[Navigation technologies in treatment of intraabdominal abscesses in children].

The results of minimally invasive US-giuded punctures or drainings of intraabdominal abscesses in 45 children, aged 1-14 years, were analyzed. 16 abscesses were subdiaphragmatic, 22 were intestinal and 19 were classified as pelvic. Differences of the echographic characteristics, features of the preoperative planning and techniques of the intervention in dependence of the abscess localization, were thoroughly depicted. The authors used the virtual 3D echography in 13.3% of patients to improve the diagnostics, surgical access and volume of the intervention. Therefore, the US guided interventional surgery remains the effective and nontraumatic means for the treatment of intraabdominal abscesses.

[Organization of specialized health care of children who have suffered during traffic accidents in the Moscow Region].

The paper describes some experience in organizing and delivering specialized emergency health care to children who have suffered during traffic accidents in the Moscow Region, by attracting the forces and means of a disaster medicine service. In May 2004 to October 2008, examinations were made among 615 children, 552 of whom were evacuated to Moscow by intensive care cars (n = 469) and medical helicopters (n = 83). The paper shows that the two-stage medical victim medical evacuation provision system is effective and provides evidence for prospects for putting the developed model into practice of rendering a medical aid to traffic accident victims on out-of-town highways.

[Organization of the treatment of children with cranio-cerebral injuries]. / Organizatsiia lecheniia detei s cherepno-mozgovoi travmoi.

The character of craniocerebral injuries in 2743 children admitted to a children's traumatological division within 1976 to 1979 is analyzed. Clinical data characterizing craniocerebral injuries of various gravity are presented, and principles of individualized treatment of the patients are described. A great diagnostic value of special examination methods, such as cerebrospinal fluid examination, electroencephalography, rheoencephalography, and electromyography is demonstrated. The multiform neuropsychic changes revealed in most of 192 children on subsequent clinico-psychological examinations stress the urgent necessity of purposeful rehabilitation measures.

[Ultrasonic diagnosis of limited forms of appendicular peritonitis in children]. / Ekhografiia v diagnostike otgranichennykh form appendikuliarnogo peritonita u detei.

Results of an analysis of echographic diagnostics of appendicular peritonitis in 60 children have shown its high informative value. Under consideration are problems of the rational technique of investigation depending on localization of the pathological focus. Differential diagnostic criteria of various forms of limited peritonitis in children are presented. Possibilities of the method to establish the objective efficiency of the therapeutic treatment and substantiation of tactics of the treatment are shown.

Telemedicine for a Children's Field Hospital in Chechnya.

In 2001, the Children's Field Hospital in the Gudermes area of the Chechen Republic was connected to a telemedical centre at the Scientific Institute of Pediatrics and Children's Surgery in Moscow, via the Russian SCA HeliosNet satellite system. An asymmetric satellite link, in which there was a high-speed downlink from the satellite to Gudermes and a low-speed uplink from Gudermes to the satellite was used. In total, 179 teleconsultations were carried out from October 2001 until February 2002, when the field hospital was closed. Of the 179 teleconsultations, 26 were real-time, by videoconference and the rest were asynchronous, by email. Almost half of consultations were carried out for emergency or urgent reasons, thus demonstrating the value of providing access to the necessary experts. The use of satellite communication allowed telemedical support for medical decisions in a wide range of disease and trauma in children and teenage in a conflict situation.

[X-ray diagnosis of injuries to the posterior part of the pelvic ring in children]. / Rentgenodiagnoska povrezhdenii zadnego otdela tazovogo kol'tsa u detei.

Proceeding from morphoroentgenological investigation of 48 isolated pelvic specimens from dead children, a new method for radiodiagnosis of fractures of lateral sacral masses (LSM) and rupture of sacroiliac joints (SIJ), based on quantitative assessment of pelvic ring deformity has been developed. Limitations of the method were established. The introduction of this roentgenometric method into clinical practice for diagnosis of injury of the posterior pelvic semiring permitted an increase in x-ray detection of LSM fractures 10-fold and SIJ ruptures 2.5-fold.

Pelvic polyfractures in children. Radiographic diagnosis and treatment.

Results of clinical and radiographic examinations of 43 patients, 4 to 15 years old, with pelvic polyfractures during acute- and long-term periods of trauma, and postmortem and experimental data were presented. A high rate of diagnostic mistakes and treatment failures in patients with pelvic polyfractures are defined. Depending on the location and pattern of pelvis injuries, the main reasons for complications are determined. A technique of external fixation with the application of a pivot device for managing pelvic polyfractures in children is described. The efficacy of the proposed curative tactics is shown by treatment results of 12 patients with pelvic polyfractures.

Organ-sparing treatment for closed spleen injuries in children.

The results of organ-saving treatment for 84 children with closed transcapsular spleen rupture were studied. Criteria for the stipulation of differential curative tactics were present. Twenty-five children were treated conservatively. In 57 patients, different endosurgical manipulations were done. Laparotomy was done in 5 patients, including 3 patients who primarily had endosurgical treatment. Long-term results were studied for 29 children. The followup period was from 3 months to 4 years. Investigators showed that recommended tactics helped save organs in > 90% of children with transcapular splenic injuries. The possibility of restoring splenic structure and functional activity and preventing hyposplenism was proven by orthotopic saving of injured spleens.

[The system of evaluation of the severity of injuries (status and prospects of the problem)]. / Sistema otsenki tiazhesti travm (sostoianie i perspektivy problemy).

The authors have substantiated the necessity of elaboration and introduction of a single all-state++ system of objective quantitative evaluation of the severity of the injuries. A brief comparative characteristic of the most popular Soviet and foreign systems of the severity of the injuries is presented. The synthesized scales (elaborated at the prognosis laboratory of the Central Institute of Traumatology and Orthopedics ) for a quantitative evaluation of the character and the localization of the fractures are presented.