Clinical and radiographic results of multilevel surgical interventions forhip subluxation and dislocation in children with cerebral palsy

Introduction The purpose of this work was to study the results of orthopedic correction performed according to the principles of one-stage multilevel surgical intervention in cerebral palsy patients with hip dislocation. Material and methods We studied the results of operative orthopedic treatment in 50 children suffering from cerebral palsy (GMFCS levels IV and V, mean age 6.2 ± 1.4 years at the beginning of treatment) who underwent multilevel interventions with the purpose of hip joint reconstruction and correction of other orthopedic complications of cerebral palsy in the knee and foot. The parameters of the orthopedic status were studied as well as such radiographic data as the Reimers index, acetabular index, acetabular frontal depth index, projection neck-to-shaft angle, Wiberg index, tibiotalar angle, angle of the talocalcaneal divergence in the sagittal and frontal planes, coverage of the head of the talus with the navicular bone. The mean follow-up period was 2.8 ± 1.7 years. Results Patients underwent 91 reconstructive interventions during the study period involving 461 surgical elements (5.07 per operation on average). The goals of the pathology correction were achieved in all cases. In all patients, by the end of the first year after the operation, hip abduction was more than 30 degrees and flexion was more than 100 degrees. Comfortable sitting posture and correct passive symmetrical verticalization, pain relief in everyday life were reported in all cases. The shape and position of the foot made it possible to use comfortable regular footwear during verticalization, as well as during walking. By the end of the second follow-up year, a decrease in hip abduction to 20 ° was detected in only two patients. In two cases, a partial recurrence of foot valgus was observed which occurred by axial limb loading and required the use of an orthotic appliance. All radiological indicators examined after the treatment remained within the limits of normal values during the follow-up period. But there was a mild tendency to reduction of hypercorrection achieved which was within the normal boundaries. Conclusion Multilevel operations in children with severe types of cerebral palsy and hip dislocation as the leading pathology are aimed at achieving correction of all orthopedic problems in the lower limbs. The result of such interventions is not only normal anatomical parameters but also the creation of conditions for rehabilitation measures, especially postural management, which is extremely important for normal hip joint development and prevention of hip subluxation and dislocation recurrence in children

Orthopaedic, psychological, social and philosophical aspects of achondroplasia patients treated with the Ilizarov method

Introduction Achondroplasia is the most common skeletal dysplasia with limb shortening that can be symptomatically be treated with the Ilizarov method developed in the 20th century. Achondroplasia patients were shown to have medical and surgical possibilities for height increase with indications being controversial, and psychological and social implications to be considered. Objective The purpose of the study was to review our own data and reported findings on possibilities, results and complications of Ilizarov treatment of achondroplasia patients. Material and methods Outcomes of 750 achondroplasia patients treated at the Kurgan Ilizarov Center between 1976 and 2017 were reviewed. The patients’age ranged from 4 to 23 years. Results Long-term outcomes were followed up in all the cases. Radiography was used to assess limb elongation at follow-ups and MRI, MSCT and US were optional. Ten-to-fifteen-year follow-ups showed persisted length gain, early osteoarthritis of the hip and knee joints due to baseline articular changes, completely restructured femur and tibia at the distraction site, normal anatomy and area of muscle cross-section, normal structure and thickness of tibial muscles. Social and psychological profile appeared to improve. We have data from the patients who underwent limb lengthening 30 years ago. Many of them are employed, have family and children. Conclusion The findings suggest that achondroplasia patients, a comparatively small group of short statured people, have good reasons to feel empowered, get social support, make parents happy and contribute to the success of the country. The Ilizarov method has turned the idea of height increase into an accomplishment for benefits of doctors and patients being an achievement of orthopaedic world to address orthopaedic, social, psychological and philosophical issues

Easy method to simplify “freehand” subaxial cervical pedicle screw insertion

Study Design: Technical note. Objectives: The objective of this study is to check out safety and rationality of standardized and fast tricks to select trajectory of subaxial cervical pedicle screw (SCPS) insertion, based on simple angles to bony landmarks. Materials and Methods: Stage 1 – Computed tomography (CT)-morphometric analysis of C3–C7 vertebrae of ten patients with cervical degenerative diseases. Stage 2 – SCPS insertion in 6 cadavers, according to the developed technique (59 pedicle screws). Stage 3 – SCPS insertion in 6 patients, according to the developed technique (32 pedicle screws). Results: CT-morphometric analysis showed that the average length of C3–C7 pedicle channels was 32 mm, the average angle between a pedicle axis and an axis of contralateral lamina - 180°, the average angle between a pedicle axis and plane of a posterior surface of a lateral mass amounted to 90° and the coordinates of an optimal entry point – 2 mm from a lateral edge and 2 mm from an upper edge of the lateral mass posterior surface. During the cadaveric study, 39 screws had a satisfactory position (66.1%), 7 screws permissible (11.9%), and 13 screws unacceptable (22%). During the clinical study, 26 screws (81.25%) had satisfactory position, 4 (12.5%) had permissible position, and 2 (6.25%) unacceptable position. Conclusion: Developed and clinically approved a method for simplicity SCPS insertion is relatively safe and cheap. No doubt, it requires further investigation, but the results of primary analysis allow us to recommend it to wide practical application

Observation of the B<SUP>+</SUP>→ Jψη<SUP>′</SUP>K<SUP>+</SUP> decay (vol 2023, 174, 2023)

LPHE-OSSCI-SB-FBLPHE-L

Amplitude analysis of the D+→π−π+π+D^+\to\pi^- \pi^+\pi^+ decay and measurement of the π−π+\pi^-\pi^+ S-wave amplitude

An amplitude analysis of the D$^{+}$→ π$^{−}$π$^{+}$π$^{+}$ decay is performed with a sample corresponding to 1.5 fb$^{−1}$ of integrated luminosity of pp collisions at a centre-of-mass energy $\sqrt{s}$ = 8 TeV collected by the LHCb detector in 2012. The sample contains approximately six hundred thousand candidates with a signal purity of 95%. The resonant structure is studied through a fit to the Dalitz plot where the π$^{−}$π$^{+}$ S-wave amplitude is extracted as a function of π$^{−}$π$^{+}$ mass, and spin-1 and spin-2 resonances are included coherently through an isobar model. The S-wave component is found to be dominant, followed by the ρ(770)$^{0}$π$^{+}$ and f$_{2}$(1270)π$^{+}$ components. A small contribution from the ω(782) → π$^{−}$π$^{+}$ decay is seen for the first time in the D$^{+}$→ π$^{−}$π$^{+}$π$^{+}$ decay.[graphic not available: see fulltext

Observation of the B+→J/ψη′K+B^+ \rightarrow J/\psi \eta^{\prime} K^+ decay

The B$^{+}$ → Jψη′K$^{+}$ decay is observed for the first time using proton-proton collision data collected by the LHCb experiment at centre-of-mass energies of 7, 8, and 13 TeV, corresponding to a total integrated luminosity of 9 fb$^{−1}$. The branching fraction of this decay is measured relative to the known branching fraction of the B$^{+}$ → ψ(2S)K$^{+}$ decay and found to be$\frac{\mathcal{B}\left({B}^{+}\to {J\psi \eta}^{\prime }{K}^{+}\right)}{\mathcal{B}\left({B}^{+}\to \psi (2S){K}^{+}\right)}=\left(4.91\pm 0.47\pm 0.29\pm 0.07\right)\times {10}^{-2},$where the first uncertainty is statistical, the second is systematic and the third is related to external branching fractions. A first look at the J/ψη′ mass distribution is performed and no signal of intermediate resonances is observed.[graphic not available: see fulltext

Search for CP\it{CP} violation in D(s)+→K−K+K+D_{(s)}^{+}\rightarrow K^{-}K^{+}K^{+} decays

A search for direct CP violation in the Cabibbo-suppressed decay ${D}_s^{+}$→ K$^{−}$K$^{+}$K$^{+}$ and in the doubly Cabibbo-suppressed decay D$^{+}$ → K$^{−}$K$^{+}$K$^{+}$ is reported. The analysis is performed with data collected by the LHCb experiment in proton-proton collisions at a centre-of-mass energy of 13 TeV corresponding to an integrated luminosity of 5.6 fb$^{−1}$. The search is conducted by comparing the ${D}_{(s)}^{+}$ and ${D}_{(s)}^{-}$ Dalitz-plot distributions through a model-independent binned technique, based on fits to the K$^{−}$K$^{+}$K$^{+}$ invariant-mass distributions, with a total of 0.97 (1.27) million ${D}_s^{+}$ (D$^{+}$) signal candidates. The results are given as p-values for the hypothesis of CP conservation and are found to be 13.3% for the ${D}_s^{+}$→ K$^{−}$K$^{+}$K$^{+}$ decay and 31.6% for the D$^{+}$→ K$^{−}$K$^{+}$K$^{+}$ decay. No evidence for CP violation is observed in these decays.[graphic not available: see fulltext

Measurement of the ratio of branching fractions B(Bc+→Bs0π+)/B(Bc+→J/ψπ+) \mathcal{B}\left({B}_c^{+}\to {B}_s^0{\pi}^{+}\right)/\mathcal{B}\left({B}_c^{+}\to J/\psi {\pi}^{+}\right)

The ratio of branching fractions of ${B}_c^{+}\to {B}_s^0{\pi}^{+}$ and ${B}_c^{+}\to J/\psi {\pi}^{+}$ decays is measured with proton-proton collision data of a centre-of-mass energy of 13 TeV. The data were collected with the LHCb experiment during 2016–2018, corresponding to an integrated luminosity of 5.4 fb$^{−1}$. The ${B}_s^0$ mesons are reconstructed via the decays ${B}_s^0\to J/\psi \phi$ and ${B}_s^0\to {D}_s^{-}{\pi}^{+}$. The ratio of branching fractions is measured to be $\mathcal{B}\left({B}_c^{+}\to {B}_s^0{\pi}^{+}\right)/\mathcal{B}\left({B}_c^{+}\to J/\psi {\pi}^{+}\right)=91\pm 10\pm 8\pm 3$ where the first uncertainty is statistical, the second is systematic and the third is due to the knowledge of the branching fractions of the intermediate state decays.[graphic not available: see fulltext

Search for the baryon- and lepton-number violating decays <math display="inline"><msup><mi>B</mi><mn>0</mn></msup><mo stretchy="false">→</mo><mi>p</mi><msup><mi>μ</mi><mo>-</mo></msup></math> and <math display="inline"><msubsup><mi>B</mi><mi>s</mi><mn>0</mn></msubsup><mo stretchy="false">→</mo><mi>p</mi><msup><mi>μ</mi><mo>-</mo></msup></math>

A search for the baryon- and lepton-number violating decays B0→pμ- and Bs0→pμ- is performed at the LHCb experiment using data collected in proton-proton collisions at s=7, 8 and 13 TeV, corresponding to integrated luminosities of 1, 2, and 6  fb-1, respectively. No significant signal for B0→pμ- and Bs0→pμ- decays is found and the upper limits on the branching fractions are determined to be B(B0→pμ-)&lt;2.6(3.1)×10-9 and B(Bs0→pμ-)&lt;12.1(14.0)×10-9, respectively, at 90% (95%) confidence level. These are the first limits on these decays to date

Model-independent measurement of charm mixing parameters in <math display="inline"><mover accent="true"><mi>B</mi><mo stretchy="false">¯</mo></mover><mo stretchy="false">→</mo><msup><mi>D</mi><mn>0</mn></msup><mo stretchy="false">(</mo><mo stretchy="false">→</mo><msubsup><mi>K</mi><mi>S</mi><mn>0</mn></msubsup><msup><mi>π</mi><mo>+</mo></msup><msup><mi>π</mi><mo>-</mo></msup><mo stretchy="false">)</mo><msup><mi>μ</mi><mo>-</mo></msup><msub><mover accent="true"><mi>ν</mi><mo stretchy="false">¯</mo></mover><mi>μ</mi></msub><mi>X</mi></math> decays

A measurement of charm mixing and CP-violating parameters is reported, using B¯→D0(→KS0π+π-)⁢μ-ν¯μX decays reconstructed in proton-proton collisions collected by the LHCb experiment during the years 2016 to 2018, corresponding to an integrated luminosity of 5.4  fb-1. The measured mixing and CP-violating parameters are xCP=[4.29±1.48(stat)±0.26(syst)]×10-3, yCP=[12.61±3.12(stat)±0.83(syst)]×10-3, Δx=[-0.77±0.93(stat)±0.28(syst)]×10-3, Δy=[3.01±1.92(stat)±0.26(syst)]×10-3. The results are complementary to and consistent with previous measurements. A combination with the recent LHCb analysis of D*+→D0(→KS0π+π-)π+ decays is reported