15.01.2007
Igor has come to the hospital for follow-up treatment. He is more or less
all right. The boy's mother Tatiana is telling:
"Igor will turn 14 this year. He has a congenital false joint.
We are from the city of Penza. At our local hospital, we had nine
surgeries and received treatment for 12 years, but there was no
result. A little more than a year ago, we came to the RCCH in Moscow.
And here, in one year, the joint was almost completely healed.
Actually, when we were admitted to this hospital, we learned that
the only chance to help Igor is the use of stem cells.
In November 2005, Igor had this surgery: bone chips together
with stem cells were introduced. Then, 20 days later, the cells
were introduced again. And then many similar procedures. Finally,
they fixed the leg in an Ilizarov apparatus and allowed Igor
to go home. Now, during this visit to the hospital, the Ilizarov
apparatus was removed. Of course, there are still problems:
the leg is atrophied, osteoporosis has developed, and this leg is
11 cm shorter than the other one. After all, the false joint
was diagnosed at the age of 10 months, and the child has had
virtually no experience of walking. The leg was always either
in plaster or in an Ilizarov apparatus. But now, when the
false joint has been healed, we hope that everything will yet
change. Now we need ortheses and special boots. Besides,
Igor has managed to break his femur, and so he is in plaster
again for the time being.
Fortunately, Igor does not feel unhappy and shy. In spite
of the apparatus and plaster, he manages to play football, or
go fishing, or pick mushrooms in the forest. He likes studying,
and little kids love him. He is especially interested in biology
and plans to become a biology teacher. The doctors like him.
And we are whole-heartedly grateful to all physicians who helped us.
We thank our physician Lev Makhrov and all our sponsors!"
11.10.2005
Money for bone grafts and osteoblast cultivation has been paid for
patients of the Department of Traumatology and Orthopedics Yana
Mikheenko and
Igor Mikhailov ($1000 each). The money transferred
to our account for Yana and Igor will be reserved for later treatment
of other patients with similar disorders, which, unfortunately,
are not too rare in children.
My name is Tatiana Mikhailova. We need financial help in surgical
treatment of my son Igor. He is 12 years old, and all these years
we have been trying to cure his pathology: congenital false joint
of the tibia. There have been nine operations but no improvement.
Now we are to have an operation using a skin graft and stem cells.
It gives us genuine hope that we will finally be able to get rid
of the false joint and to recover the leg. But we will have to pay
$1000 for this operation. And we are unable to raise this sum by
ourselves. We live and work in a village, and my husband's monthly
salary is just 1500 to 2000 roubles ($50-70). I have got no regular
earnings, because I take care of my disabled child.
This operation is our best hope. Please help us! Tatiana Mikhailova
Penza region, Kamensk locality
село
Болтино.
Excerpt from case history: Igor S. Mikhailov, b. 1993. Ds.: congenital relapsing
false joint of the lower third of the left tibia, avascular form.
Condition after application of Ilizarov apparatus and plastic surgery
of the joint.
At the age of 9 months, after falling from a stroller, the patient
developed deformation of the left shin and pathological mobility
in the lower third of the shin. Fracture of tibia was diagnosed.
Immobilization for 1.5 months did not lead to its healing. Subsequent
ds.: congenital false joint of the tibia. The child had an operation
at the age of 22 months: economical resection of ends of tibia,
application of Ilizarov apparatus. Compression in an Ilizarov apparatus
for 4 months did not lead to bone healing. Repeated application
of Ilizarov apparatus with plastic surgery of the false joint was
performed 6 months later. Shin became 3 cm longer, but the false
joint did not disappear. There were 5 more attempts to heal the
false joint, 3 autoplastic operations with rib tissue and 6-cm elongation
of the shin. The last attempt to heal the joint took place in 2003.
Presently the boy is 12 years old. He walks on crutches. Left leg
is 10 cm shorter than the right one. There is angular deformation
of left shin at the level of the false joint, marked muscular hypotrophy
of the shin, multiple post-operative scars of the leg skin, pathological
mobility at the level of the false joint, hypoplasia of the foot.
The doctor's comment:
Dr. Sergei N. Moiseev, Deputy Head of Department of Traumatology
and Orthopedics:
One of the most serious problems in orthopedics is treatment of patients
with grave congenital bone defects, including congenital false joints.
This is a pressing problem all over the world. Children with this
disorder go through numerous operations, including those using metal
osteosynthesis, but often no positive results are attained.
A very promising contemporary technique is bone plastic surgery
of such defects using specially cultivaled autologic osteoblast
cells, which are produced from stem cells extracted from the child's
blood. This method shows good results in healing large defects of
long tubular bones, including shinbones. Unfortunately, a congenital
false joint of shinbone is a very frequent pathology. Such children
have to go through dozens of operations, which do not produce due
effect: the false joint is preserved, the extremity is unsupportive,
and the child and parents suffer.
Another advantage of autoplastic bone grafting
is that it is performed in one stage, without metal osteosynthesis.
In six to eight months, the child will feel that the extremity supports
him or her. The use of the new method notably shortens the difficult
time of leg immobilization in plaster.
However, to perform this operation, significant
financial expenses are required for extraction and cultivation of
stem cells and for preparation of a bone graft from a dead body.
The final cost is over $1000 per child.
Presently two children at our department need
this operation. They are Igor Mikhailov and Yana Mikheenko, and
they have similar defects: congenital false joint of shinbone. Both
children have already had numerous operations without due effect.
We will be grateful to everybody who will help us and these children
in performing autoplastic bone grafting, which will give a good
chance to both children.
