bluuebunny/crossref_metadata_2025 huggingface dataset:
Total Hip Arthroplasty with Tantalum Constructions
Authors: Murylev V Yu , Terent'ev Dmitriy Igorevich , Elizarov P M , Rukin Ya A , Kazaryan G M , Murylyov V Yu , Terent'ev D I , Elizarov P M , Rukin Ya A , Kazaryan G M
Published: October 2020

Results of acetabular reconstruction with tantalum constructions were analyzed for 56 patients (25 men and 31 women) aged 35 to 70 years. Primary arthroplasty was performed in 30 and revision intervention in 26 patients. In case of primary total hip arthroplasty the following etiologic factors were considered: posttraumatic acetabulum deformity (21 patients), deficit of acetabular walls resulted from dysplasia (4), femoral head protrusion (5). Evaluation of the defect and selection of tantalum construction were made using defect classification by W.G. Paprosky. Results were assessed by Harris scale at terms 3,6 and 12 months after operation and every year thereafter. Excellent, good and satisfactory results were achieved in 96.8% of cases. The most common complication was the dislocation of hip implant head. It developed in 2 patients after revision arthroplasty and in 1 patient after primary total hip arthroplasty.
Influence of Bone Morphogenetic Protein in Composition of Biocomposite Material upon Osteogenesis and Bone Mineralization
Authors: Mironov S P , Rodionova Svetlana Semenovna , Torgashin A N , Semenova L A , Mironov S P , Rodionova S S , Torgashin A N , Semenova L A
Published: October 2020

Influence of bone morphogenetic protein (BMP-2) in its local application in combination with demineralized lyophilized bone implant (DLBI) upon the process of osteogenesis and bone mineral density in the zone of surgical intervention and the whole segment (tibia) was studied in experiment (40 rats). The animals were divided into 2 groups. In animals from the study group the defect zone was filled with both DLBI and BMP-2 while in control group only with DLBI. In evaluation of morphologic changes by points at terms 7 and 12 weeks no reliable differences between the groups were noted. However at 12 weeks in study group cases of marked osteogenesis with full remodeling of bone implant were observed. It was shown that use of BMP-2 in combination with DLBI reliably increased bone mineral density both in the zone of surgical intervention and in the segment as a whole. That fact was regarded as the evidence of BMP-2 positive effect upon the mechanical strength of the forming regenerate.
Reconstructive Operations on Hip Joint in Children with Epiphyseal Dysplasias
Authors: Kamosko M M , Mel'chenko Evgeniy Viktorovich , Kamosko M M , Mel'nichenko E V
Published: October 2020

Retrospective analysis of examination and treatment results for 100 patients with epiphyseal dysplasias (ED), aged 3 months - 18 years, was performed. In 22 patients conventional palliative surgical interventions for the elimination of defected limb position were performed. Authors have treated 78 patients: in 25 patients corrective shortening femur osteotomy (CSFO) and in 31 - pelvic osteotomy in combination CSFO was performed. Follow up period was from 3 years to 8 years. By the results of clinical and roentgenologic dynamics of hip joint deformity development in children with ED 3 clinic-roentgenologic-anatomic manifestations of the disease were determined: initial changes (from birth to 6 years), marked changes (7 - 11 years) and severe changes (from 12 years). It was shown that reconstructive operations on pelvic and femoral joint components possessed positive effect especially pronounced in children of the younger age group.
Comparative Assessment of Endothelium-Associated Correction of Experimental Osteoporosis with Resveratrol and Etoksidol
Authors: Faytel'son Aleksandr Vladimirovich , Dubrovin G M , Gudyrev O S , Pokrovskiy M V , Ivanov A V , Radzhkumar D SR , Faitel'son A V , Dubrovin G M , Gudyrin O S , Pokrovskiy M V , Ivanov A V , Radjkumar D SR
Published: October 2020

Osteoprotective action of resveratrol and etoksidol was studied on the model of experimental osteoporosis (140 female Wistar rats). It was detected that endothelial dysfunction of bone tissue microcirculation bed that led to osteoporosis development. In contrast to etoksidol, resveratrol prevented the reduction of bone tissue microcirculation level and the aggravation of bone remodeling processes in developing osteoporosis that was manifested by delayed bone trabeculae thinning and averting of microfractures in them.
Register of Dupuytren’s Disease (Contracture) in Tatarstan Republic: Efficacy of Surgical Treatment
Authors: Magomedov R. O , Mikusev G. I , Baykeev R. F , Mikusev I. E , Nikitina A. E
Published: October 2020

Analysis of Dupuytren’s contracture (DC) surgical treatment efficacy according to the Tatarstan Republic DC Register (258 patients, 343 hands) was performed. Partial wedge-shaped excision of palmar aponeurosis was the most common intervention on both the right and left hand. Late (1 year and over) postoperative complications (POC) — relapse, dissemination, progression were detected in 41.8% of patients at terms up to 15 years. Presence of POC on the operated hand caused disturbance of its function in 11.9% of cases on the right and 16.3% of cases on the left. Curability from DC made up 34.9 — 73.8% depending on the operated hand. Complete restoration of hand function was achieved in 22.2—100% of observations. Surgical treatment of DC enabled to ensure favorable patient’s condition at term 1 year and over in 67.5 and 59.9% of cases on the right and left hand respectively.
Treatment of Fractures of the Distal Femur at Polytrauma
Authors: Plotnikov I. A , Bondarenko AV. V , Rodionov A. M
Published: October 2020

Retrospective analysis of treatment results of 157 patients with 163 fractures of the distal femur at polytrauma was perfomed. Used an osteosynthesis distal a pins with blocking, plates with angular stability, devices of external fixing. Estimated frequency and character of complications, duration and number of the hospitalisation, the remote results of treatment. It is revealed that at patients with polytrauma at supracondylaris fractures of the distal femur and sagittalis intraar- ticulate fractures without displacement by an optimum method of treatment the osteosynthesis nails with blocking is, at intraarticulate splintered fractures with displacement and a face-to- face line of a break is shown opened reposition with an osteosynthesis plates with angular stability.
Role of Cytological Examination in Diagnosis and Monitoring of Large Joints Peri-Implant Inflammation
Authors: Voloshin V. P , AV Eremin V , Zubkov V. S , Shatokhina S. N , Martynenko D. V , Zakharova N. M , Oshkukov S. A
Published: October 2020

Cytologic specimens from pathologic foci of 20 patients aged 20— 80 years with acute, chronic and low-grade inflammation in the area of large joint implants were examined. Three variants of cystograms were differentiated: reactive state in response to foreign body, chronic proliferative inflammation and chronic inflammation with bone tissue resorption. Tactics foe surgical treatment of peri-implant inflammation was chosen according to the variant of cytologic picture. Inflammation process was arrested in all patients. Cytologic method can be recommended as a component of complex examination for patients with forthcoming large joints revision arthroplasty as well as measure to prognosticate the inflammation relapse after sanitation procedures
Comparative Study of Certain Serum Markers in Experimental Osteosynthesis Using Implants with Titanium Nitride and Hafnium Coating
Authors: Akhtyamov I. F , Shakirova F. V , Gatina E. B , Zubairova L. D , Aliev E. I
Published: October 2020

Simulation of intramedullary osteosynthesis was performed at experimental tibia fracture in 30 rabbits, 6-7 months aged. In main group pins from medical steel coated by mixture of titanium nitride and hafnium were used, in comparative group pins without coating were used. Comparative study of certain biochemical blood indices, P and Ca content was performed. It was shown that application of implants coated by titanium nitride and hafnium that possessed high firmness and chemical stability did not cause additional reactive changes in experimental animals as compared with implants of medical steel. It confirmed the prospects of bioinert titanium nitride and hafnium coated nanotechnologic implants application for prevention of possible individual intolerance of metals.
Matrix Properties, Biocompatibility and Osteoplastic Potentialities of Composite Materials Based on Polylactoglycolide and Natural Coral Skeleton Granules of Various Dispersity
Authors: Sergeeva N. S , Sviridova I. K , Frank G. A , Kirsanova V. A , Akhmedova S. A , Shanskiy Ya. D , Krotova L. I , Popov V. K
Published: October 2020

Results of in vitro and in vivo medico5biological study of mineral-polymer composites (MPC) based on high molecular polylactoglycolide and natural A. cervicornis coral skeleton with vari5 ous dispersity (600 µm) as materials for bone defects substitution are presented. On the model of human fibroblasts in vitro it was shown that MPC were not toxic and possessed satisfactory matrix (for cells) properties. The optimum for composite size of natural coral granules made up 200-600 µm. MPC biocompatibility was shown in subcutaneous test in mice. However comparatively slow subcutaneous substitution of both polylactoglycolide and MPC on its basis by connective tissue. Study of MPC and its components’ osteoplastic potential showed that in the zone of fenestral tibia defect in rats polylactoglycolide was substituted by connective tissue. Periosteal osteogenesis that in MPC was supplemented by enchondral osteogenesis was observed around the particles of natural coral skeleton.
Information Provision for Data Collection on Injuries in Foreign Countries
Authors: Mironov S. P , Andreeva T. M , Kakorina E. P , Ogryzko E. V
Published: October 2020

Database on injuries in various countries including USA, Canada, Australia and European Union is presented
Treatment of Infectious Complications after Transpedicular Fixation: Case Report and Analysis of Modern State of the Problem
Authors: Pas’kov R. V , Plyushchenko D. S , Sergeev K. S , Faryon A. O , Yapryntsev I. M , Katrenko I. N
Published: October 2020

Female patient was treated for wound suppuration after transpedicular fixation of complicated unstable spine injury. Step-by-step treatment technique was used. First step included removal of transpedicular fixative, wound debridement and extrafocal external transpedicular fixation to prevent spine deformity relapse. Second step was performed after wound healing – external fixative was replaced by the internal (ventral) one. Duration of fixation in the apparatus and hospitalization made up 36 and 90 days respectively.
Problems in Acetabular Fractures Treatment
Authors: Lazarev A. F , Solod E. I , Gudushauri Ya. G , Kakabadze M. G , Stoyukhin S. S , Sakharnykh I. N
Published: October 2020

Modern approaches to the treatment of patients with acetabular fractures are considered. Peculiarities of diagnosis and surgical interventions performed for the fracture itself as well as for related complications and sequelae are presented.
Radionuclide Evaluation of Pulmonary Perfusion in Patients with Severe Thoracic Scoliosis Before and After Surgery
Authors: Karalkin AV. V , Lisyanskiy I. N , Kuleshov A. A , Vetrile M. S
Published: October 2020

The purpose of the study was to evaluate the influence of severe scoliosis surgical correction upon pulmonary microcirculation. The study included 8 patients aged 12— 27 years with severe thoracic scoliosis. Angle deformity by Cobb ranged from 80 to 140° (mean 120.4°). Deformity correction and fixation was performed on the concave side of thorax using multilevel CotrelDubousset instrumentation (CDI) and elevating thoracoplasty (ET). Perfusion radionuclide pulmonary scintigraphy was performed prior to, 3 months and 1 year after surgery. Analysis of pulmonary scintigrams included both the qualitative (visual) and quantitative assessments. Besides, examination of external respiration function (spirometry and spirography) was performed. Mean postoperative Cobb angle made up 67.4°. No loss of correction was noted. Prior to surgical intervention pulmonary scintigrams showed deformation of lung fields, displacement along the vertical axis towards opposite to curvature side, decreased perfusion in the zone of intercostal retraction on the concave side of thorax. Postoperatively restoration of vertical axis, increase of lungs size and improvement of perfusion were observed. Mean vital lung capacity increased from 1510 (540-2280) to 2090 (640-3010) ml. Thus, combined application of CDI and ET enabled to perform adequate correction of severe thoracic scoliosis as well as to improve pulmonary microcirculation and radionuclide perfusion scintigraphy was a highly informative method for the evaluation of lung condition.
Arthroscopic Reconstruction of Anterior Cruciate Ligament with Allogenic Lyophilized Patellar Ligament Graft
Authors: Tretyakov V. B , Malyuchenko L. I
Published: October 2020

Comparative analysis of long-term outcomes of arthroscopic intervention for 373 patients with isolated ACL injuries was performed. Surgical interventions were performed using arthroscopic technique and block (bone—tendon—bone) allograft of patellar ligament. In 95 patients lyophilized block allograft from patellar ligament was used as a plastic material. Histologic and biochemical results of allogenic graft examination confirmed the preservation of tendinous tissue structure and strength characteristics after lyophilization and radiation sterilization (г-irradiation). Initial condition and long-term surgical outcomes were evaluated by IKDC scale: mean score prior and after surgery made up 50.96 and 81.23 (p
Importance of Bone Tissue Quality in Risk of Osteoporotic Fracture Development
Authors: Rodionova S. S
Published: October 2020

Evaluation of the importance of quantitative and qualitative characteristics of bone in provision of its strength is given on the basis of the results of own studies of strength of the bioptates from the upper flaring portion of the ilium and literature review. Techniques for invasive and noninvasive evaluation of bone strength assessment and possibilities to use achieved data for the prognostication of risk of fractures that is important both scientifically and practically as enables to prescribe treatment timely are presented.
Treatment of Vertically Unstable Pelvic Ring Injuries in Patients with Complicated Pelvic Trauma
Authors: Ushakov S. A , Lukin S. Yu , Nikol’skiy A. V
Published: October 2020

The purpose of the work was to improve the treatment results for patients with complicated pelvic injury using differentiated application of transosseous and internal osteosynthesis. Retrospective analysis of treatment results is presented for 52 patients with vertically unstable pelvic ring injuries and concomitant abdominal injuries. Clinical cases demonstrate the variants of clinical decision depending on the type of injury, degree of pelvic ring instability, pattern of concomitant abdominal injuries. Protocol of patient management in such injuries is suggested.
Techniques for Final Pelvic Ring Fixation Based on the Method of Finite Element Modeling
Authors: Donchenko S. V , Dubrov V. E , Golubyatnikov A. V , Chernyaev A. V , Kuz’kin I. A , Alekseev D. V , Lebedev A. F
Published: October 2020

Method of finite element modeling was used for mathematic modeling of pelvic fractures and various variants of anterior and posterior pelvic ring fixation with reconstructive plates, cannu- lated sacroiliac screws and pelvic screws. Four most common types of fracture were simulated. Stress-deformed conditions of metal constructions for every type of fracture and variant of its fixation were determined. Study results enabled to determine the optimum fixation techniques in various types of fractures, to confirm the significance of both anterior and posterior pelvic stabilization, as well as to substantiate the possibility of early rehabilitation with full weight bearing in such severe patients
Complicated Cases of Knee Arthroplasty
Authors: Zagorodniy N. V , Kagramanov S. V , Kudinov O. A , Nikolaev I. A , Chragyan G. A , Ivanov A. V , Kilasoniya I. D
Published: October 2020

Experience in treatment of 190 patients (mean age 61 years) with marked (> 15°) knee deformity due to various pathology (idiopathic gonarthrosis, rheumatoid arthritis, posttraumatic gonarthrosis) is presented. In 19 cases revision interventions for aseptic instability of implant were performed. In all cases «Smith & Nephew» RT-PLUS system of either standard or modular modification was used. In 183 (96.3%) cases satisfactory results were noted: steady remission of chronic pain syndrome was achieved, limb axis, joint mobility and weight bearing ability were restored, conditions for early loading and mobilization were provided. All that promoted the improvement of patients’ life quality. Complications included 1 case of periprosthetic fracture, 5 cases of deep purulent inflammation 2 of which required implant removal with creation of arthrodesis in functionally favorable position, and 3 cases of arthrofibrosis. As a whole the achieved results enable to recommend the use of RT-PLUS system in complicated cases of arthroplasty.
Efficacy of Analgesic Therapy after Hip and Knee Arthroplasty
Authors: Markov P. V , Pal’shin G. A , Komissarov A. N
Published: October 2020

Efficacy of pain syndrome drug therapy using aceclofenac in combination with tolperisone after total knee and hip arthroplasty was studied. Study included 100 patients. Patients from group 1 ( n =30) received ketorolac, from group 2 (n=35) - aceclofenac, from group 3 (n=35) - aceclofenac in combination with tolperisone, for 3 postoperative days in recommended doses. Severity of pain syndrome by VAS, range of motion, and dynamics of soft tissue edema was assessed. It was shown that combined therapy with aceclofenac and tolperisone was more effective in pain syndrome reduction, contributed to more marked regress of soft tissue edema and more complete restoration of movements as compared to monotherapy with nonsteroid anti- inflammatory drugs.
Posterior Interosseous Artery Flap for Hand Reconstruction
Authors: Golubev I. O , Grishin V. M , Maksimov A. A , Merkulov M. V , Bushuev O. M , Kutepov I. A , Yulov R. V
Published: October 2020

Results of hand reconstructions with posterior interosseous artery flap were analyzed for 37 patients (25 males and 12 females) aged from 13 month to 56 years. The reasons for plasty were the following: acute trauma with soft tissue defect - 6 cases, posttraumatic hand and fingers deformity - 18 cases, hand pathology - 5 cases, congenital hand deformities - 8 cases. In 26 patients plasty with posterior interosseous artery flap was performed in combination with other techniques of hand microsurgical reconstruction. At terms up to 3 weeks the flap settled nicely in 35 (94.6%) patients, in 2 patients partial necrosis of the flap was observed. In 1 year after operation all patients and/or their relatives were satisfied with the cosmetic view of hand and donor site on the forearm.
Structural Parameters of Proximal Femur in Evaluation of Its Strength
Authors: Rodionova S. S , Torgashin A. N , Solod E. I , Morozova N. S , Morozov A. K , Lapkina S. V
Published: October 2020

Comparative assessment of software HAS for Hologic densitometer was performed in two groups of osteoporotic patients (mean age 60.4 years) with and without proximal femur fractures. The area of cross-section, cross-section moment of inertia, axial moment of section resistance, cortical bone thickness and coefficient of bending were assessed in three zones of the femur (narrow part of the neck, intertrochanteric and diaphyseal zones). Results of linear discriminant analysis showed that totality of 9 out of 15 geometric parameters assessed by that program enabled with 100% probability to differentiate patients with and without fractures and gave the background to introduce that method into clinical practice for timely detection of patients with high risk of proximal femur fracture.
Surgical Correction of Severe Secondary Anterior Foot Deformity
Authors: Privalov A. M
Published: October 2020

Clinical case of successful correction of severe iatrogenic foot deformity following several failed operations for transverse platypodia correction is presented. Application of several surgical techniques totality in combination with restoration of foot bones anatomical arrangement enabled to achieve positive result.
Experience in use of Wagner SL Revision Stem for Revision Hip Arthroplasty
Authors: Kavalerskiy G. M , Murylyov V. Yu , Rukin Ya. A , Kholodaev M. Yu , Elizarov P. M
Published: October 2020

Experience in revision hip arthroplasty with change of femoral stem was analyzed for 165 patients. In 107 operations (64.8%) Wagner SL Revision Stems were used, in the rest of cases - femoral components of other manufacturers. Distribution of patients by femoral defect type by Paprovsky was the following: I type - 27 patients, II type - 75, IIIA type - 59, IIIB and IV type - 4 patients. Good results at use of Wagner SL Revision Stems and stems of other manufacturers were comparable and made up 87.9 and 86.2%, respectively. Achieved data enabled to make conclusion that Wagner SL Revision Stem use is reasonable for patients with hip implant instability in I-IIIA femoral bone deficit, as they are cheaper than the modular revision stems and their design prevents the wear in the area of modular junction.
Injuries of ACL with Avulsion of Bone Fragment from Tibial Intercondylar Eminence in Children and Adolescents
Authors: Merkulov V. N , Dovluru R. K , El’tsin A. G , Mininkov D. S
Published: October 2020

Experience in arthroscopic treatment of 54 patients aged 5-18 years with ACL injury and bone fragment avulsion from the tibial intercondylar eminence is presented. Type I injury (by Meyers & McKeever - Zaricznyi classification) was diagnosed in 2 %, type II - in 49%, type III - in 40% and type IV - in 9% of patients. In patients with type I injury arthroscopic intervention was performed for concomitant injuries diagnosis and knee joint sanitation. In patients with II-IV types of injury arthroscopic osteosynthesis of tibial intercondylar eminence fractures with wire loop by original technique was performed. Excellent results were achieved in 44 (81.1%), good - in 7 (12.1%) and satisfactory - in 3 (6.8%) patients. Neither complications nor cases of nonunion were noted. Advantages of the proposed technique are the minimal traumatization of tibial growth zone, rigid fracture fixation, possibility to use this method of fixation in comminuted fractures
Peculiarities of Bone Tissue Regeneration at Application of Osteoplastic Material in Experimental Model of Purulent Bone Wound
Authors: Bugrov S. N , Mitrofanov V. N , Aleinik D. Ya , Kulakova K. V , Zhivtsov O. P , Lekishvili M. V
Published: October 2020

Results of study of new osteoplastic material conditionally named «Kombas» were presented. That material consisted of nondemineralized animal collagen in a form of chips impregnated by vascular endothelium growth factor. The first step of experiment included in vitro study of the material was for cytotoxicity in diploid fibroblast cultures of 4-6 passages. At the second step purulent bone wounds were modelled in 36 Chinchilla rabbits. After debridement bone defect in the study group of animals (n=18) was filled with study material, in control group (n=18) the defect was not filled. Radiologic (X-ray, CT) and morphologic examination were performed at terms 1, 2 and 3 months. For objectification of the achieved data integral indices were proposed. Index of bone defect restoration in study group was 70% higher in 1 month, 47 % - in 2 months and 24% - in 3 months, as compared to the control group. In control group the index which characterized the completion of reparative processes exceeded that index in study group by 42% in 2 months and by 54% in 3 month of observation. Study results showed that elaborated material was not cytotoxic, possessed plasticity, marked osteoinductive and osteoconductive properties, as well as an ability to substitute bone tissue defects under conditions of purulent bone cavity in animal experiment.
Applied Anatomy of Median and Ulnar Nerve Branches in Operations for Forearm Muscles Neurotization
Authors: Golubev I. O , Zhuravlyov S. A
Published: October 2020

To determine the potentialities of median nerve motor branches neurotization by the ulnar nerve and vice versa the anatomy of muscular branches of median and ulnar nerves in the forearm was studied in detail. Study was performed on 20 upper extremities from 10 adult cadavers. The number of branches, their length and precise place of divergence from the main trunk were assessed. It was stated that topographic anatomy of muscular branches of the median and ulnar nerves in the forearm was quite invariable. For neuratization from the median nerve the longest branches that passed to pronator teres muscles and superficial flexor muscle of fingers can be used; from the ulnar nerve - long branch to the ulnar flexor muscle of wrist.
Methodic Approaches to Evaluation of Requirements in Traumatologic and Orthopaedic Care to Child Population in Novosibirsk Region
Authors: Myl’nikova T. A , Shalygina L. S , Gusev M. V , Ivaninskiy O. I , Tsytsorina I. A
Published: October 2020

High social significance of traumatism in child population (2 nd place by the level of primary morbidity and 8 th one by the causes of disability) determines the priority of traumatologic and orthopaedic service development. Great importance is given to the prognosis of justified requirement in this type of medical care for the short term prospective. Study was performed basing on the analysis of official statistic data on Novosibirsk region for 2005-2012 as well as on the results of expert evaluation of traumatologic and orthopaedic service condition, problems and prospective of development. It is stated that provision of traumatologic and orthopaedic care availability to child population in Novosibirsk region requires 19 additional beds (5 traumatologic and 14 orthopaedic). Requirement in outpatient trauma and orthopaedic surgeons makes up 32 specialists. Complex analysis of traumatologic and orthopaedic service personnel showed the presence of internal potentials for its perfection. Realization of measures on raising the qualification of trauma and orthopaedic surgeons, general surgeons and child surgeons working in the field of pediatric traumatology and orthopaedics will not require additional personnel.
Vascularized Bone Autoplasty with Graft from Medial Femoral Epicondyle in Scaphoid Pseudarthrosis
Authors: Golubev I. O , Yulov R. V , Bushuev O. M , Merkulov M. V , Kutepov I. A , Maksimov A. A , Grishin V. M
Published: October 2020

Nineteen patients (16 - 49 years) with scaphoid pseudarthrosis were treated using vascularized bone autograft from medial femoral epicondyle. Mean term since scaphoid fracture made up 30.5 ± 21.2 months. In all cases avascular necrosis of the proximal fragment, scaphoid humpbach deformity and dorsal intercalated segment instability (DISI) were present. In 16 (84.2%) consolidation in the zone of scaphoid pseudarthrosis was achieved at terms from 8 to 12 weeks after operation. In 3 (15.8%) unsatisfactory results were observed. Average scapholunate angle correction made up 13°. Average force of feast and pinch grasps increased on the average by 2.5 and 1.5 times, respectively. One year after surgery the average estimation by DASH scale decreased by 9.6 points at average, from 27 to 13.4 points.
Clinical Analysis of Gait and Assessment of Surgical Treatment Outcomes in Children with Neurogenic Feet Deformity
Authors: Kosov I. S , Merkulov V. N , Imyarov Sh. D , Mikhailova S. A
Published: October 2020

Clinical analysis of gate in children with neurogenic feet deformities before and 1 year after musculotendinous transposition was performed. Study was performed using programmable hardware complex combined with dynamometric platform and electromyelograph. Temporal, kinematic and kinetic parameters of a stride cycle were determined. Degree of walking asymmetry was evaluated using asymmetry parameter. Besides the pattern of joint mobility disturbance and degree of muscular function loss or decrease were taken into account. Complex clinical analysis of walking enabled to detect and worked out in details the disturbances of injured extremity function before surgery as well as to establish the improvement of weight bearing ability of the injured extremity, decrease in compensatory overload of the collateral healthy extremity and lowering of asymmetry parameter after surgery.
Biochemical Indices at Assessment of Traumatic Disease Course in Multiple Fractures of Extremity Bones When Treated by Ilizarov Technique
Authors: Kireeva E. A , Stogov M. V , Samusenko D. V
Published: October 2020

Dynamics of concentration of the products of protein, carbohydrate, lipid and mineral metabolism in serum and daily urine was studied in 60 patients with multiple closed fractures of the extremities treated by Ilizarov technique. In the period of early traumatic disease complications alkaline phosphatase activity, calcium and hydroxyproline excretion, intensity of hypoproteinemia, hypocalcemia, hypocholesterinemia and hypotriglyceridemia increased in proportion to injury severity. Maximum changes in metabolic status during the period of early traumatic disease complications were observed in patients been operated on 2 nd - 3 rd days after injury. At early terms of traumatic disease the criteria for evaluation of multiple injury severity were the following: increase in alkaline phosphatase level, marked hypocalcemia and hypercalciuria. Long-term preservation of hypocalcemia and hypercalciuria on the background of blood urea increase at traumatic disease stages confirms the disturbance of osteoreparation and requires medicamental correction.
Modified Technique of Arthroscopic Posterior Cruciate Ligament Reconstruction
Authors: Kuznetsov I. A , Fomin N. F , Shulepov D. A , Ryabinin M. V , Orlov Yu. N , Salikhov M. R
Published: October 2020

Basing on the anatomic examination results the main principles of safe bone tunnels formation at arthroscopic plasty of posterior cruciate ligament (PCL) were formulated. Additional instrumentation of original design and original surgical technique directed to minimization of the risk of popliteal artery injury at tibial bone tunnel formation were proposed. During the period from 2010 through 2013 twenty one patients with PCL injuries were operated on at endoscopic surgery department. In 20 n patients treatment results were assessed in 6 and 12 months after intervention. Evaluation was performed by clinical results, IKDC forms, Lysholm - Gillquist score and visual pain scale. Preoperatively mean point by IKDC questionnaires was 46.80±18.07, by Lysholm - Gillquist score - 51.62±20.34 and in 6 months postoperatively - 68.64±10.13 and 73.84±11.16, respectively, that was statistically significant higher than prior to operation (p
Optimization of Postoperative Period Management in Patients with Axial Deformities of Lower Extremities
Authors: Teterin O. G , Makarov A. D , Petrov D. Yu , Chernyavskiy M. A , Lemeshkin S. S
Published: October 2020

Peculiarities of postoperative period management are presented for 186 patients with axial lower limb deformities. In the main group (n=95) computer technologies to plan the outcomes and control the treatment course as well as drug prevention of possible complications, i.e. deep vein thrombosis and deformity relapse, were used. In control group (n=91) such measures were not used. Results were assessed at the stage of correction completion, after external fixation device removal and at terms from 1 to 3 years after discharge. In control group the indices of mean duration of correction (11.1±0.2 days), fixation (29.8±0.5 days) and overall term of treatment (47.9±0.6 days) were statistically significant (p
Study of Motor Ability Indices and Postural Status in Patients with Hemihypoplasia
Authors: Mikhailova L. K , Eryomushkin M. A , Kosov I. S , Mikhailova S. A , Murav’yova N. V
Published: October 2020

One hundred seventeen patients with hemihypoplasia and discrepancy of lower limbs length of 1 - 3 cm were examined during the period from 2008 through 2013. Series of functional tests to evaluate conditional and coordination skills as well as stabilometry in European and American variants were performed. All patients demonstrated frontal postural disorders, marked weakness of the abdominal muscles and muscles of the back that resulted caused postural imbalance that resulted in formation of myofascial trigger points and development specific pain syndrome. Stabilometry and coordination tests results showed the predominance of proprioceptive body balance control over the visual one.
Step by Step Extra-Focal Fixation of Unstable Pelvis with Separate Anterior and Posterior Modules
Authors: Borozda I. V , Ganzhurov N. A , Kapustyanskiy A. A , Nikolaev R. V
Published: October 2020

Results of step by step treatment of 28 patients with disintegrative pelvic ring injuries are presented. In 14 patients (main group) step by step extra-focal pelvic fixation with application of anterior (antishock) and posterior modules was performed. In 14 patients (control group) osteosynthesis by external fixation device with circular support was used. Long-term results were assessed in1 year after injury. In control group residual deformity averaged 5 (4-7) mm and was noted in 10 (71.4%) patients. In the main group residual deformity was observed in 4 (28.6%) cases and averaged 2.5 (2-3) mm (p=0.0039). In the main group functional result by Majeed scale was also significantly better (p=0.000319). Excellent and good results were achieved in 9 (64.3%) and 5 (35.7%) of patients, respectively. In control group results were considered to be excellent in 3 (21.4%), good - in 6 (42.9%), satisfactory - in 4 (28.6) and poor - in 1 (7.1%) of cases. Advantage of the proposed transosseous osteosynthesis technique is the modular principle of the construction use that enables to perform separate fixation with anterior (antishock) module followed by final reposition of the pelvic ring with posterior module after stabilization of patient’s vital functions. This allows to increase the number of external pelvic fixation in patients with polytrauma.
Osteosynthesis of Distal Humeral Metaepiphyseal Fractures Via Posterior Approach with Olecranon Preservation
Authors: Kalantyrskaya V. A , Golubev I. O
Published: October 2020

Eighteen patients with distal humeral metaepiphyseal fractures were operated on during the period from 2010 to 2013. Mean age of patients made up 43.1±8.4 (22-72) years, term after injury - 4.6±1.9 (2-11) days. According to AO classification C1 fractures were diagnosed in 13, C2 - in 3, C3 - in 2 patients. In all patients distal humeral metaepiphyseal osteosynthesis with two plates placed at 90° to each other was performed. Surgical intervention was performed without olecranon osteotomy and triceps tendon was kept intact. In 12 (66.7%) cases longitudinal dissection of the triceps in its middle third was performed. Residual intraarticular displacement averaged 0.2±0.03 mm. Long term results were assessed in 10 patients at an average 12 months after operation. Mean score by subjective and objective scales made up 4.3±0.3 and 4.2±0.3 points, respectively. Main advantages of the applied osteosynthesis technique were preservation of forearm extensor muscles integrity; absence of additional fixatives in olecranon zone; absence of the necessity to perform additional intervention to remove fixatives from the olecranon.
Experience in Treatment of Total Hand Syndactyly in a Child with Apert Syndrome
Authors: Kozhevnikov O. V , Ivanov A. V , Gavrilova Yu. V
Published: October 2020

Experience in surgical treatment of total hand syndactyly in a child with Apert syndrome is presented. Surgical technique that includes the application of МЦТ-01 apparatus, distraction period and interdigital space formation with local tissues, i.e. interchanging triangular or oblique-trapeziform flaps is described. Within 18 months interdigital spaces between II and III, III and IV, IV and V fingers were formed in turn. Besides marked cosmetic effect comparatively good functional result was achieved.
Comparison of Fibroarchitectonics and Strength Properties Preservation Criteria of Lyophilized Allografts with Different Type of Fibrous Framework
Authors: Shangina O. R , Khasanov R. A , Bulgakova L. A , Musina L. A
Published: October 2020

An overall estimation of the structure and strength properties of lyophilized connective tissue allografts from 73 cadavers of both sexes, aged from 20 to 50, was performed. Criteria for preservation of their fibroarchitectonics depending upon the type of the connective tissue fibrous framework and presence of the main substance were determined. It was shown that lyophilization process was accompanied by changes in architectonics and reduction of strength properties in allografts made of dense formed connective tissue with orientated (Achilles tendon) and mixed (dura mater, broad fascia) type of fibrous framework. A spatial non-orientated type of derma fibrous framework in weight bearing foot segments stipulated preservation of architectonics and plastic properties after lyophilization.
In Vitro Evaluation of the Composite Alginate - Calcium Phosphate Materials for Prototyping Technologies in Bone Defects Substitution
Authors: Sergeeva N. S , Komlev V. S , Sviridova I. K , Kirsanova V. A , Akhmedova S. A , Kuvshinova E. A , Fedotov A. Yu , Teterina A. Yu , Barinov S. M
Published: October 2020

Porous granular composite biomaterials based on sodium alginate and calcium phosphate component: 1% sodium alginate; sodium alginate with gelatin (80/20); calcium phosphate ceramics (CHA, TCP and OCP) and composite materials alginate/CHA, alginate/TCP, alginate/OCP, alginate/gelatin (80/20)/TCP and alginate/TCP/CHA/OCP were investigated for cytotoxicity and matrix (for cells) properties in dynamics of cultivation (up to 21 days). Two adhesive cell lines - immortalized human fibroblasts (HF, strain 1608 hTERT) and human osteosarcoma (MG-63) were used for in vitro MTT assay. OCP material showed its cytotoxicity while all its composites possessed weak matrix properties. For further research on the development of prototyping technologies 3 samples of composite materials were selected: alginate/CHA, alginate/TCP and alginate/gelatin (80/20)/TCP that are characterized by cytocompatibity and the presence of either expressed or moderate matrix properties of the surface for cells.
Nachal'nye etapy distraktsionnogo osteogeneza
Authors: Mironov S. P , Omel’yanenko N. P , Karpov I. N , Ivanov A. V , Khlystova A. V
Published: October 2020

Analysis of literature data dedicated to the study of distraction osteosynthesis is presented. In accordance with the ideas of the mechanisms of reparative regeneration in distraction osteosynthesis, the main factors responsible for the triggering of reparative regeneration are artificially created tissue “deficit” and tension-stress effect on the vascular network that was formed during the latent period. Consecutive local effect of growth factors and other peptide regulators provides sufficient level of reparative osteogenesis within the whole distraction period. The volume and quality of newly formed bone tissue depend upon the spatial and temporal characteristics of distraction as well as on the potentialities of concrete individual.
Skriningovaya diagnostika skolioza metodom komp'yuternoy stabilometrii
Authors: Davydov O. D , Montile A. I , Marchuk Yu. V , Montile A. A
Published: October 2020

The study involved 47 young people aged 18 to 20 years. Among them, 11 people with previously diagnosed idiopathic scoliosis of the 1 st and 2 nd levels were the group "scoliosis", 36 persons without orthopedic and neurological disorders were the group "norm." A method of computed stabilometry was used. We obtained functional dependences that characterized the distribution of movement rate of foot pressure center on support surfaces in the frontal plane, which differed parametrically in both groups. Diagnostic feature, namely the number of movement intervals with the constant velocity of 0.02 seconds was identified, which allowed to include the subject in the scoliosis risk group. Clinical testing method was carried out in two groups of children aged 7-8 years. The first group, "scoliosis control", had 12 children with clinically confirmed diagnosis of the 1 st and 2 nd degrees idiopathic scoliosis. In the second group of "normal control" 12 children were without orthopedic and neurological disorders. The sensitivity of this method was 92%.
Use of Rivaroxaban for Prevention of Thromboembolism after Major Joints Arthroplasty under Conditions of Real Clinical Practice in Russia (on the data of prospective multicenter non-interventional study SOPRANO)
Authors: Zagorodniy N. V , Bukhtin K. M
Published: October 2020

Results of first Russian local prospective multicenter observational study with participation of 2293 patients who received rivaroxaban for prevention of thromboembolism after major joints arthroplasty are presented. The study was performed under conditions of “real clinical practice”, i.e. without any changes in postoperative management. Demographic indices, prevalence of aggravating anamnestic factors that determined the risk of thromboembolism development, and adverse effects (AE) against the background of drug intake were studied. Interruptions of rivaroxaban intake were noted in 5% of patients. The number of AE made up 52 in 45 patients and only in 11 cases AE were associated with rivaroxaban intake. Drug efficacy and tolerance was assessed by physicians as excellent and good in 97.9% and 98.8% of patients, respectively. The overwhelming majority (98.4%) of patients appreciated the convenience of oral anticoagulant intake. It was stated that under conditions of the organizational peculiarities of medical care in Russia the efficacy of rivaroxaban was comparable to that, demonstrated in foreign studies.
Russian Experience in Rational Thromboprophylaxis in Traumatology and Orthopaedics
Authors: Firsov S. A , Levshin A. G , Matveev R. P
Published: October 2020

Analysis of safety and efficacy of the currently marked peroral anticoagulants was performed in long term follow up of patients after large joints arthroplasty. Total number of 5025 patients after total knee arthroplasty and 5216 patients after total hip arthroplasty were examined. All patients were divided into groups depending on the prescribed anticoagulant. The course of anticoagulant therapy made up 35 days and 6 weeks after surgery, respectively. US examination of the veins of lower extremities was performed to all patients prior to and on day 5 after operation. In patients on Dabigatran the rate of clinically significant deep vein thrombosis was lower than in group of patients on Rivaroxaban and Apixaban, but the rate of postoperative hematomas in lust two groops was higher.
Hip-spineSyndrome and its Significance in Complex Treatment of Patients with Combination of Degenerative Dystrophic Pathology of Hip Joint and Spine (literature review)
Authors: Kudyashev A. L , Khominets V. V , Shapovalov V. M , Miroevskiy F. V
Published: October 2020

In foreign literature a combination of degenerative dystrophic changes in hip joint and lumbosacral spine accompanied by their mutual aggravation is referred to as hip-spine (coxo-vertebral)syndrome. This pathologic condition is characterized by the variety of clinical forms, morphologic manifestations and degrees of the pathologic process intensity that predetermines objective difficulties in diagnosis and treatment of such patients. The main role in the process of degenerative dystrophic changed development is played by biomechanical factors including vertebropelvic relationships. In the overwhelming majority of patients with coxarthrosis the low back pain is caused by the changes in spinal motion segments that progress with the development of hip deforming arthrosis resulting in biomechanical disorders. All that leads to objective difficulties in diagnosis of this complex pathology and patients’ dissatisfaction with the hip arthroplasty results.
Method for Glenoid Bone Defect Plasty in Recurrent Shoulder Instability
Authors: Prokhorenko V. M , Fomenko S. M , Filipenko P. V
Published: October 2020

Technique for glenoid bone defect plasty in posttraumatic shoulder instability using the porous titanium nickelide (Ti-Ni) graft is presented. This method is an alternative to Latarjet operation and autoplasty with the graft from the iliac crest. The shape and size of the graft was determined by MSCT data and the graft was sawed out from cylindrical billets with diameter of about 2.5 cm and wall thickness - 1 cm. Two screw holes were drilled and the graft was placed into the defect. That technique was applied in 6 patients with long lasting history of recurrent anterior instability and instability relapses after shoulder stabilization using other surgical techniques. Preoperative shoulder functional state by Rowe scale averaged 35.0 points versus 93.3 points after operation. One year follow up showed no cases of instability relapse. The advantages of this technique are the possibility of accurate glenoid anatomic shape reconstruction, absence of graft resorption and reduction of intervention duration.
Carbonic Nano-Structural Grafts - Innovation Product for Traumatology and Orthopaedics.Part 1: Experimental Study Results
Authors: Mironov S. P , Shevtsov V. I , Kononovich N. A , Stepanov M. A , Gorbach E. N , Golubev G. Sh , Sergeev K. S , Arkhipenko V. I , Grin’ A. A , Skryabin V. L , Reznik L. B , Shatokhin V. D , Baimuratov A. A
Published: October 2020

Study of the general organism response to carbonic nano-structural grafts, their osteoinductive properties, possibilities of bone defects substitution and acceleration of the distraction regenerate formation was performed. Four series of experiments were performed on 69 animals (Chinchilla rabbits and adult mongrel dogs). Laboratory and roentgenologic data showed that study grafts possessed pronounced osteoconductive properties, were not toxic and did not cause rejection response. Their application ensured the formation of strong osteo-carbonic block at the interface bone-implant. Distraction regenerate achieved required strength in 37 days after carbonic graft implantation into the bed formed in the regenerate. That enabled to discontinue external fixation with the apparatus.
Idiopathic Multifocal Osteolysis: Case of Surgical Treatment
Authors: Pozdeev A. P , Zakhar’yan E. A , Buklaev D. S , Krasnogorskiy I. N , Zubairov T. F
Published: October 2020

Idiopathic osteolysis is a rare disorder characterized by spontaneous, massive and progressive resorption of bone tissue. Massive osteolysis results from proliferation of blood and lymphatic vessels with thin walls, resembling capillaries, in the bone and surrounding soft tissues. Literature review on this problem and clinical case of a patient successfully operated on using the technique elaborated at our clinic are presented. Surgical interventions enabled to achieve the restoration of tubular bones integrity and ensured conditions for independent patient’s movement. Possibility of the performance of reconstructive surgical interventions for the restoration of limb weight bearing ability that is reasonable to combine with bisphosphonate therapy.