Mini warp: Warrior Evo Warp Mini
Super Mario Bros. 3 is a platform action-adventure game for the Famicom and NES and is officially the third installment in the Super Mario series. It was released for consoles in Japan on October 23, 1988, in North America on February 12, 1990, and in Europe and Australia on August 29, 1991. Prior to its North American release on the NES,
Super Mario Bros. 3
Shortly after the release of the game, a cartoon named The Adventures of Super Mario Bros. 3 was made. The cartoon was based on the game, but with a different plot. In the cartoons, King Koopa and the Koopalings tried to take over the real world as well as the Mushroom Kingdom. The cartoon series was produced by DIC Entertainment Productions in association with Nintendo.
The following text is taken directly from the instruction booklet.
Peace has returned to the Mushroom Kingdom thanks to the efforts of Mario and Luigi; however, Bowser sent his own seven children (Larry, Morton, Wendy, Iggy, Roy, Lemmy, and Ludwig) to the other countries of the Mushroom World. The Mushroom Kingdom forms a gateway to these lands, and the Koopalings have stolen the respective royal magic wands of the seven kings, using them to transform the kings into various helpless creatures.
Super Mario Bros. 3 plays similarly to Super Mario Bros., with several additions. The game features a world map where the player can choose which path to take and which level to play. Toad Houses and Spade Panels are also found on the world map. Halfway through each world, Mario or Luigi enter a fortress, where they fight Boom Boom. At the end of each world, they enter the world’s airship, where one of the seven Koopalings is fought.
The first player controls Mario, while the second player controls his brother, Luigi, with the two players taking turns. New moves include being able to pick up an object and kick it, and the Slope Slide, which allows Mario or Luigi to slide down a hill, a move which has been carried over in the future Mario games. The Fire Flower returns in this game, where it acts as it does in Super Mario Bros., allowing Mario or Luigi to transform into their Fire forms and shoot fireballs. Several new power-ups are also introduced, including the Super Leaf, a leaf power up that transforms Mario or Luigi into their Raccoon forms, allowing them to fly into the sky, and the Hammer Suit, which transforms the brothers into their Hammer forms, letting them throw hammers at enemies.
Another object is the Goomba’s Shoe, only obtainable in World 5-3 of the game. This object allows Mario to safely hop across dangerous objects and jump on spiky enemies, such as Piranha Plants and Spinies. It is obtained from bumping a Kuribo’s Goomba off a block from below. It is only found in this game and its remakes. However, since it is not a power-up, it does not overtake any previous powers the player may have had. For example, if Fire Mario mounts a Goomba’s Shoe, then loses it, he will still retain his Fire form, similar to Yoshi in Super Mario World.
In international releases of this game, after players obtain a power-up that is greater than a Super Mushroom, any injury will turn them back to their Super form, like in every 2D Super Mario game after Super Mario World. In the original Japanese Famicom release, any hit reduces the player back to Small form, like in Super Mario Bros., Super Mario Bros: The Lost Levels and Super Mario World. Also, getting hit while in the Goomba’s Shoe in the Japanese Famicom release also changes Mario into Small form, regardless of what power-up he had while in the Goomba’s Shoe.The map of the Mushroom World in Super Mario Advance 4: Super Mario Bros. 3.
Unlike Super Mario Bros. and Super Mario Bros. 2, this game has a world map, a feature that has been carried over into every subsequent title in the series. Like Super Mario Bros., the game features eight total worlds spread out across eight different maps, each one featuring a different name, theme, and boss; the inclusion of thematic worlds would also be carried over into future titles in the series. In the remakes and the original NES release of this game, most of the worlds were given different names (indicated in parentheses in the table below). In Super Mario Advance 4: Super Mario Bros. 3, the world map gains interactive features.
2 Player Game
Bonus stages in battle mode
In 2 Player Game, Mario (player one) and Luigi (player two) take turns to complete levels. After one brother completes a level or loses a life, the other brother plays. Also, if one brother picks a level that the other brother completed, they enter Battle Mode in their small forms. Whoever wins will be their turn to play the main game.
Most Battle Mode stages are similar to Mario Bros. In these stages, five enemies will emerge from the top pipes. The objective is to survive while defeating all five enemies with the one getting the most wins. Enemies to defeat are Spinies, Sidesteppers, and Fighter Flies, but defeating a Fireball does not count. Players can also indirectly kill each other by forcing the rival to collide with an enemy to gain victory. Players can also steal goal cards from each other by bumping from below, stomping, or using the POW Block. If a brother gets his third card, then he is instantly awarded extra lives in the main game equal to their combination. However, if a loose card is not grabbed before a round ends, it is lost. Any deaths incurred in the Battle Mode will not affect the player’s lives in the main game.
Every fourth match is a bonus stage of which there are three types. The first bonus stage is to simply grab at least three of the five coins. The second is a stage that has a vertical pipe that shoots out Fireballs and coins. The player that collects at least three coins or survives wins. The final bonus stage has the players climbing ladders to retrieve coins under boxes, some of which are empty. All five coins must be collected with the winner being the one who obtained the most.
Super Mario All-Stars also includes a different Battle Game in the main menu for Super Mario Bros. 3.
Development for Super Mario Bros. 3 began shortly after Super Mario Bros.: The Lost Levels was finished in the Spring of 1986. Originally, the game was developed with a bird’s-eye view in mind, similar to The Legend of Zelda, where the player would be looking down at the characters from above. With jumping as one of Mario’s main moves, this overhead view made it difficult to determine whether Mario was touching the ground or not, so the view was switched to the side-view used in earlier titles. However, relics of the overhead view can still be found in the final game, such as the black-and-white checkerboard seen at the title screen.
When Takashi Tezuka was designing concepts for the game, he didn’t want it to be like Super Mario Bros.: The Lost Levels where only the levels and difficulty was changed. Instead, he wanted to rework everything, from giving Mario an improved moveset to overhauling the character sprites. Programmers also had what they called a “Map Room”, which was a long, narrow meeting room where they looked at sheet papers and programmed map data all day. There were 20 to 30 people working on Super Mario Bros. 3, compared to Super Mario Bros.‘s seven or eight. However, Koji Kondo was completely alone on sound design, and he claims it was difficult to come up with music to fit the genre of the game. Additional sounds were possible to use during Super Mario Bros. 3‘s development which weren’t able to be used during Super Mario Bros. ‘s. The Japanese version of the game was originally planned to release in Spring of 1988, but because of the developers wanting to add so many new features, the game ended up getting pushed back another six months.
The hard part of creating a video game with old characters is making the old characters seem fresh and new. In many ways, Super Mario Bros. 3 revived the series and brought many new young and old fans back to the adventures of the Mario Bros. The game was first shown in North America in the 1989 movie The Wizard as a way to advertise it; this also marked the first time that a Mario game was advertised in a movie.
Remakes and ports
Super Mario Bros. 3 was later remade and included in Super Mario All-Stars, with updated graphics and sound for the Super Nintendo Entertainment System, and with further minor upgrades in the re-issue, Super Mario All-Stars + Super Mario World, and the game’s eventual port to the Wii as Super Mario All-Stars Limited Edition. A notable addition to the All-Stars version of Super Mario Bros. 3 was a save feature which allow players to save the progress and continue the world where they left off. Additionally, there’s a Battle Game feature in the title screen that works differently from the ones featured from the maps in the 2-Player Game Mode. Other than that, retaining some localization changes and certain glitches fixed, gameplay was not altered.
The original game is also one of the 30 titles included in the NES Classic Edition and Nintendo Classic Mini: Family Computer, and was made available as one of the 20 NES titles with added online play at the Nintendo Switch Online subscription service’s launch in September 2018.Super Mario Advance 4: Super Mario Bros. 3
Super Mario Bros. 3 was ported to the Game Boy Advance handheld system as the fourth and final installation in the Super Mario Advance series, Super Mario Advance 4: Super Mario Bros. 3. It used the same graphics and sounds as the Super Mario All-Stars version, and also incorporated the use of the e-Reader: by scanning in certain cards, players could unlock new items and levels, including content originally from the other classic Mario platformers.
The game has received critical acclaim and is considered to be one of the greatest games of all time. IGN placed it at the number one spot of their top 100 NES games of all time list.
Among the merchandise based on the game are a Nelsonic Game Watch, and chocolate chip swirl cookies manufactured by Salerno, which features a maze on the box. 
id Software’s attempted PC port
PC developer id Software sent to Nintendo a demo of a PC port of the game, with the intent being to gain authorization to make an official port. The demo reached the Nintendo of Japan management (including Shigeru Miyamoto), who were impressed by the port’s quality. However, Nintendo declined to greenlight an official PC version of the game as the company had no plan to release its products outside their own platform.
The pitch followed a tech demo named Dangerous Dave in “Copyright Infringement”, which was a playable recreation of World 1-1 with Mario’s sprite being replaced with that of the titular character. Dangerous Dave was notable for featuring smooth scrolling, something unheard for PC games of the time. With a distribution deal with Scott Miller of Apogee Software, Ltd., “Copyright Infringement” id developers John Romero and John Carmack along with Tom Hall (who originally had the idea) later used the engine they had developed to create the Commander Keen series, a series of shareware platform games for MS-DOS.
On December 14, 2015, John Romero uploaded gameplay footage of the port on the video-sharing website Vimeo.
References to other games
References in later games
There are four known versions of Super Mario Bros. 3 released for Family Computer and Nintendo Entertainment System: the original Japanese version, the North American PRG0 and PRG1 versions (NES cartridges will display
Level design changes
PAL version changes
Pre-release and unused content
One of the early ideas was a power-up to turn Mario into a Centaur (half-man, half-horse), although this was rejected before being implemented into the game. (Tilden 1990, 21)
Additionally, Cheep-Cheeps and Para-Beetles respectively have unused tan and green variations, which would have moved faster than their ordinary counterparts.
Names in other languages
External linksSuper Mario Bros. 3 coverage on other NIWA wikis:
Wizard – Stardew Valley Wiki
|“||“Wizard studies the spirit world from his tower in cindersap forest. He is fluent in many elemental languages.”|
|— Steam Description|
The Wizard, also known as M. Rasmodius, is a villager who lives in the Wizard’s Tower to the far west of Cindersap Forest.
The Wizard does not leave the Wizard’s Tower (except for festivals), and can be found there when the tower is accessible (6am to 11pm). After the player has unlocked the Witch’s Hut, he can be found in his tower after 11pm by using the warp spot in the Witch’s Hut.
- Main article: Friendship
- See also: List of All Gifts
You can give the Wizard up to two gifts per week (plus one on
birthday), which will raise or lower
friendship with you. Gifts on
birthday (Winter 17) will have 8× effect and show a unique dialogue.
For loved or liked gifts, the Wizard will say
|“||“You remembered my birthday? I’m impressed. Thanks.”|
|“||“Oh, is it my birthday today? I guess it is. Thanks. This is nice.”|
For neutral gifts, the Wizard will say
|“||“For my birthday? Thanks.”|
For disliked or hated gifts, the Wizard will say
|“||“It’s my birthday and you give me this? Is this some kind of joke?”|
|“||“Ahh, this is imbued with potent arcane energies. It’s very useful for my studies. Thank you!”|
|“||“Many thanks. This item has some very interesting properties.”|
|“||“Thank you, this will prove useful, I think.”|
|“||“This?… I suppose I’ll cast it into the flames and see what happens.”|
*Note that Dinosaur Eggs are considered Artifacts and not Eggs for gifting purposes.
|“||“Ughh… These are utterly mundane. Please refrain from bothering me with this in the future.”|
At any friendship level greater than zero friendship points, you may receive a gift in the mail from the Wizard. The chance of receiving a gift in the mail increases as your friendship with the Wizard increases.
Players gain access to the basement of the Wizard’s Tower, where they can change their character’s appearance at The Shrine of Illusions for 500g.
Note: The Wizard is not always accessible at festivals. Regardless, he has unique dialogue for each.
Dance of the Moonlight Jellies
Stardew Valley Fair
Festival of Ice
Feast of the Winter Star
This page or section contains unmarked spoilers from update 1.5 of Stardew Valley. Mobile players may want to avoid or be cautious toward reading this article.
- “Meet the Wizard”: The morning after examining the golden scroll in the Crafts Room of the Community Center, the Wizard will send you a letter saying he has information for you. Visit the Wizard’s Tower and he will give you a potion that allows you to read the language of the Junimos.
- “A Dark Reagent”: The Wizard will send you a letter on the 12th of Winter requesting that you bring him a Void Essence. The reward is 1,000g and 1 Friendship heart.
- “Staff of Power”: The Wizard will send you a letter on the 5th of Winter, year 2, requesting that you bring him an Iridium Bar. The reward is 5,000g and 1 Friendship heart.
- “Dark Talisman”: After completing the Community Center Bundles or the Joja Community Development Form, trigger a cutscene at the Railroad, where the Wizard will request that you find a Dark Talisman. Speak to Krobus in The Sewers, who will remove the force-field blocking the entrance to the Mutant Bug Lair. Obtain the Dark Talisman from a chest in the Mutant Bug Lair, then bring it back to the Railroad area and place it on the artifact blocking the cave. Inside the cave is a teleportation rune which leads to the Witch’s Swamp. This unlocks The “Goblin Problem” Quest.
- “Goblin Problem”: Once inside the Witch’s Swamp, the Witch’s Henchman will be blocking the way to the Witch’s Hut. He will only allow the player to pass if he is given Void Mayonnaise, which completes the quest Goblin Problem and gives access to the Dark Shrines inside the Witch’s Hut. Recover the Magic Ink inside the Witch’s Hut, then bring the ink back to the Wizard, who will unlock four Wizard buildings for The Farm.
- The Wizard may request that you slay a certain number of Monsters or bring him a random item at the “Help Wanted” board outside Pierre’s General Store. The reward for slaying monsters varies by the number/type of monster, but is always an amount of gold. The reward for an item delivery quest is 3x the item’s base value and 150 Friendship points.
- The Wizard is to be gifted the Arctic Shard in The Pirate’s Wife quest.
- “A Curious Substance”: On or after the 1st of Fall, The Wizard may randomly request you to give him 1 Ectoplasm on the Special Orders board. Ectoplasm can be found after killing Ghosts in the mines. Successfully completing the quest will reward you with 2,500g and the Mini-Obelisk Recipe.
- “Prismatic Jelly”: On or after the 1st of Fall, The Wizard may randomly request you to give him 1 Prismatic Jelly on the Special Orders board. Prismatic Jelly can be found after killing Prismatic Slimes in the mines. Successfully completing the quest will reward you with 5,000g and the Monster Musk Recipe.
- Because the door to his house is locked at the start of the game, the Wizard does not count towards the introductions quest.
- Introduction to the Wizard normally occurs at his invitation to see him about the Junimos, a part of the preparation for unlocking the Community Center bundles. When you see him at that time, you must play through the entire cutscene. If you do not, the game does not record that you have met him. Although the bundles are still unlocked, friendship and communications with him will not occur until you go to him another time to record the meeting.
- The Wizard’s Tower is unlocked upon purchasing a Joja membership. After that, the player must speak with him at any time (including during Festivals) to commence friendship.
- Despite being unreachable in most festivals, the Wizard has unique dialogue for every festival, some with backstory on the events.
- The Wizard mentions being married for years until he “made a mistake that drove her (his wife) away”. The mistake is not specified, but it was enough to turn her “green” out of anger and envy, presumably explaining how she became a witch.
- The Wizard suspects that one of the villagers is his daughter, asking you not to tell anyone. Dialogues with Caroline, Pierre, and Abigail heavily imply that this refers to Abigail herself. There is also some minor evidence that it could be Emily, based on dialogue with Haley, her hair color, and her interest in the spiritual side of the occult.
- 1.3: Added unique blue stationery used exclusively for letters from the Wizard.
WARRIOR EVO WARP MINI LACROSSE STICK
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Compare Samsung Galaxy S5 Mini vs ZTE Warp 4G: Price, Specs, Review
|performance||Quad core||Dual core||–||–|
|display||4.5″ (11.43 cm)||4.5″ (11.43 cm)||–||–|
|storage||16 GB||8 GB||–||–|
|camera||8 MP||8 MP||–||–|
|battery||2100 mAh||2070 mAh||–||–|
|ram||1.5 GB||1 GB||–||–|
special features (2)
|other sensors||Light sensor, Proximity sensor, Accelerometer, Compass, Gyroscope||Proximity sensor, Accelerometer||–||–|
|also known as||Samsung Galaxy S5 Mini Duos , Samsung Galaxy S5 Mini SM-G800H||–||–||–|
|operating system||Android v4.4.2 (KitKat)||Android v4.1 (Jelly Bean)||–||–|
|sim slots||Dual SIM, GSM+GSM||Single SIM, CDMA||–||–|
|model||Galaxy S5 Mini||Warp 4G||–||–|
|custom ui||TouchWiz UI||–||–||–|
|sim size||SIM1: Micro||–||–||–|
|network||4G: Available (doesn’t support Indian bands) 3G: Available, 2G: Available||–||–||–|
|audio jack||3.5 mm||3.5 mm||–||–|
|chipset||Exynos 3 Quad 3470||Qualcomm Snapdragon S4 Plus MSM8930||–||–|
|graphics||Mali-400 MP4||Adreno 305||–||–|
|processor||Quad core, 1.4 GHz, Cortex A7||Dual core, 1.2 GHz||–||–|
|ram||1.5 GB||1 GB||–||–|
|thickness||9.1 mm||10.4 mm||–||–|
|width||64.8 mm||66 mm||–||–|
|weight||120 grams||127.6 grams||–||–|
|waterproof||Yes Water resistant, IP67||–||–||–|
|height||131.1 mm||132.1 mm||–||–|
|colours||Black, Blue, White, Gold||Black||–||–|
|display type||Super AMOLED||IPS LCD||–||–|
|pixel density||326 ppi||326 ppi||–||–|
|screen protection||Corning Gorilla Glass v3||–||–||–|
|screen to body ratio calculated||65.67 %||–||–||–|
|screen size||4.5 inches (11.43 cm)||4.5 inches (11.43 cm)||–||–|
|screen resolution||HD (720 x 1280 pixels)||HD (720 x 1280 pixels)||–||–|
|touch screen||Yes Capacitive Touchscreen, Multi-touch||Yes Capacitive Touchscreen, Multi-touch||–||–|
|internal memory||16 GB||8 GB||–||–|
|expandable memory||Yes Up to 64 GB||Yes Up to 64 GB||–||–|
|camera features||Digital Zoom, Auto Flash, Face detection, Touch to focus||Digital Zoom, Face detection, Touch to focus||–||–|
|image resolution||3264 x 2448 Pixels||3264 x 2448 Pixels||–||–|
|sensor||Exmor-R CMOS image sensor||–||–||–|
|shooting modes||High Dynamic Range mode (HDR)||High Dynamic Range mode (HDR)||–||–|
|resolution||2.1 MP Front Camera||1 MP Front Camera||–||–|
|flash||Yes LED Flash||Yes LED Flash||–||–|
|video recording||1920×1080 @ 30 fps||1280×720 fps||–||–|
|talktime||Up to 16 Hours(3G)||–||–||–|
|capacity||2100 mAh||2070 mAh||–||–|
network connectivity (10)
|wifi||Yes Wi-Fi 802.11, a/b/g/n/n 5GHz||Yes Wi-Fi 802.11, b/g/n||–||–|
|wifi features||Wi-Fi Direct, Mobile Hotspot||Mobile Hotspot||–||–|
|bluetooth||Yes v4.0||Yes v4.0||–||–|
|usb connectivity||USB 2.0, microUSB 2.0||microUSB 2.0||–||–|
|network support||4G (doesn’t support Indian bands), 3G, 2G||–||–||–|
|gps||Yes with A-GPS, Glonass||Yes with A-GPS||–||–|
|sim 1||4G Bands:FD-LTE 2100(band 1) / 1800(band 3) / 2600(band 7) / 900(band 8) / 850(band 5) / 800(band 20)3G Bands: UMTS 1900 / 2100 / 850 / 900 MHz2G Bands: GSM 1800 / 1900 / 850 / 900 MHz 4G Speed: 50 Mbit/s ? 150 Mbit/s ? (LTE category 4)3G Speed: HSDPA 21 Mbit/s ?, HSUPA 5.76 Mbit/s ?GPRS:Available EDGE:Available||2G Bands: CDMA 1900 / 2000 / 800 MHz||–||–|
|sim size||SIM1: Micro||–||–||–|
|sim 2||2G Bands: GSM 1800 / 1900 / 850 / 900 MHz||–||–||–|
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Moth Gray Dashed Pointelle Pullover Wool Sweater
Anthropologie Farm Rio Metallic Pleated Gold Skirt
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Elizabeth & James Denissa Cut-out One-shoulder Top
Vantel Pearl Pink Seahorse Pearl Stretch Bracelet
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Women’s Stainless Steel Geometric Color 8oz Flask
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Thakoon Black & White Multi Open Back Mini Dress
Cabi The Poet Gold Denim Brocade Boho Jean Jacket
Vince Ladder Stitch Drape V-Neck Silk Blend Blouse
Tieks Metallic Bronze Ballet Flats
Adidas Purple Purglo 3 Stripe Tee Mini Dress
Sparrow Striped Knit Long Cozy Cardigan Sweater
Rag & Bone Canyon Wash Blue Distressed Capri Jeans
Eliza J Grandiflora Pink Floral Print Swing Dress
Eliza J Grandiflora Pink Floral Print Swing Dress
Patagonia 19″ Minimalist Wavefarer Board Shorts
Madewell Seamed Step Hem 9″ High Rise Skinny Jeans
Tracy Reese x Anthropologie Catamaran Striped Top
Free People Turquoise Softly Structured Knit Tunic
L’Agence Beetle Roxy Paperbag Silk Cargo Pants
Blank NYC Still Water Crop Girlfriend Cut Jeans
Koral Black & Black & Bisque Curve Crop Leggings
Louise Et Cie Lo-Caden Fringe Brown Strap Sandals
Tory Burch Blue Silk Sylvie Tunic Tassel Top
Helmut Lang Noa White Pony Lapel Suiting Blazer
Frame LE HIGH SKINNY DOUBLE RAW ANKLE Jeans
Barefoot Dreams Black Lite® Calypso Wrap Cardigan
Madewell Night Sparkle Mock Neck Sweater Dress
Madewell Black & White Stripe Short Sleeve Sweater
Free People Dark Indigo Denim Babydoll Tie Dress
Alo Deep Electric Blue Illusion 4 Yoga Leggings
Rails Plaid Marina & Flamingo Hunter Button Top
Yosi Samra Metallic Silver Pewter Samara II Flats
Athleta Black Power Kick Capri Crop Leggings
Free People Cheetah Print Crop Cutoff Denim Jacket
B Brain Atwood Fontanne Sugar Glitter Suede Heels
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FRAME Navy Multi Backstage Stripe Trousers Pants
Frame Expose Zipper Le Crop Bell Flare Black Jeans
Donald J Pliner Coley Crisscross Slip on Sneakers
Chalk the Label Sweet Nothings Lace Button Bomber
Parts & Accessories LUMITEC Sea Blaze mini/White 01245 6>>FREE>>> WARP SPEED>>>> SHIPPING>>>>> Boat Parts
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Aspects of minimally invasive surgery for static deformities of the forefootAbstract:
The review is devoted to various approaches to the possibilities of minimally invasive surgery in the treatment of static deformities of the forefoot. The basis for minimally invasive correction of static deformities of the forefoot is formed by methodological approaches aimed at the implementation of non-fixable wedge-shaped osteotomy of the first metatarsal bone and the main phalanx of the big toe while preserving the cortical layer opposite to the base of the wedge, as well as the central metatarsal bones, which lengthen the extensor thenotomies without overlapping tendon suture, which ensures the correct orientation of the metatarsal heads from an orthopedic point of view under the influence of early full physical exertion on the foot and prevents excessive movement of the tendon ends.
1 Ezhov M.Yu. Foot: Degenerative-dystrophic diseases of the foot and ankle joint. N. Novgorod, 2011; 336 s.
2 Kardanov A.A., Makinyan L.G., Lukin M.P. Surgical treatment of deformities of the first ray of the foot: history and modern aspects. M., 2008 104 p.
3 Zagorodny H.B. Chevron osteotomy and osteotomy “SCARF” in the treatment of hallux valgus of the first toes. In Sat: VIII Congress of Orthopedic Traumatologists of Russia: abstracts. report Samara, 2006; from.186-7
4 Minasov B.Sh., Gutov S.P., Bilyalov A.R. and other Diagnostics of degenerative-dystrophic diseases of the foot. Ufa, 2005; 56 s.
5 Kotelnikov G.P., Chernov A.P., Losev I.I. etc. Our method of surgical treatment of hallux valgus of the first toe. Traumatology and Orthopedics of Russia 2008; 2 (appendix): 120
6 Minasov B. 111., Gutov S. P., Bilyalov A. R. et al. Surgical treatment of degenerative-dystrophic diseases of the feet. Ufa, 2005; 84 s. 90 175 7 BaroukLS. Forefoot reconstruction.Paris: Springer Verlag, 2002; p. 359-64 90 175 8 Maffulli N, Easley M, eds. Minimally Invasive Surgery of the Foot and Ankle. Springer Verlag London Limited, 2011; 470 p. 90 175 9 Robinson AH. Limbers JP Modern concepts in the treatment of hallux valgus. Bone Joint Surg Br 2005; 87: 1038-45
10 Imams A.M. Minimally invasive surgical and restorative treatment of forefoot deformities: author. dis. … Cand. honey. sciences. Saratov, 2016; 25 s. 90 175 11 Imamov A. M., Kireev S. I., Kireev V.S. et al. Minimally invasive surgical correction of static foot deformities. In collection: Classics and innovations in traumatology and orthopedics: collection of materials of the All-Russian scientific-practical conference dedicated to the 75th anniversary of Professor A.P. Barabash, 2016; from. 157-9
12 Imams A.M., Emkuzhev O.L., Kireev B.C. and other Navigational technology of distal subcutaneous osteotomy of the metatarsal bones. In collection: The contribution of young scientists to the development of traumatology, orthopedics and neurosurgery: Scientific and practical conference of young scientists dedicated to the 75th anniversary of Professor V.G. Ninel, 2014; from. 45-7 90 175 13 De Prado M, Ripoll PL, Vaquero J, et al. Tratamiento quirurgico per cutaneo del hallux mediante osteotomies multiples. Rev Orthop Traumatol 2003; 47: 406-16
14 Berezhnoy S. Yu., Afanasyev DS Percutaneous osteotomy of the central metatarsal bones in the treatment of static metatarsalgia. Astrakhan Medical Journal 2010; 5 (4): 83-6
15 Taj AA, Protsko VG, Cherevtsov VN et al. Comparison of the results of Helal and Weil osteotomy for the treatment of metatarsalgia in secondary dislocation in the metatarsophalangeal joints 2,3 and 4 metatarsal bones.Diary of Kazan Medical School 2017; 3 (17): 54-61
16 Khrennikov Ya. B., Pavlov VP Complex treatment of forefoot deformities in patients with rheumatoid arthritis using reconstructive and joint-saving operations. Scientific practical rheumatology 2011; (3): 82-5
17 Kopysova V.A., Kaplun V.A., Gorodilov V.Z. and other Reconstructive surgery for static deformity of the foot. Bulletin of Traumatology and Orthopedics. N.N. Priorova 2010; (2): 66-9
18 Yu.A., Al D., Oslanova A.G. Biomechanical studies in patients with foot deformities. Modern problems of science and education 2014; (2): 308
19 Rasputin D.A. Peculiarities of treatment of diseases of the forefoot in patients of the older age group. In collection: Clinical and fundamental aspects of gerontology / ed. G. P. Kotelnikova, S. V. Bulgakova. Samara: Samar. state honey. un-t, 2017; from. 386-9.
Classification of Haglund’s syndrome (deformity) | Sereda
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3.Sella E.J., Caminear D.S., Mclarney E.A. Haglund’s syndrome. J Foot Ankle Surg. 1998; 37 (2): 110-114.
4. Lohrer H., Nauck T., Dorn N.V., Konerding M. A Comparison of endoscopic and open resection for Haglund tuberosity in a cadaver study. Foot Ankle Int. 2006; 27 (6): 445-450. DOI: 10.1177 / 107110070602700610.
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7. Madarevic T., Rakovac I., Ruzic L., Tudor A., Gudac Madarevic D., Prpic T., Sestan B. Ultrasound-assisted calcaneoplasty.Knee Surg Sports Traumatol Arthrosc. 2014; 22 (9): 2250-2253. DOI: 10.1007 / s00167-013-2692-8.
8. Ortmann F.W., Mcbryde A.M. Endoscopic bony and soft-tissue decompression of the retrocalcaneal space for the treatment of Haglund deformity and retrocalcaneal bursitis. Foot Ankle Int. 2007; 28 (2): 149-153. DOI: 10.3113 / faI.2007.0149.
9.Kang S., Thordarson D.B., Charlton T.P. Insertional achilles tendinitis and Haglund’s deformity. Foot Ankle Int. 2012; 33 (6): 487-491. DOI: 10.3113 / faI.2012.0487.
10. van Dijk C.N., Van Sterkenburg M.N., Wiegerinck J.I., Karlsson J., Maffulli N. Terminology for achilles tendon related disorders. Knee Surg Sports Traumatol Arthrosc. 2011; 19 (5): 835-841. DOI: 10.1007 / s00167-010-1374-z.
11.Efimenko N.A., Gritsyuk A.A., Sereda A.P. Diagnosis of ruptures of the Achilles tendon. Clinical medicine. 2011; 89 (3): 64-70.
12. Sereda A.P., Moisov A.A., Smetanin S.M. Plantar fasciitis: diagnosis and treatment. Siberian Medical Journal (Irkutsk). 2016; 143 (4): 5-9.
13. Tuchkov V.E., Suzdaleva I.A., Kuznetsova O.V., Samoilov A.S., Sereda A.P. Kinesiological taping in medical practice. M .: FMBC im. A.I.Burnazyan, 2017.80 p.
14. Sammarco G.J., Taylor A.L. Operative management of Haglund’s deformity in the nonathlete: a retrospective study. Foot Ankle Int. 1998; 19 (11): 724-729. DOI: 10.1177 / 1071100798012.
15. Qi J., Gong L., Liu J., Li Y., Li Q. [Endoscopic calcaneoplasty for Haglund’s deformity with hindfoot pain]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016; 30 (6): 700-704. DOI: 10.7507 / 1002-1892.20160142. (In Chinese).
16. Mattila V.M., Sillanpää P.J., Salo T., Laine H.J., Mäenpää H., Pihlajamäki H. Can orthotic insoles prevent lower limb overuse injuries? a randomized-controlled trial of 228 subjects. Scand J Med Sci Sports. 2011; 21 (6): 804-808.DOI: 10.1111 / j.1600-0838.2010.01116.x.
17. Aliyev R., Muslimov Q., Geiger G. Results of conservative treatment of achillodynia with application microcurrent therapy. Georgian Med News. 2010; (187): 35-42.
18. Kardanov A.A., Boiley N.M., Rusanova V.V., Nepomyashchiy I.S. Results of surgical treatment of Haglund’s disease. Traumatology and Orthopedics of Russia.2013; (1): 67-71. DOI: 10.21823 / 2311-2905-2013-1-67-71.
19. Anderson J.A., Suero E., O’Loughlin P.F., Kennedy J.G. Surgery for retrocalcaneal bursitis: a tendon-splitting versus a lateral approach. Clin Orthop Relat Res. 2008; 466 (7): 1678-1682. DOI: 10.1007 / s11999-008-0281-9.
20. Angermann P. Chronic retrocalcaneal bursitis treated by resection of the calcaneus.Foot Ankle. 1990; 10 (5): 285-287.
21. Brunner J., Anderson J., O’Malley M., Bohne W., Deland J., Kennedy J. Physician and patient based outcomes following surgical resection of Haglund’s deformity. Acta Orthop Belg. 2005; 71 (6): 718-723.
22. Chen C.H., Huang P.J., Chen T.V., Cheng Y.M., Lin S.Y., Chiang H.C. et al. Surgical treatment for Haglund’s deformity.Kaohsiung J Med Sci. 2001; 17 (8): 419-422.
23. Biyani A., Jones D.A. Results of excision of calcaneal prominence. Acta Orthop Belg. 1993; 59 (1): 45-49.
24. Lehto M.U., Jarvinen M., Suominen P. Chronic achilles peritendinitis and retrocalcanear bursitis. Knee Surg Sports Traumatol Arthrosc. 1994; 2 (3): 182-185.
25.Leitze Z., Sella E.J., Aversa J.M. Endoscopic decompression of the retrocalcaneal space. J Bone Joint Surg Am. 2003; 85 (8): 1488-1496. DOI: 10.2106 / 00004623-200308000-00009.
26. Nesse E., Finsen V. Poor results after resection for Haglund’s heel. analysis of 35 heels in 23 patients after 3 years. Acta Orthop Scand. 1994; 65 (1): 107-109.90 170 27.Pauker M., Katz K., Yosipovitch Z. Calcaneal ostectomy for Haglund disease. J Foot Surg. 1992; 31 (6): 588-589.
28. Schepsis A.A., Wagner C., Leach R.E. Surgical management of achilles tendon overuse injuries. A long-term follow-up study. Am J Sports Med. 1994; 22 (5): 611-619. DOI: 10.1177 / 036354659402200508.
29. Schneider W., Niehus W., Knahr K. Haglund’s syndrome: disappointing results following surgery: A clinical and radiographic analysis. Foot Ankle Int. 2000; 21 (1): 26-30. DOI: 10.1177 / 107110070002100105.
30. Natarajan S., Narayanan V.L. Haglund Deformity – Surgical Resection by the lateral approach. Malays Orthop J. 2015; 9 (1): 1-3. DOI: 10.5704 / Moj.1503.006.
31.Jiang Y., Li Y., Tao T., Li W., Zhang K., Gui J., Ma Y. The doublerow suture technique: a better option for the treatment of haglund syndrome. Biomed Res Int. 2016; 2016: 1895948. DOI: 10.1155 / 2016/1895948.
32. Ahn J.H., Ahn C.Y., Byun C.H., Kim Y.C. Operative treatment of haglund syndrome with central achilles tendon-splitting approach. J Foot Ankle Surg. 2015; 54 (6): 1053-1056. DOI: 10.1053 / j.jfas.2015.05.002.
33.Vega J., Baduell A., Malagelada F., Allmendinger J., Dalmau-Pastor M. Endoscopic achilles tendon augmentation with suture anchors after calcaneal exostectomy in haglund syndrome. Foot Ankle Int. 2018; 39 (5): 551-559. DOI: 10.1177 / 1071100717750888.90 170 34. Lin C., Ma L., Chen W., Tao X., Yuan C.S., Zhou B.H., Tang K.L. [Acomparative study of the calcaneal closingwedge calcaneal osteotomy versus posterior-superior prominence removal in both sides with Haglund syndrome].Zhonghua Yi Xue Za Zhi. 2017 19; 97 (35): 2733-2736. DOI: 10.3760 / cma.j.issn.0376-2491.2017.35.004. (In Chinese).
35. Jardé O., Quenot P., Trinquier-Lautard J.L., Tran-Van F., Vives P. [Haglund disease treated by simple resection of calcaneus tuberosity. an angular and therapeutic study. apropos of 74 cases with 2 years follow-up]. Rev Chir Orthop Reparatrice Appar Mot. 1997; 83 (6): 566-573. (In French).90 170 36.Jerosch J., Schunck J., Sokkar S.H. Endoscopic calcaneoplasty (ecP) as a surgical treatment of Haglund’s syndrome. Knee Surg Sports Traumatol Arthrosc. 2007; 15 (7): 927-934. DOI: 10.1007 / s00167-006-0279-3.
37. Morag G., Maman E., Arbel R. Endoscopic treatment of hind-foot pathology. Arthroscopy. 2003; 19 (2): e13. DOI: 10.1053 / jars.2003.50063.90 170 38.Scholten P.E., Van Dijk C.N. Endoscopic calcaneoplasty. Foot Ankle Clin. 2006; 11 (2): 439-446, viii. DOI: 10.1016 / j.fcl.2006.02.004. 90 170 39. van Sterkenburg M.N. Achilles tendinopathy: new insights in cause of pain, diagnosis and management [Dissertation]. amsterdam: faculty of Medicine universiteit van amsterdam, 2012.239 p. ISBN 978-94-6169-210-8. 90 170 40.van Dijk C.N., Van Dyk G.E., Scholten P.E., Kort N.P. Endoscopic calcaneoplasty. Am J Sports Med. 2001; 29 (2): 185-189. DOI: 10.1177 / 036354650102
41. Wu Z., Hua Y., Li Y., Chen S. Endoscopic treatment of Haglund’s syndrome with a three portal technique. Int Orthop. 2012; 36 (8): 1623-1627. DOI: 10.1007 / s00264-012-1518-5.90 170 42.Syed T.A., Perera A. Aproposed staging classification for minimally invasive management of haglund’s syndrome with percutaneous and endoscopic surgery. Foot Ankle Clin. 2016; 21 (3): 641-664. DOI: 10.1016 / j.fcl.2016.04.004.
43. Zadek I. An operation for the cure of achillobursitis. Am J Surg. 1939; 43: 542-546.90 170 44. Hunt K.J., Cohen B.E., Davis W.H., Anderson R.B., Jones C.P. Surgical treatment of insertional achilles tendinopathy with or without flexor hallucis longus tendon transfer: a prospective, randomized study. Foot Ankle Int. 2015; 36 (9): 998-1005. DOI: 10.1177 / 1071100715586182.
45. Wagner E., Gould J.S., Kneidel M., Fleisig G.S., Fowler R. Technique and results of achilles tendon detachment and reconstruction for insertional achilles tendinosis.Foot Ankle Int. 2006; 27 (9): 677-684.90 170 46. Fowler A., Philip J. F. Abnormality of the calcaneus as a cause of painful heel its diagnosis and operative treatment. Br J Surg. 1945; 32 (128): 494-498. 90 170 47. Fuglsang F., Torup D. Bursitis retrocalcanearis. Acta Orthop Scand. 1961; 30: 315-323. 90 170 48.Heneghan M.A., Pavlov H. The Haglund painful heel syndrome. Experimental investigation of cause and therapeutic implications. Clin Orthop Relat Res. 1984; (187): 228-234. 90 170 49. Vega M.R., Cavolo D.J., Green R.M., Cohen R.S. Haglund’s deformity. J Am Podiatry Assoc. 1984; 74 (3): 129-135. DOI: 10.7547 / 87507315-74-3-129. 90 170 50. Steffensen J.C. A., Evensen A. Bursitis retrocalcanea achilli. Acta Orthop Scand. 1958; 27 (3): 229-236.
51. Chauveaux D., Liet P., Le Huec J.C., Midy D. A new radiologic measurement for the diagnosis of Haglund’s deformity. Surg Radiol Anat. 1991; 13 (1): 39-44.
52. Tourné Y., Baray A.L., Barthélémy R., Moroney P. Contribution of a new radiologic calcaneal measurement to the treatment decision tree in Haglund syndrome.Orthop Traumatol Surg Res. 2018; 104 (8): 1215-1219. DOI: 10.1016 / j.otsr.2018.08.014.90 170 53. Dickinson P.H., Coutts M.B., Woodward E.P., Handler D. Tendo achillis bursitis. Report of twenty-one cases. J Bone Joint Surg Am. 1966; 48 (1): 77-81.
54. Efimenko N.A., Sereda A.P., Zelensky A.A. Antibiotic prophylaxis in surgery. Infections in surgery.2007; 5 (4): 14.
55. Efimenko N.A., Gitsyuk A.A., Sereda A.P. Antibiotic prophylaxis in traumatology and orthopedics. Infections in surgery. 2008; 6 (2): 9.
56. Sereda A.P., Anisimov E.A. Infectious complications after surgical treatment of sports injuries of the Achilles tendon. Emergency medicine. 2015; (4): 90-97.
An innovative method of gentle foot deformity surgery: mini TightRope
And the first ones again!
The Clinic on Komarova has started to use an innovative method of sparing foot deformity surgery: mini TightRope.
Hallux valgus is a disease in which the metatarsophalangeal joint of the first toe is bent and the rest of the fingers are deformed. The problem of various deformities of the foot worries a lot of people, but most often they are women from 30 years of age and older. The most common deformity of the first toe is when the so-called “bumps” or “bones” develop on the foot.
Evgeniy Ivanovich BELOUSOV, traumatologist-orthopedist:
– Various deformities of the foot – a consequence of transverse and longitudinal flat feet.The reason for which, in turn, can be: heredity, hormonal changes, excess weight, systemic diseases of the connective tissue, osteoporosis. Improperly fitted shoes, including high heels and narrow toes, contribute to the progression of foot deformity.
Hallux valgus symptoms:
- Deviation of the big toe outward, gradual increase in the “bone”.
- Hammer-like deformity of the remaining toes.
- Rapid fatigue of the legs.
- Difficulties with the selection of shoes.
– Evgeny Ivanovich, is it possible to cure the deformity of the foot, get rid of the bones and other changes?
– I must say right away that it is impossible to correct the deformation of the bone using conservative methods. As for the surgical treatment of Hallux valgus, there are quite a few techniques. And since there are so many of them, it means that there is no ideal method, the best one for most patients.Those osteotomies that are performed today on the first metatarsal bone are quite traumatic. Often they cause complications, especially in the elderly, smokers, in patients with any vascular disorders. Nevertheless, we have performed such operations and are performing them according to indications, since in some cases the deformity of the foot can progress and lead to complications.
– But a new method of low-traumatic surgical treatment has appeared?
– Yes, the mini TightRope method eliminates all these problems.The operation is easy, minimally invasive, there are no complications, as with other techniques. It is easily tolerated by all patients and there is no age limit for it. In fact, the method is not so innovative, in Europe and America it has been used for a long time, in Moscow, St. Petersburg, too, for several years. It is an absolute innovation for the Far East, Vladivostok. We perform operations on hallux valgus using the mini TightRope method on the basis of the Clinic of Professional Cosmetology and Medicine.This technique consists in the use of special titanium plates (mini TightRope), which are inserted into the canal, attracted, fixed, correcting bone deformity. The very next day, the patient walks on his own, after about a month he begins to wear his usual shoes.
– Evgeny Ivanovich, this effect is temporary, can the “bumps” grow again?
– No, the foot can no longer deform in any way. The uniqueness of the method also lies in the fact that TightRope will securely and permanently fix it in the correct physiological state.
The iPhone case is bent, deformation, gaps. Replacing the housing
The body is the main supporting structure of the smartphone. It is to it that all external and internal parts are attached. On the iPhone, the case is often called a “frame”, since in fact only its edges are visible externally, although there is a metal plate with fasteners inside. In the event of falls, impacts and crushing – the geometry of the frame may be violated, resulting in gaps, dents, deformation.In this case, you will need to replace the iPhone case, which you can order in our Apple service “Yablochko” (Istra district, Pavlovskaya Sloboda).
IPhone Case Damage Signs
As we have already mentioned, mechanical damage is the main cause of case breakage. Although the material of the “frame” is quite strong and flexible, a strong impact can deform the metal. All damage can be divided into two categories: cosmetic (damage to the appearance without consequences for performance) and critical (breakage of fasteners, change in shape).Here are the main symptoms of the problem:
- Dents and deep scratches appeared on the visible parts of the case.
- The geometry was violated, gaps appeared, bulging of the display, rear window;
- Stuck buttons, deformation of the holes for the connectors.
- The body bent strongly, became convex, uneven.
Can the iPhone’s body be replaced?
Yes, there is such a possibility.But you need to understand that the work is quite difficult. It requires a complete disassembly of the phone, dismantling of all external and internal components and transferring them to a new “frame”. There are a lot of parts in the Apple device, including various screws, protective screens, cables, etc. Sometimes, when you try to replace the case yourself, some parts are lost or installed incorrectly. Therefore, to order such a service, it is better to contact our professional service center.
Installing a new case on all iPhone models in the Yablochko SCWe invite you to a free diagnosis in , our service .A qualified engineer will inspect the damage, check the internal equipment for hidden defects. After that, you can order a replacement iPhone case of the desired color. These components for various versions of smartphones are available, the work is carried out as quickly as possible, with a quality guarantee. We are waiting for you in our Apple workshop in Pavlovskaya Sloboda (Bessarabka shopping center, direction New Riga).
Is geotechnical monitoring of building deformation useful?
The other day I had to inspect the building built in 1946 – “Management of the Nizhne-Svirskaya HPP”.The building has undergone critical deformations of the foundation due to soil erosion. The reason for this was the connection of the sewage system and the leaky chasing of the seams in the well.
In the course of time, the slopes of the walls were, in absolute value, more than 10 cm and the height deformation of the foundation exceeded 20 cm. All this time, high-precision leveling was carried out using sedimentary marks deep into the building. Deformations were confirmed annually and increased, but no appropriate measures were taken to eliminate them.
Thus, we can conclude that not always knowing the problem allows you to avoid the consequences of this problem. At different periods of time, decisions were made to try to strengthen the foundation, to put buttresses on the falling wall. However, they did not dare to do elementary things – the slipping of the sandy base of the foundation was not prevented.
Our specialists suggested a way to solve the problem – centralizing the outflow of storm water (which was not the case before), i.e. storm water accumulated under one of the corners of the foundation (based on the high-altitude terrain) and went along with soil particles into the sewer, then into the cliff.In addition, we proposed to stamp the seams of the wells and change the relief in such a way that there would be a natural outflow of water from the building towards the road, and not vice versa.
Up to this point, several decades ago, they tried to strengthen the foundation, metal buttresses were exposed, which did not save one of the parts of the building from subsequent subsidence and further erosion of the sandy base of the foundation. I believe that this building can still be saved, but the picture seems to be sad.
The funny thing in this situation is that during the entire period of the building’s operation, high-precision leveling was carried out using metal deformation marks of both the canal foundation and the canal foundation of the Nizhne-Svirskaya HPP. Judging by the magazines, the measurement accuracy was 0.1mm in height. How could it be possible not to notice deformations in tens of centimeters, not to establish and prevent further deformations? Most likely, measurements were taken, magazines were written, but no one opened them or read them.Or none of the exploiters tried to sound the alarm.
Measures to prevent a critical situation began to be taken only after the appearance of open cracks, centimeter critical deformations and when it became visually visible that there were problems with the preservation of the building. I believe that monitoring, which is not always correctly performed with high accuracy, is able to prevent or keep from destruction of a building. Much also depends on the specialists who read the report, understand what is at stake and make engineering decisions until the moment when the situation becomes critical.
A similar reason was the critical deformation of the balconies, or simply the breakage of a slab at a new construction site in St. Petersburg (we will not give the address). Increasing the pace of construction and following a tight work schedule with geotechnical monitoring, nevertheless, all 16 floors of balconies on both sides of the building (32 balconies) were critically deformed (in other words, broken off).
The picture is as follows: the cantilever balconies according to the architecture of the building were laid in two rows with a continuous layer of brick 500 mm thick, then, a curtain facade.The brickwork started too early, no retaining posts were installed, and the monolithic floor slab had not yet gained sufficient strength. A month after the completion of the brickwork, the balconies began to tilt gradually and cracks formed separating the balcony from the main slab.
The slope of the front part of the wall on each floor was from 10 to 20 mm with the separation of the masonry from the main wall of the building so that a gap formed in the inner corners of the balconies. The monitoring on this building had to be increased in intensity – measurements were carried out 2-3 times a week.A number of design decisions were made to strengthen all the balconies, and work on the site was suspended for a month. After the installation of the reinforcing structures, tests are carried out with and without load to increase or decrease the height deformations.
The project has not yet been completed, but I believe that the result will be a successful test of the balconies and the successful operation of the building in the next period of time.
Thus, we can conclude that geotechnical monitoring is an extremely useful thing, both for buildings that have been in use for a long time, and for newly constructed ones.
How should geotechnical monitoring of building deformations be carried out?
It is very important to approach the issue not formally, but with an engineering understanding of the results of this monitoring. This allows you to take the necessary engineering and technical measures in a timely manner to eliminate problems with the operation of the building. At the same time, understanding the accuracy of measurements can fade into the background.
As a rule, engineering decisions begin to be made with significant deformations (more than 5 mm), which can be detected by class 4 engineering leveling (it is not necessary to use class 2 leveling).
It is fundamentally important not to miss the moment, and for this the density and frequency of measurements are increased, as well as timely analysis and data processing are carried out.
There is a wide variety of forms and methods for controlling the stability of XYZ coordinates of buildings:
- method based on trigonometric leveling;
- a method that allows you to remotely monitor the safety of buildings 24 hours a day;
- it is possible to install inclinometers to monitor the inclination of walls, etc.
About the Company
Our company has at its disposal robotic total stations and offers to conduct geotechnical monitoring, which ensures the accuracy of leveling marks close to the second class (with this, the accuracy of observing the mark will be 1-2mm in height). As a rule, it is enough to place up to 30 reflective deformation marks on one three-entrance building.
Craniostenosis in children
About the disease
Among the deformities of the skull, there are congenital and acquired.Congenital ones appear even during pregnancy, and the child is born with a certain developmental defect. Acquired ones occur after childbirth, most often as a result of trauma or certain intervention, such as surgery.
Craniostenosis in children can be either congenital or acquired after birth. This defect is an early fusion or absence of sutures in the bones of the skull, which normally must remain plastic for the natural growth and development of the child’s brain.As a result, intracranial pressure increases and the shape of the skull changes. When it comes to malformation, craniostenosis in newborns can be accompanied by other defects that affect the brain and other organs of the body. In the case of acquired disease, suture fusion occurs due to trauma or surgery.
Craniostenosis occurs in one in 1000 newborns.
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What causes the disease
Doctors are unanimous in their opinion: heredity does not affect premature fusion of the skull bones.And if the situation with an acquired disease is more or less clear, then the appearance of a congenital one with varying degrees of probability can be influenced by:
- congenital malformations of the fetus;
- difficulties in the formation of the embryo’s skull in the first 12 weeks of pregnancy;
- infections affecting the fetus in utero (herpes, rubella, toxoplasmosis and others).
What is the danger of craniostenosis
The absence of movable sutures in the skull severely restricts the brain.Therefore, the sooner help comes with craniostenosis, the higher the likelihood of a complete cure of the child in the future. Compensation mechanisms in infants under 2 years of age are very high, while rehabilitation after this age is more difficult and longer. If you do not undergo treatment in a timely manner, the disease can cause the following conditions:
If you do not undergo treatment in a timely manner, the disease can cause the following conditions:
- retardation of physical, mental, intellectual development;
- violation of normal brain functions;
- skeletal underdevelopment;
- compression and atrophy of the optic nerve up to complete loss of vision;
- ophthalmic diseases;
What is craniostenosis in children
First of all, it depends on whether the child has other developmental defects. Sometimes pathology accompanies various syndromes – then it is called syndromic. For example, it can occur simultaneously with the fusion of fingers or toes, a cleft palate or lip, or cerebral hernias.
If the fusion of the seams in the bones of the skull occurs without other developmental defects, it is considered non-syndromic, that is, independent.
Doctors classify the disease into types based on which cranial sutures are fused:
Synostosis – or fusion of sutures – can involve one to several sutures. There is a concept of pansynostosis – complete overgrowth of all seams. This type of pathology can be considered the most severe, it occurs less often than others.
How is craniostenosis treated in children
There is only one way to eliminate pathology – surgery. It is performed to restore the shape of the bones of the skull. After the bones return to their natural shape, they are held together with mini-screws or mini-plates, surgical wire, which are removed after a year. They are removed after a year. During the operation, doctors use a modern technologically advanced biodegradable material that does not need to be removed surgically – it gradually dissolves on its own, and its own bone tissue grows in its place.This greatly simplifies patient recovery.
Best results can be expected if the surgery is performed between 3-4 months and 2 years of age. Severe deformities of the skull can sometimes be noticed only after the bones have completed their formation, that is, at the age of 5–6 years. In such cases, the pathology manifests itself as severe headaches, blurred vision and increased intraocular pressure, increased fatigue and irritability.
If the disease occurs as a response to craniotomy or after trauma, the deformed area of the bone is removed, and an implant made of modern material – polymer, metal or ceramic – is placed in its place.