Developmental dysplasia of the hip, particularly Crowe type IV, presents significant challenges in orthopedic surgery due to severe anatomical deformities and biomechanical instability. This study focuses on evaluating the biomechanical performance of a prosthesis–femur–derotation plate system designed to address these challenges. Using FEA, a comprehensive assessment of stress distribution, displacement, and safety factors was conducted under physiological loading conditions. The derotation plate was specifically engineered to stabilize the femur and restore the anatomical and biomechanical axis of the limb. Results demonstrated that the derotation plate effectively eliminated rotational and axial displacement, with a peak displacement of 0.08 mm, and maintained sufficient strength reserves, with a minimum safety factor of 3.63. The maximum von Mises stress in the plate was 76 MPa, significantly below the yield strength of the titanium alloy, ensuring long-term durability and reliability. The system as a whole exhibited favorable biomechanical properties, confirming its ability to manage high stress loads without the risk of material failure or instability. These findings underscore the potential of this novel system to improve surgical outcomes in complex cases of hip dysplasia. Future clinical trials will further validate its practical utility, providing valuable insights for advancing orthopedic implant design and patient care.

Aims. To evaluate the efficacy of the modified Stoppa approach for surgical treatment of pelvic bone injuries based on clinical (sex distribution, fracture type), surgical (duration of operation, intraoperative blood loss, incision length, quality of reduction), and functional outcome (hip joint function). Materials and methods. A total of 31 patient were included in a retrospective cohort study from 2019 until March 2022 with various injuries of acetabulum in the N.D. Batpenov National Scientific Center of Traumatology and Orthopaedics (NSCTO).The inclusion criteria for this study were: patients with acetabulum injuries, and who underwent surgical interventions using one of two surgical approaches (modified Stoppa, ilioinguinal approaches), patients over 18 years old. Exclusion criteria: other operative approaches to pelvic bones and patients under 18 years of age. 21 patients underwent surgery with the use of modified Stoppa approach (group A) and 10 surgeries were performed using the ilioinguinal approach (group B). Efficiency was evaluated by comparison of duration of surgical procedures, amount of blood lossbetween groups, size of skin incision, quality of reduction and functional outcomes. Results. There are males – 18(58.1%), females – 13(41.9%) in the study. The clinical study results showed that average volume of intraoperative blood loss and size of skin incision were significantly less during Stoppa approach then ilioinguinal approach though average duration of surgical procedures did not reveal significant differences between two groups. Average duration of surgical procedures did not reveal significant differences between two groups – 109.5 min (±54.7) among group A and 126 min (±58.9) in group B. The volume of intraoperative blood loss averaged 338±254.5 ml of blood for the total sample. The volume of intraoperative blood loss was 525.0 ±322.5 ml of blood in group B, which is more than twice the estimated blood loss for group A (250 ±157.3 ml). When using a Stoppa approach, the length of the cutaneous surgical incision averaged at 8.8 ± 1.5 cm, while with an ilioinguinal approach, this value was estimated at 20.6 ± 8.5 cm, which suggests a favorable cosmetic effect of Stoppa approach. Conclusion. The positive results obtained with the modified Stoppa approach, which are reflected in a reduction in the length of the skin incision and the amount of intraoperative blood loss, suggest that the use of this approach in clinical practice provides an opportunity to improve the surgical treatment of acetabular fractures by obtaining variability in the study of surgical approach. Nevertheless, the frequency and complexity of the occurring pelvic bone injuries dictate the need for further search and improvement of more optimal access options for surgical treatment.

Background: Iatrogenic hallux varus is a rare but functionally disabling complication most commonly following hallux valgus surgery. Traditional revision techniques, such as tendon transfer or arthrodesis, may compromise joint mobility or require implants. This study evaluates a biologically autologous alternative—local soft tissue myoligamentoplasty—for the correction of flexible deformities. Methods: A retrospective case series of seven patients (mean age 62 years) with flexible iatrogenic hallux varus following prior hallux valgus surgery was conducted at a single tertiary care center. All patients underwent local soft tissue myoligamentoplasty using an F-shaped medial capsular flap and lateral release via a double-incision approach. Outcomes were assessed using the Visual Analog Scale (VAS) for pain, the American Orthopaedic Foot & Ankle Society (AOFAS) hallux score, and radiographic measurements (hallux valgus angle [HVA], intermetatarsal angle [IMA]) over a 12-month follow-up. Results: Mean VAS improved significantly from 6.1 ± 1.2 preoperatively to 1.4 ± 0.8 at 12 months (p < 0.01), and AOFAS scores increased from 47.6 ± 6.9 to 83.7 ± 7.1 (p < 0.01). HVA was corrected from −15.4° ± 4.3° to 2.7° ± 3.8° (p < 0.01), while IMA remained unchanged (10.3° ± 1.9° to 9.8° ± 2.1°, p = 0.12), indicating mechanical neutrality. No recurrences, reoperations, or complications were reported. Patient satisfaction was high, with 5/7 “completely satisfied” and 2/7 “satisfied with minor concerns.” Conclusion: Local soft tissue myoligamentoplasty offers a safe, effective, and joint-preserving surgical option for correcting flexible iatrogenic hallux varus. The technique provides durable pain relief, functional improvement, and cosmetic restoration without the need for tendon harvesting or implants, making it especially suitable for patients with preserved joint surfaces or in resource-limited settings.

Background: Acetabular fractures are complex injuries of the hip joint. Careful design of fixation plates is crucial for achieving stable osteosynthesis, especially in patients with poor bone quality. Finite element analysis (FEA) is widely used for biomechanical evaluation of orthopedic implants. Objective: The aim of this study was to perform a comparative finite element analysis of three acetabular plate designs differing in bridge geometry and to identify the configuration with the most favourable biomechanical performance. We hypothesized that a plate with two parallel bridges would provide more favourable stress distribution and a higher safety factor compared to single-bridge and non-parallel-bridge designs. Methods: A three-dimensional model of the pelvic bone was reconstructed from CT data. Three titanium alloy (Ti-6Al-4V, thickness 2.5 mm) plates with different bridge configurations (single bridge, two parallel bridges, two non-parallel bridges) were virtually implanted using CAD software (KOMPAS-3D, Autodesk Inventor). The FEA model included cortical and cancellous bone with mechanical properties taken from the literature. A load of 250 N applied at 15° to the inner plate surface simulated partial weight-bearing in the early postoperative period. Von Mises equivalent stress, linear displacement, and safety factor were evaluated. Results: Maximum von Mises equivalent stresses were 207 MPa for the single-bridge plate, 170 MPa for the two-parallel-bridge plate, and 344 MPa for the two-non-parallel-bridge plate. The corresponding minimum safety factors were 1.33, 1.62, and 0.8. The obtained stress values are consistent with findings from similar studies. Conclusion: The plate with two parallel bridges exhibited the highest safety factor and appears to be the most promising candidate for further experimental evaluation based on the present computational findings. The single-bridge and two-non-parallel-bridge designs require further design modification, particularly in the bridge cross-sections, because of their lower static safety margins. FEA is a useful tool for comparative biomechanical assessment of implant designs.

Жамбас буынының дисплазиясы – бұл дер кезінде диагноз қойылмаса және емделмесе, жамбас буынының қызметінің бұзылуына әкелетін тірек-қимыл аппаратының ауыр патологиясы. Ол хирургиялық араласуды қажет ететін остеоартриткеәкеледі.Бұл мақалада 6,5 см болатын көлденең ұршықасты қысқарту остеотомиясымен сол жақ жамбас буынының цементсіз толық жамбас артропластикасы жасалған науқастың жағдайды сипатталады.Клиникалық жағдайдың ерекшелігі – остеотомия аймағында ротациялық және осьтік тұрақтылықты қамтамасыз ететін жаңадан әзірленген пластинаның қолданылуы болды. Пациенттің жағдайы әрі қарай бақылауда және тиісті ем жүргізілуде. Зерттеу мен пациенттің жағдайын қадағалау процесі әлі де жалғасып жатыр.

В статье анализируются причины развития воронкообразной деформации грудной клетки, современные подходы оперативного лечения и их осложнения. Работа нацелена на рассмотрение имеющихся в настоящий момент данных об этиологии, диагностике воронкообразной деформации грудной клетки, современные методы хирургической коррекции, а также интра- и послеоперационные осложнения. Произведен информационный поиск научных статей по базам данных Scopus, Web of Science, PubMed, Cyberleninka с использованием ключевых слов: «pectus exavatum», «funnel chest», «thoracoplasty», «pectus exavatum surgery». Было проанализировано 54 статьи, включающие вопросы причиниы развития, диагностики, существующих методов оперативного и неоперативного лечения воронкообразной деформации грудной клетки. На сегодняшний день нет единой теории возникновения воронкообразной деформации грудной клетки. Тем не менее, большинство авторов связывают появление деформации с дизэмриогенезом соединительной ткани. Различные методы оперативного лечения деформации грудной клетки обуславливают и возникновение интра- и послеоперационных осложнений. Отсутствие единого метода лечения деформации грудной клетки обусловлено большим количеством хирургических методик коррекции деформации грудной клетки. Необходим дифференцированный подход к каждому случаю воронкообразной деформации грудной клетки. Вопрос хирургического лечения остается актуальным и требует дальнейшего изучения. Мақалада кеуде қуысының шұңқыр тәрізді деформациясының даму себептері, хирургиялық емдеудің заманауи тәсілдері және олардың асқынулары талданады. Жұмыстың мақсаты - қазіргі уақытта кеуде қуысының этиологиясы, шұңқыр тәрізді деформациясының диагностикасы, хирургиялық түзетудің заманауи әдістері, сондай - ақ интра және отадан кейінгі асқынулар туралы мәліметтерді қарастыру. "Pectus exavatum", "funnel chest", "thoracoplasty", "pectus exavatum surgery"кілт сөздерін қолдана отырып, Scopus, Web of Science, PubMed, Cyberleninka деректер базасы бойынша ғылыми мақалаларды ақпараттық іздеу жүргізілді. Кеуде қуысының шұңқыр тәрізді деформациясын ота жасау арқылы және отасыз емдеудің қолданыстағы әдістері,даму себептері, диагностикасы туралы мәселелер қарастырылған 54 мақала талданды. Бүгінгі күні кеуде қуысының шұңқыр тәрізді деформациясының пайда болуының бірыңғай теориясы жоқ. Дегенмен, авторлардың көпшілігі деформацияның пайда болуын дәнекер тінінің дизэмриогенезімен байланыстырады. Кеуде деформациясын хирургиялық емдеудің әртүрлі әдістері интра және отадан кейінгі асқынулардың пайда болуына әкеледі. Кеуде қуысының деформациясын түзетудің көптеген хирургиялық әдістері әлі де кеуде деформациясын емдеудің бірыңғай әдісі жоқ екендігіне байланысты. Кеуде қуысының шұңқыр тәрізді деформациясының әр жағдайына сараланған көзқарас қажет. Хирургиялық емдеу мәселесі өзекті болып қала береді және одан әрі зерттеуді қажет етеді. The article analyzes the causes of the development of funnel-shaped chest deformity, modern approaches to surgical treatment and their complications. Aim if this work is to review the currently available data on the etiology, diagnosis of funnel-shaped chest deformity, modern methods of surgical correction, as well as intra- and postoperative complications. An informational search of scientific articles was performed on the databases Scopus, Web of Science, PubMed, Cyberleninka using the keywords: "pectus exavatum", "funnel chest", "thoracoplasty", "pectus exavatum surgery". 54 articles were analyzed, including the issues of the cause of development, diagnosis, existing methods of surgical and non-surgical treatment of funnel-shaped chest deformity. Conclusion: To date, there is no unified theory of the occurrence of...