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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Traumatology and Orthopedics of Russia</journal-id><journal-title-group><journal-title xml:lang="en">Traumatology and Orthopedics of Russia</journal-title><trans-title-group xml:lang="ru"><trans-title>Травматология и ортопедия России</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2311-2905</issn><issn publication-format="electronic">2542-0933</issn><publisher><publisher-name xml:lang="en">Vreden National Medical Research Center of Traumatology and Orthopedics</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">15533</article-id><article-id pub-id-type="doi">10.17816/2311-2905-15533</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>CLINICAL STUDIES</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="zh"><subject>Clinical studies</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Effect of Radical Hip Reconstruction in Children With Hip Subluxation on Sagittal Balance and Type of Vertical Posture: Mid-Term Results</article-title><trans-title-group xml:lang="ru"><trans-title>Влияние радикальной реконструкции тазобедренного сустава у детей с подвывихом бедра на показатели сагиттального баланса и тип вертикальной осанки: среднесрочные результаты</trans-title></trans-title-group><trans-title-group xml:lang="zh"><trans-title/></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4931-2817</contrib-id><name-alternatives><name xml:lang="en"><surname>Bortulev</surname><given-names>Pavel I.</given-names></name><name xml:lang="ru"><surname>Бортулёв</surname><given-names>Павел Игоревич</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>pavel.bortulev@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4235-5048</contrib-id><name-alternatives><name xml:lang="en"><surname>Vissarionov</surname><given-names>Sergei V.</given-names></name><name xml:lang="ru"><surname>Виссарионов</surname><given-names>Сергей Валентинович</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Dr. Sci. (Med.), Professor</p></bio><bio xml:lang="ru"><p>чл.-корр. РАН, д-р мед. наук, профессор</p></bio><email>vissarionovs@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9084-5634</contrib-id><name-alternatives><name xml:lang="en"><surname>Barsukov</surname><given-names>Dmitriy  B.</given-names></name><name xml:lang="ru"><surname>Барсуков</surname><given-names>Дмитрий Борисович</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>dbbarsukov@gmail.com</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7026-1586</contrib-id><name-alternatives><name xml:lang="en"><surname>Pozdnikin</surname><given-names>Ivan Yu.</given-names></name><name xml:lang="ru"><surname>Поздникин</surname><given-names>Иван Юрьевич</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci. (Med.)</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>pozdnikin@gmail.com</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2534-9252</contrib-id><name-alternatives><name xml:lang="en"><surname>Poznovich</surname><given-names>Makhmud S.</given-names></name><name xml:lang="ru"><surname>Познович</surname><given-names>Махмуд Станиславович</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>poznovich@bk.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9865-2434</contrib-id><name-alternatives><name xml:lang="en"><surname>Baskaeva</surname><given-names>Tamila V.</given-names></name><name xml:lang="ru"><surname>Баскаева</surname><given-names>Тамила Владимировна</given-names></name><name xml:lang="zh"><surname></surname><given-names></given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>tamila-baskaeva@mail.ru</email><xref ref-type="aff" rid="aff3"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery</institution></aff><aff><institution xml:lang="ru">ФГБУ «Национальный медицинский исследовательский центр детской травматологии и ортопедии им. Г.И. Турнера» Минздрава России</institution></aff><aff><institution xml:lang="zh"></institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Mechnikov North-Western State Medical University</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России</institution></aff><aff><institution xml:lang="zh"></institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery</institution></aff><aff><institution xml:lang="ru">ФГБУ «Национальный медицинский исследовательский центр детской травматологии и ортопедии им. Г.И. Турнера» Минздрава России</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2023-11-15" publication-format="electronic"><day>15</day><month>11</month><year>2023</year></pub-date><pub-date date-type="pub" iso-8601-date="2023-12-28" publication-format="electronic"><day>28</day><month>12</month><year>2023</year></pub-date><volume>29</volume><issue>4</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><issue-title xml:lang="zh"/><fpage>35</fpage><lpage>48</lpage><history><date date-type="received" iso-8601-date="2023-08-30"><day>30</day><month>08</month><year>2023</year></date><date date-type="accepted" iso-8601-date="2023-10-18"><day>18</day><month>10</month><year>2023</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2023, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2023, Эко-Вектор</copyright-statement><copyright-statement xml:lang="zh">Copyright ©; 2023,</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">Эко-Вектор</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-nd/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://journal.rniito.org/jour/article/view/15533">https://journal.rniito.org/jour/article/view/15533</self-uri><abstract xml:lang="en"><p><bold>Background<italic>.</italic></bold> Hip instability in the form of hip subluxation, regardless of its etiology, leads not only to the formation of excessive pelvic anteversion and lumbar hyperlordosis, but also to the early development of hip osteoarthritis. The lack of information in the world literature on possible changes in sagittal balance parameters in this category of patients after triple pelvic osteotomy requires such studies.</p> <p><bold>Aim of the study</bold> is to evaluate the spino-pelvic sagittal balance and the type of vertical posture in children with hip subluxation of different genesis after radical reconstructive intervention in the mid-term follow-up period.</p> <p><bold>Methods<italic>.</italic></bold> The study is based on the analysis of clinical and X-ray results of 50 patients (50 hip joints) aged 10 to 17 years with hip subluxation operated on between 2018 and 2019. The patients were divided into two groups: group I consisted of 30 patients (30 hip joints) with Crowe type I dysplasia; group II consisted of 20 patients (20 hip joints) with Legg-Calvé-Perthes disease. All children underwent triple pelvic osteotomy.</p> <p><bold>Results<italic>.</italic></bold> Different approaches to triple pelvic osteotomy in patients with hip instability of various genesis allowed to significantly affect the spino-pelvic sagittal balance and the type of vertical posture. In all patients there was a decrease in the sacral slope value, spino-sacral angle, the magnitude of lumbar lordosis, as well as a change in the sagittal vertical axis value from strongly negative to neutral.</p> <p><bold>Conclusion<italic>. </italic></bold>Analysis of mid-term results of surgical treatment of children with hip instability in the form of hip subluxation and Legg-Calvé-Perthes disease using 3D modeling and prototyping of individual guides showed that the triple pelvic osteotomy leads to the reduction of both excessive pelvic anteversion and lumbar hyperlordosis, resulting in the transformation of physiologically disadvantageous hyperlordotic type of vertical posture into harmonious one.</p></abstract><trans-abstract xml:lang="ru"><p><bold>Актуальность<italic>. </italic></bold>Нестабильность тазобедренных суставов в виде подвывиха бедра вне зависимости от его этиологии приводит не только к формированию чрезмерной антеверсии таза и гиперлордозу поясничного отдела позвоночника, но и к раннему развитию коксартроза. Отсутствие в мировой литературе сведений о возможных изменениях параметров сагиттального баланса у данной категории пациентов после выполнения тройной остеотомии таза диктует необходимость проведения таких исследований.</p> <p><bold>Цель исследования<italic> </italic></bold>— оценить состояние сагиттальных позвоночно-тазовых соотношений и тип вертикальной осанки у детей с подвывихом бедра различного генеза после выполнения радикального реконструктивного вмешательства в среднесрочном периоде наблюдения.</p> <p><bold>Материал и методы<italic>. </italic></bold>Исследования основано на анализе результатов клинико-рентгенологического обследования 50 пациентов (50 тазобедренных суставов) в возрасте от 10 до 17 лет с подвывихом бедра, прооперированных в период с 2018 по 2019 г. Пациенты были разделены на две группы: группу I составили 30 пациентов (30 тазобедренных суставов) с дисплазией I степени по Crowe; группу II — 20 пациентов (20 тазобедренных суставов) с болезнью Легга – Кальве – Пертеса. Всем детям выполнена тройная остеотомия таза.</p> <p><bold>Результаты<italic>. </italic></bold>Различные подходы к выполнению тройной остеотомии таза у пациентов с нестабильностью тазобедренного сустава различного генеза позволили значительно повлиять на состояние сагиттальных позвоночо-тазовых соотношений и тип вертикальной осанки. У всех пациентов произошло уменьшение угла наклона крестца, позвоночно-крестцового угла, величины поясничного лордоза, а также изменение значения сагиттальной вертикальной оси из резко негативного к нейтральному.</p> <p><bold>Заключение<italic>.</italic></bold> Анализ среднесрочных результатов хирургического лечения детей с нестабильностью тазобедренного сустава в виде подвывиха бедра и болезнью Легга – Кальве – Пертеса с применением технологии 3D-моделирования и прототипирования индивидуальных шаблонов-направителей показал, что выполнение тройной остеотомии таза приводит к уменьшению как избыточной антеверсии таза, так и гиперлордоза поясничного отдела позвоночника, в результате чего происходит трансформация физиологически невыгодного гиперлордотического типа вертикальной осанки в гармоничный.</p></trans-abstract><trans-abstract xml:lang="zh"><p/></trans-abstract><kwd-group xml:lang="en"><kwd>children</kwd><kwd>hip dysplasia</kwd><kwd>Legg-Calvé-Perthes disease</kwd><kwd>hip subluxation</kwd><kwd>spino-pelvis balance</kwd><kwd>triple pelvic osteotomy</kwd><kwd>3D modeling</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>дети</kwd><kwd>дисплазия тазобедренного сустава</kwd><kwd>болезнь Легга – Кальве – Пертеса</kwd><kwd>подвывих бедра</kwd><kwd>позвоночно-тазовые соотношения</kwd><kwd>тройная остеотомия таза</kwd><kwd>3D-моделирование</kwd></kwd-group><funding-group><award-group><funding-source><institution-wrap><institution xml:lang="ru">Министерство здравоохранения Российской Федерации</institution></institution-wrap><institution-wrap><institution xml:lang="en">Ministry of Health of the Russian Federation</institution></institution-wrap></funding-source><award-id>121031700122-6</award-id></award-group></funding-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><citation-alternatives><mixed-citation xml:lang="en">Vaz G., Roussouly P., Berthonnaud E., Dimnet J. 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