delay of physical and motor development; and signs of hypoplasia in some of the muscle groups. There was also a right-sided congenital muscular torticollis. X-ray analysis revealed a moderate antecurvation deformity of the lower legs and femurs, with cortical thinning. Laboratory data detected an abnormal beta-cross lap increase.Treatment of osteoporosis by inhibitors of osteoclastic resorption (pamidronate) had a positive effect, and the elimination of flexion contractures at the elbow using plaster bandages with the distraction device also resulted in a positive effect.

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2014

The paper describes the treatment of arthrogryposis, which is a severe congenital pathology. It p... more The paper describes the treatment of arthrogryposis, which is a severe congenital pathology. It provides an overview of the natural history and etiology, as well as the development of a system for assisting patients with arthrogryposis in the Institute n. a. G. I. Turner. We described in detail the variants of upper and lower limb deformities, as well as methods of complex treatment in infants, depending on the nature and degree of severity.

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2018

Introduction. Shoulder internal rotation contracture is the most common deformity affecting the s... more Introduction. Shoulder internal rotation contracture is the most common deformity affecting the shoulder in patients with obstetric brachial plexus palsy because of the subsequent imbalance of the musculature and the abnormal deforming forces that cause dysplasia of the glenohumeral joint. Aim. To assess the effects of tendon transfers in children with shoulder internal rotation deformity due to obstetric brachial plexus palsy. Materials and methods. From 2015 to 2017, we examined and treated 15 patients with shoulder internal rotation deformity caused by obstetric brachial plexus palsy. The children ranged in age from 4 to 17 years. We used clinical and radiographic examination methods, including magnetic resonance imaging, electromyography, and electroneuromyography, of the upper limbs. Results. According to the level of plexus brachialis injury, the patients were divided into 3 groups: level С5–С6 (9 patients), level C5–C7 (5 children), level С5–Th1 (1 patient). All children had ...

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2017

The reported incidence of scoliosis in patients with arthrogryposis varies greatly between 2,5% a... more The reported incidence of scoliosis in patients with arthrogryposis varies greatly between 2,5% and 69%. Curves can progress quickly. The most typical localizations of scoliosis are the thoracic and the thoracolumbar parts of the spine. In some cases, thoracolumbar scoliosis is combined with contractures in the hip and pelvis oblique. Scoliosis in children with arthrogryposis, as opposed to limb abnormalities, is generally rarely diagnosed at birth. The diagnosis is often established at the age of 5 years and can be explained by a period of rapid spine growth. The poor prognostic signs that determine the rapid development of scoliosis include progression at an early age, paralytic deformity, and pelvis oblique. Treatment options include spine casting, bracing, expandable implant surgery, and spinal fusion. The treatment goal is to allow optimal growth and development of the chest and a well-balanced spine. This article analyzes the modern approach to treatment scoliosis in patients ...

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2018

Background. Severe hypoplasia (or aplasia) of the biceps brachii is a primary cause of restrictio... more Background. Severe hypoplasia (or aplasia) of the biceps brachii is a primary cause of restriction in activities of daily living in patients with arthrogryposis. Aim. To estimate the possibility of restoring elbow active flexion via a latissimus dorsii transfer in patients with arthrogryposis. Materials and methods. From 2011 to 2018, we restored active flexion of the elbow via a latissimus dorsi transfer to the biceps brachii in 30 patients with arthrogryposis (44 upper limbs). We used different regimes including clinical examinations, EMG donor and recipient sites, and CT of the chest wall and shoulder. Results. The mean age of the patients was 4.0 ± 2.4 years, and the follow-up period was 3.2 ± 1.9 months. Follow-up results were available for 26 patients (30 upper limbs). The active postoperative elbow motion was 90.5 ± 14.9°. Elbow extension limitation occurred in 51% of cases (12.8 ± 4.3°) without any problems in activities of daily living. In total, 55.6% of patients had good ...

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2017

Poland’s syndrome is a rare congenital condition classically characterized by partial or complete... more Poland’s syndrome is a rare congenital condition classically characterized by partial or complete absence of chest muscles on one side of the body and usually webbing of the fingers of the hand on the same side. There may also be rib (aplasia or hypoplasia) and chest bone abnormalities, which may be noticeable due to less fat under the skin. Breast and nipple abnormalities may also occur, and underarm hair is sometimes sparse or abnormally placed. In most cases, the abnormalities in the chest area do not cause health problems or affect movement. Poland’s syndrome most often affects the right side of the body and occurs more frequently in males than in females. The etiology is unknown; however, interruption of the embryonic blood supply to the arteries that lie under the collarbone (subclavian arteries) is the prevailing theory. There are many methods of operative correction because of the polymorphic clinical features of this syndrome. We gathered data on the etiology, pathogenesis,...

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2016

Introduction: Treatment of wrist contractures in children with arthrogryposis multiplex congenita... more Introduction: Treatment of wrist contractures in children with arthrogryposis multiplex congenita (AMC) is extremely problematic because of the high incidence of recurrence. This study aimed to improve the outcome of wrist contracture treatment in children with AMC.Materials and Methods: A total of 90 patients (162 wrists) were examined and treated. Patients were assessed using a number of clinical, radiological, and electrophysiological examinations. There are several different clinical variants of wrist contracture, including flexion contracture of the wrist, flexion contracture associated with ulnar deviation, and isolated ulnar deviation of the wrist. Patients were divided into three groups according to the level of spinal cord lesion: С6-С7, С5-С8, and С5-Th1. As the number of damaged spinal cord segments increased, the amplitude of passive and active movements, degree of passive correction, muscle power, and wrist function decreased. Surgical treatment involved the following t...

Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, 2015

The article describes the clinical case of an infant with Bruck syndrome. The clinical and radiol... more The article describes the clinical case of an infant with Bruck syndrome. The clinical and radiological analyses showed the presence of systemic osteoporosis with pathological fractures; contractures of the elbow, knee, and ankle joints; delay of physical and motor development; and signs of hypoplasia in some of the muscle groups. There was also a right-sided congenital muscular torticollis. X-ray analysis revealed a moderate antecurvation deformity of the lower legs and femurs, with cortical thinning. Laboratory data detected an abnormal beta-cross lap increase.Treatment of osteoporosis by inhibitors of osteoclastic resorption (pamidronate) had a positive effect, and the elimination of flexion contractures at the elbow using plaster bandages with the distraction device also resulted in a positive effect.