bluuebunny/crossref_metadata_2025 huggingface dataset:
Solution for the Problem of Difficult Respiratory Tract in Planned Orthopaedic Surgery
Authors: Arzhakova N I , Efremov V A , Bessonov S V , Ukolov Konstantin Yur'evich , Novosel'tseva V A , Arzhakova N I , Efremov V A , Bessonov S V , Ukolov K Yu , Novosel'tseva V A
Published: October 2020

Methods to solve the situation of difficult intubation in planned orthopaedic surgery are presented. Total number of 101 patients with problematic conventional tracheal intubation due to various orthopaedic pathology (Bekhterev's disease, abnormality of development or posttraumatic instability of cervical spine, etc.) was studied. In 49 patients tracheal intubation was performed using laryngeal mask LMA C-Trach with videovisualization (main group), in 52 patients - using fiberoptic bronchoscope (control group). The results achieved showed high efficacy of LMA C-Trach technology for solving difficult intubation problem. Application of laryngeal mask was successfully performed even in patients with Hallo-apparatus fixed cervical spine. Unlike fiber bronchoscope insertion placing of laryngeal mask was atraumatic in relation to stomatopharynx and enabled to perform adequate pulmonary ventilation till tracheal intubation. Videovisualization ensured accurate localization of trachea and its intubation with atraumatic reinforced tube under visual control. Only in 2 patients use of that technology failed and it was related to the bleeding from tonsils after multiple unsuccessful attempts of trachea intubation using direct laryngoscopy. Above described technique is not only a highly effective method for solving the problem of difficult intubation but decreases psychologic strain of the anesthesiologic team.
Use of Autologous Stem Cells for Prevention of Pyo-Inflammatory Complications at Surgical Interventions with Surgical Aggression in Traumatologic and Orthopaedic Patients
Authors: Mironov S P , Kesyan Gurgen Abovenovich , Kondrat'eva I E , Urazgil'deev R Z , Berchenko G N , Samkov A S , Karapetyan G S , Shulashov B N , Mironov S P , Kesyan G A , Kondrat'eva I E , Urazgil'deev R Z , Berchenko G N , Samkov A S , Karapetyan G S , Shulashov B N
Published: October 2020

Study of the efficacy of in vitro cultivated autolymphocytes for homeostasis protection and pyo-inflammatory complications prevention at reconstructive operations performance. That technique was applied in 35 patients with comminuted fractures, femur pseudarthroses and coxarthrosis to whom extraosseous, intraosseous osteosynthesis and hip arthroplasty were performed. Control group included 30 patients with similar types of pathology who were treated by similar methods but without use of autolymphocytes. Post-operative use of autolymphocytes transfusion with regard for potential pyo-inflammatory complications enabled to achieve more favorable course of post-operative period, faster stabilization of patients' general condition, normalization of clinical and special indices as well as to decrease the rate of pyo-inflammatory complications.
Modern Me-thods of Infectious Knee Joint Arthritis Treatment
Authors: Orletskiy A K , Butkova Lyudmila Leonidovna , Timchenko D O , Orletskiy A K , Butkova L L , Timchenko D O
Published: October 2020

New approach to the treatment of patients with infectious knee joint arthritis using arthroscopic technique has been elaborated at CITO department of sports and ballet injury. During the period from 2004 to 2010 total number of 23 patients (32 - 67 years) has been treated. Use of arthroscopic technique enabled to improve treatments results and to decrease the duration of hospitalization. The importance of early diagnosis and timely initiation of treatment has been shown. Delay of arthroscopic revision and knee joint sanitation may result in destructive changes in cartilage and other joint components. Evaluation of treatment results by Lysholm scale showed 28.6% of good and 71.4% of satisfactory outcomes.
Version of Surgical Tactics for Spondyloptosis Treatment
Authors: Afaunov Asker Alievich , Kuz'menko A V , Basankin I V , Afaunov A A , Kuz'menko A V , Basankin I V
Published: October 2020

Tactics of surgical treatment of spondyloptosis including use of transpedicular external fixation device is presented. There were 4 patients with L5 spondyloptosis. The tactics is characterized by minor traumatization of lumbosacral spine with external fixation device, decrease of neurologic complications rate owing to gradual L5 reduction, possibility of spine deformity elimination, significant technical simplification of internal transpedicular osteosynthesis performance. Clinical results showed normalization of anatomic interrelation in lumbosacral spine, elimination of vertebroradicular conflict, restoration of trunk balance and anthropometric proportion as well as stabilization of L5-S1 segment by osteo-metalic block.
Prevention of Orthopaedic Consequences in Hip Joint Area in Children after Epimetaphyseal Osteomyelitis
Authors: Skvortsov A P , Gil'mutdinov Marat Rashatovich , Akhtyamov I F , Skvortsov A P , Gil'mutdinov M R , Akhtyamov I F
Published: October 2020

Comparative analysis of treatment results for 152 children who underwent acute hematogenic osteomyelitis at age under 3 years is presented. Introduction of individual preventive measures during the course of acute hematogenic osteomyelitis treatment and follow up period resulted in 1.32 time decrease of potential orthopaedic complications in the area of hip joint.
Complications in Hip Arthroplasty
Authors: Slobodskoy Aleksandr Borisovich , Osintsev E Yu , Lezhnev A G , Slobodskoi A B , Osintsev E Yu , Lezhnev A G
Published: October 2020

Experience in follow up of 1399 patients after 1603 hip joint arthroplasties is presented. Bilateral operations were performed in 102 patients. In 111 patients revision total hip replacement was performed. Age of patients ranged from 18 to 94 years. Different complications were present in 4,3% of cases: pyo-inflammatory - in 1,37%, implant head dislocation - 1,93%, periprosthetic fractures - 0,19%, postoperative neuritis - 0,49% and pulmonary thrombosis - in 0,31% of cases. Elderly and senile patients, severe concomitant pathology (diabetes mellitus, rheumatoid arthritis and other systemic diseases), acute proximal femur injury, earlier operated dysplastic coxarthrosis, revision and complicated total hip replacement, history of pyo-inflammatory processes in the zone of hip joint are to be considered as risk factors to complication development. Scale for complications prognosis in hip joint arthroplasty is presented.
Morphometric Indices of Hepatocytes in Shin Bones Injury
Authors: Ocheretina Rufina Yur'evna , Stogov M V , Ocheretina R Yu , Stogov M V
Published: October 2020

Morphometric indices of mononuclear hepatocytes (volumes of cells and nuclei, nucleo-cytoplasmic index, percentage of parenchymal cells of different classes) in peripheral and central zones of hepatic lobules were determined 3 days after experimental fracture of shin bones in CBA mice. Increase of hepatocyte nuclei size within the range of K3, K4 and K5 classes was revealed. This is indicative of the involvement of hepatic parenchymal cells into the process of adaptive reorganization of the organism in loco-motor system injury.
Treatment of Shoulder Deforming Arthrosis
Authors: Zorya V I , Zarayskiy Aleksandr Sergeevich , Zorya V I , Zaraiyskiy A S
Published: October 2020

Analysis and systematization of data on various methods for conservative and surgical treatment of different forms of shoulder deforming arthrosis is presented. Detailed characteristics of various treatment techniques for the elements of shoulder joint in its different pathology is described. Complex approach to the treatment of such pathology will enable to achieve better clinical and functional results in this group of patients as well as to improve their life quality.
Results of Extraosseous Osteosynthesis with Extra Stabilization of Plate by Tightening Clamps
Authors: Kopysova Valentina Afanas'evna , Kaplun V A , Svetashov A N , Kopysova V A , Kaploon V A , Svetashov A N
Published: October 2020

Results of extraosseous osteosynthesis in 160 patients with fractures and pseudarthroses of lower extremities long bones were analyzed. In 80 patients from the main group the plate was additionally fixed to the bone with ring-shaped tightening clamp with shape memory to prevent screw migration.. In 65 (81.3%) patients from control group consolidation of bone fragments with excellent results was achieved in 66.3% of cases. In 15 (18.7%) patients with mainly peri- and intraarticular femoral fractures the migration of screws and plate destruction were noted. In main group the fractures consolidated in anatomically correct position in 76 (95.0%) and good functional results of treatment were achieved.
Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine
Authors: Krut'ko A V , Akhmet'yanov Shamil' Al'firovich , Kozlov D M , Peleganchuk A V , Bulatov A V , Krut'ko A V , Akhmet'yanov Sh A , Kozlov D M , Peleganchuk A V , Bulatov A V
Published: October 2020

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.
Comparative Evaluation of Low-Molecular Weight Hyaluronic Acid and Autologous Conditioned Serum in Coxarthrosis
Authors: Noskov S M , Shirokova Larisa Yur'evna , Bakhtiarova T I , Shirokova K Yu , Parulya O M , Noskov S M , Shirokova L Yu , Bakhtiarova T I , Shirokova K Yu , Parulya O M
Published: October 2020

For the first time the results of a comparative evaluation of low-molecular weight hyaluronic acid (synocrom forte) and autologous conditioned serum (ACS) in coxarthrosis (CA) are presented. Throughout the 12-month monitoring we examined 54 patients with CA who were divided into 2 groups of comparable age and sex composition and the duration of the disease. Group №1 had a 3-week course of local therapy of synocrom forte and group №2 - of ACS. It is concluded that the use of ACS at CA to achieve favorable clinical effects is almost as good as hyaluronic acid, but it characterized by a greater duration of their conservation (from six to twelve months).
Semiotics of Proliferative Changes in Femur in Chronic Osteomyelitis Developed after Acute Hematogenous Osteomyelitis
Authors: D'yachkova Galina Viktorovna , Mitina Yu L , Diachkova G V , Mitina Ju L
Published: October 2020

Semiotics of osteonecrosis and sequestration in femur has been studied on the basis of the data from roentgenography, linear tomography and computer tomography in 39 patients with transformation of acute hematogenous osteomyelitis into chronic one with the purpose of revealing the possible and most typical variants of proliferative changes in bone. It was established that during the process of assimilation the periosteal layers can convert into both compact bone and spongy bone. The average extent of periosteal layers in the shaft zone exceeded the size of destruction by 6.1±2.1 cm and the border of endosteal borders corresponded to that of periosteal layers. In metaphyseal zone the border of periosteal layers corresponded to the border of periosteal cambial layer and was not visualized by destruction spreading: the border of destruction could be located both proximally and distally to the periosteal layers' border.
Ponseti method of treatment of severe and neurogenic clubfoot
Authors: Kenis Vladimir Markovich , Klychkova I Yu , Stepanova Yu A , Kenis V M , Klychkova I Yu , Stepanova J A
Published: October 2020

Primary results of treatment for neurogenic clubfoot of various genesis using Ponseti technique are presented. During the course of treatment and follow up period clinical and roentgenologic changes were assessed in 34 children. Mean age of patients at treatment initiation was from 4 months to 8 years. Treatment efficacy was in direct dependence upon the patient's age. The best results were achieved in children under 12 months. Use of Ponseti method in neurogenic forms of clubfoot is characterized by a number of technical features. In severe forms of disease it is reasonable to use this technique as a first step of correction which enables to reduce the volume of following surgical intervention.
Puncture Transpedicular Fixation in Surgical Treatment of Thoracic and Lumbar Vertebrae Injuries
Authors: Pas'kov R. V , Sergeev K. S , Sagitov R. Sh , Kucheryuk V. I , Katrenko I. N , Farion A. O
Published: October 2020

Results of transpedicular fixation (TPF) performed to 113 patients with injuries of thoracic and lumbar vertebrae are presented. In 26 patients original puncture TPF was performed, in 14 cases the reposition system was used. Analysis of treatment results showed high efficacy of puncture TPF. Duration of surgical intervention and volume of blood loss decreased reliably, cosmetic defect was less marked.
Complex Diagnosis of Myofascial Lumbosacral Pain Syndrome in Athletes and Ballet Dancers
Authors: Mironov S. P , Burmakova G. M , Krupatkin A. I , Mikhailova S. A , Pokin'-Chereda G. D
Published: October 2020

Myofascial lumbosacral pain syndrome is a common disorder in athletes and ballet dancers. Diagnosis of this disorder is rather difficult as usually several muscles are involved and also the combination with degenerative diseases is possible. Complex clinical and instrumental examination using ultrasonography, computed tomography and surface electromyography enables to make an accurate diagnosis and specify the severity of damage.
Standardized Assessment of Femoral Head and Neck Revascularization Outcomes in Degenerative Dystrophic Hip Joint Diseases at Late Terms
Authors: Nazarov E. A , Vesnov I. G , Musaeva R. F
Published: October 2020

Analysis of femoral head and neck revascularization efficacy at late terms (7 to 20 years) was performed using "Standardized assessment of outcomes in degenerative dystrophic diseases of loco-motor system" (SAO-3). Treatment results were assessed for 3 groups of patients with degenerative dystrophic hip joints diseases (DDHJD). Grouping ofpatients was based on the type and stage ofpathology, age of patients, terms of examination (preoperatively and in 1, 3, 5, 10, 15, 20 years after surgical intervention). Group I included 9 patients with early pre-radiologic stage of femoral head avascular necrosis (FHAN); group II — 5 patients operated on at other stages of FHAN, group III — 6 patients with coxarthrosis and cystic remodeling ofjoining bones. In patients from group I positive stable outcome was present in 20 years after operation that allowed to state their recovery. In patients with other stages of DDHJD positive surgical outcome was preserved for up to 15 years.
Arthromedullar Bypass at Knee Crucial Ligaments Endoprosthesis
Authors: Gavryushenko N. S , Malygina M. A , Bulgakov V. G , Sakharova O. M , Zabavskaya O. A , Nevzorov A. M
Published: October 2020

Arthromedullar ligamentous implant that provides the insertion of intraosseous content with pronounced lubrication and antioxidant activity into joint cavity has been proposed. Use of that implant during surgery for knee ligaments rupture (18 patients aged 18 — 52 years) side by side with mechanical fixation enabled to decrease considerably friction between the articular surfaces, contributed to a more rapid full value restoration of joint function and prevented the posttraumatic osteoarthrosis development.
Experience in 500 Total Knee Replacements
Authors: Chryagin G. A , Zagorodniy N. V , Nuzhdin V. I , Kudinov O. A , Bachiashvili V. M , Kuz;min F. A , Nikolaev I. A , Bukhtin K. M
Published: October 2020

Experience of CITO joint replacement department in knee arthroplasty with implants from various manufacturers was analyzed. Implants of three modifications were used: basic, with posterior stabilizer and "semiconstrained" one. Tactics for a choice of optimum construction depending on a disease, gender, degree and type of contracture, degree and type of limb axis curvature was demonstrated and substantiated on the example of 500 operations performed to 426 patients with various knee joint pathology during the period from 2000 to 2010. By the data of clinical and roentgenologic analysis excellent result was achieved in 90 (21%), good inv 277 (65%), satisfactory in 51 (12%) and poor in 8 (2%) patients. This treatment tactics may be considered as an adequate one.
Osteochondritis Dissecans of Femoral Condyles in Children and Adolescents
Authors: Merkulov V. N , Avakyan A. P , El'tsin A. G , Mininkov D. S
Published: October 2020

Experience in treatment of 76 children with K^ig's desease during the period from 1992 to 2011 is presented. Examination plan included roentgenography, CT, US, MRT and arthroscopy. In 41 children 1 st and 2 nd stages of the disease was diagnosed, in 9 and 26 patients 3 rd and 4 th stages, respectively. Defect size averaged 3.17 sq. cm with 6.8 mm depth. In 1 st and 2 nd stages of the disease osteoperforation was performed, in 3 rd and 4 th stages — intrafocal osteoperforation of the defect bottom and cartilaginous defect plasty with Chondro Gide collagen membrane was applied. All interventions were performed arthroscopically. Excellent results were achieved in 69 (90.7%) patients, good in 5 (6.5%) and satisfactory in 2 (2.6%) patients.
Application of Cross-Section Corrective («Translation») Forces at Surgical Treatment for Scoliosis
Authors: Jalilov Ya. R , Verdiyev V. Q , Jalilov T. Y
Published: October 2020

Surgical treatment results for 53 patients with III—IV stage of scoliosis are presented. In all patients original endocorrector has been applied. Endocorrector is based on the application of cross-section corrective («translation effect») forces that enable to shift the vertebrae of the main scoliotic arch to the median line of the trunk. Endocorrector was the most effective in curvature arch under 75° and provided 35—45° correction. Mathematic modeling of a situation «endocor- rector—curved spine» was performed as well as the pattern of forces created by endocorrector and participated in the scoliotic deformity correction was studied. Surgical intervention enabled to achieve stable fixation of the spine with its sagittal contours preservation. At long-term follow up (1—6 years) loss of correction did not exceed 8—10°. In scoliosis with arch over 75° step-by- step corrections were performed and loss of correction could make up 15°.
Clinical, Roentgenologic and Pododynamography Results of Minimum Invasive Total Hip Arthroplasty
Authors: Laykher F. , Sandler K. , Scheider S. , Babisch J. , Seleznyov M. N , But-Gusaim A. B , Sirotin I. V , Pimenov A. Anatol'evich , Rot A.
Published: October 2020

Clinical, roentgenologic and pododynamographic data were analyzed for 195 patients after 207 total hip arthroplasties performed via modified minimum invasive anteroexternal approach by Watson-Jones during the period from 2004 to 2006. Clinical results showed reduction of rehabilitation period and significant relief of postoperative pain syndrome. The rate of complications corresponded to that at conventional technique application. Despite slight varus position of the femoral component roentgenologic examination results were also comparable. Analysis of gait showed its considerable improvement and decrease in preoperative asymmetry between healthy and operated sides already in 4 months after operation. Residual differences were almost not observed in 6 months after intervention. Obtained clinical results confirmed the advantages of the applied technique.
Clinical Efficacy and Safety of Primary Thrombotic Complications Prevention after Orthopaedic Operations
Authors: Kulinchik T. V , REbrova O. Yu , Margieva A. V , Avkcent'eva M. V , Voskresenskiy O. Yu , Petrova N. V , Reino E. V
Published: October 2020

Comparative study of clinical efficacy and safety of dabigatran etexilate (DE) and other widely used anticoagulants (AC) in primary thromboprophylaxis after orthopedic interventions was performed. Retrospectively 828 patients from 13 hospitals located in 10 different Russian towns were evaluated. Seven hundred sixty one patients (91,9%) underwent total arthroplasty of either knee or hip joints and 67 patients — other orthopedic operations. Clinical efficacy of AC was evaluated by the rate of postoperative vein thrombosis, safety of AC — by the rate of postoperative bleedings. No statistically significant difference in the incidence of venous thromboembolism at DE and other AC intake after total arthroplasty (distal thrombosis — 4% [2%, 7%] and 4% [2%, 6%] in DE and other AC subgroups, respectively; proximal thrombosis — 0% [0%, 1%>] in both subgroups and after other orthopaedic interventions (distal thrombosis — 4% [0%, 18%] and 3% [0%, 13%]; proximal thrombosis — 4% [0%, 18%] and [0%, 9%] in DE and other AC subgroups, respectively) was detected. The incidence of bleeding after arthroplasty also showed no significant difference between DE and other AC (minimum postoperative bleeding was 1% and 1% in DE and other AC subgroups, respectively; massive bleeding — 0% in both subgroups. No postoperative bleeding was observed after other orthopaedic interventions. Thus clinical efficacy and safety of DE is comparable to other widely used AC for thrombosis prevention.
Iatrogenic Neuropathy of Extremity Peripheral Nerves
Authors: Savitskaya N. G , Abdrayzyakova D. M , Yankevich D. S , Pavlov E. V
Published: October 2020

Retrospective clinical-ENMG analysis of data on 419 patients with mononeuropathy of different genesis (traumatic and nontraumatic) was presented. In 48 patients (11.4%) out of them mononeuropathy was of iatrogenic character. Neuropathy of radial and peroneal nerves was detected more often, 48% and 28%, respectively. Main causes of nerve injury were the mistakes in preoperative planning and inobservance of operative technique. It was showed that in most cases iatrogenic injury of nerve could be avoided. The ways of iatrogenic neuropathy prevention included the optimization of surgical and particularly traumatologic tactics.
Tribochemical Component of Oxidative Stress Development at Artificial Joints Implantation. Part 4. Use of Lubrication and Antioxidant Action of Bone Fat in Total Hip Implant
Authors: Gavryushenko N. S , Bulgakov V. G
Published: October 2020

Human bone fat possesses expressed lubrication action, essentially reduces the torque moment of various friction units, inhibit formation of toxic free radicals. With the purpose of patient's bone fat use in Movshovich — Gavryushenko hip joint implant an arthro-medullar canal that connect bone marrow cavity and wear bearing surface of implant is present. Axial loadings of this implant cause flow of liquid bone fat via canal to friction unit thus promoting improvement of tribologic parameters and inhibiting the development of free radical reactions. Application of bone fat can reduce or completely block the action of several negative factors that deteriorate outcomes of total joint replacement.
Variants of Spine Deformity Correction in Children with Idiopathic Scoliosis of Thoracic Localization
Authors: Vissarionov S. V , Kokushin D. N , Drozdetsky A. P , Belyanchikov S. M
Published: October 2020

Treatment results for 24 patients (21 girls and 3 boys), aged 14—17 years, with idiopathic thoracic scoliosis are presented. In all cases right-side type of deformity was observed. The main arch of curvature ranged from 52° to 92° by Cobb. The operation was performed from dorsal approach with application of metallic devices with transpedicular supporting elements using 3D-CT navigation. Depending on anatomical and anthropometric peculiarities of vertebral bone structures within the curvature arch, two variants of surgical correction were applied. Correction of the first type was performed in 18 patients; second type of correction was applied in 6 children. Second type of deformity correction differed from the first one by the sequence of rods implantation relative to the sides of main arch and corrective maneuvers at deformity correction. In the first group postoperative deformity correction in frontal plane made up 92—99%, derotation correction of the apical vertebra from 72 to 94% versus 91—100% and from 11,4 to 29,4% in the second group.
Two-Step Total Hip Arthroplasty in Deep Periprosthetic Infection
Authors: Voloshin V. P , Eryomin A. V , Onoprienko G. A , Lekishvili M. V , Vasil’ev M. G
Published: October 2020

Modern notions about surgical techniques for the treatment of deep purulent processes in the zone of hip implant are presented. In 13 cases surgical sanitation without implant removal was performed. In case of implant loosening treatment tactics was determined by the possibility of total revision arthroplasty. In 76 patients with periprosthetic infection surgical sanitation was aimed at inflammation arrest and restoration of extremity weight bearing after compelled implant removal. In 44 patients resection arthroplasty with formation of neoarthrosis by Girdlestone was performed. In 17 cases a two-step surgical intervention with implantation of antibiotic impregnated cement spacer followed by revision arthroplasty was used. Clinical, microbiologic and immunologic criteria of favourable treatment outcome with minimum risk of inflammatory process relapse were determined.
Experimental Morphologic and Clinical Substantiation of Autothrombocytic Growth Factors in Complex Treatment of Achilles Tendon Rupture
Authors: Kesyan G. A , Berchenko G. N , Nakhapetyan T. G , Gavryushenko N. S , Uraxgil’deev R. Z , Mikelaishvili D. S , Arsen’ev I. G , Muradyan D. R , Dan I. M
Published: October 2020

Study of the influence of autothrombocytic growth factors upon the injured tendinous tissue was performed. Experimental results (60 Chinchilla rabbits, 3—5 kg) showed that administration of autologous platelet-rich plasma (PRP) into Achilles tendon (AT) injury zone promoted activiza- tion of reparative processes with diminution of inflammatory manifestations; increase in angio- genesis, proliferative and synthetic fibroblasts activity, fibrillogenesis processes; earlier tendon healing. Clinical study included 57 patients (33—68years) with acute (8—48 hours) and old (1—12 months) AT ruptures. After AT surgical reconstruction(Cuneo tendon sutures in acute AC ruptures and Chernavsiautoplasty in the old ones) PRP was additionally administrated to 30 patients from the main group. Treatment results were evaluated by J. Leppilahti and AOFAS scales in 4 months after surgical intervention. In no one patient from the main group AT reruptures were recorded while in control groupreruptures were recorded in 26% of patients.
Some Aspects of Funnel Chest Diagnosis in Children
Authors: Shamik V. B , Davud B. A
Published: October 2020

Examination results for 294 children aged 7 days — 17 years with funnel chest deformity were presented. Anthropometric measuring of the chest was performed. New method for calculation of chest flattening index was used. New ways for the determination of deformity index, area of entrance to the cavity and cavity volume were suggested. Notion of «deformity coefficient» was introduced; local and diffuse types of funnel chest were identified. Dependence between the indices of chest deformity in sagittal plane, patient’s age and deformity severity was established.
Treatment of Patients with Dislocation of Hip Implant Head
Authors: Kagramanov Sergey Vladimirovich , Zagorodniy N V , Nuzhdin V I , Buravtsova M E , Kagramanov S V , Zagorodniy N V , Nuzhdin V I , Buravtsova M E
Published: October 2020

Experience in treatment of 40 patients (41 cases) with dislocation of the head of hip joint implant operated on during the period from April 2002 to November 2011 at CITO joint replacement department is presented. Causes and factors of that complication development have been analyzed, techniques of treatment applied at CITO joint replacement department have been described and conclusions on the importance of certain aspects of patients' management have been made.
Peculiarities of Shin Muscles Bioelectric Activity in Children with Infantile Cerebral Palsy
Authors: Shamik Viktor Borisovich , Tupikov V A , D'yakova V N , Shamik V B , Tupikov V A , D'yakonova V N
Published: October 2020

Electroneuromyography (ENMG) indices were analyzed for 207 patients aged from 4 to 16 years with cerebral palsy. All patients had equinus foot deformity and myofascial pain syndrome of various severity degree. One hundred thirty three children were treated conservatively and in 74 patients various surgical interventions were performed. Results of needle ENMG performed to 21 patients with severe myofascial pain syndrome confirmed presence of skeleton muscles lesion with scarry degeneration. In operated children indices of electrogenesis were higher than in conservatively treated patients.
Experience in Arthroscopic Treatment of Adhesive Shoulder Joint Capsulitis
Authors: Lomtatidze E. Sh , Lazko F. L , Kubashev A. A , Savitskiy P. P , Prizov A. P
Published: October 2020

Arthroscopic treatment results were presented for 74 patients, aged 38— 69 years, with adhesive capsulitis (78 shoulder joints). In 68 cases idiopathic capsulitis was diagnosed. Tactics of arthroscopic intervention was proposed and surgical procedure was described in detail. Active movements were initiated on 5-7 day. Mean value of shoulder joint function prior to operation made up 11 (7—14) points, in 2 weeks after intervention — 27 (23—30) points that corresponded to good and excellent result. In 6 months after operation range of movements in the operated joint was equal to that in the healthy joint.
Correction of Spine Pathology in Patients with Meningocele
Authors: Kolesov S. V , Baklanov A. N , Shavyrin I. A
Published: October 2020

Treatment results for 8 patients aged 3 to 17 years with neuromuscular spine deformities on the background of meningocele are presented. In all patients spine deformities were accompanied by spinal dysraphias. Average curvature arch was 86°. Surgical treatment was performed either in one (5patients) or in two (3 patients) steps. In 2 patients vertebral column resection (VCR) was performed. Average achieved scoliotic deformity correction made up62% and postoperative value of thoracic/thoracolumbar kyphosis approximated the physiologic one (40°). Surgical treatment of kyphoscoliosis on the background of meningocele that consisted of extensive spine instrumentation with pelvis fixation favoured the normalization of trunk balance, improved cardiopulmonary function, patients’ appearance and life quality. In this group of patients surgical intervention is associated with high intraoperative risk and rate of postoperative complications.
Outcomes of Innovative Programmed Treatment of Children with Malignant Loco-Motor System Tumors in Moscow
Authors: Shvarova A. V , Volkova L. D , Ochkurenko A. A , Ivanova N. V
Published: October 2020

During the period from 2005 to 2010 forty nine patients from Moscow city aged 1 — 16 years (mean age 9.4 years) were treated for malignant tumors (MT) of loco-motor system. Localized process was diagnosed in 25 (51%) patients, IV stage of disease in 24 (49%) children. Use of adopted treatment program including intensive polychemotherapy, organ-saving surgical treatment and radiotherapy enabled to achieve optimistic results. Overall 2-years survival rate for children with loco-motor system MT made up 64.3±7.2%, i.e. 86.5±7.2% in localized and 42.6±10.5% in disseminated process.
Peculiarities of Bone Regenerate Structural Condition in Patients with Achondroplasia and Congenital Varus Deformity
Authors: Menshchikova T. I , Aranovich A. M
Published: October 2020

Peculiarities of osteogenesis course in patients with achondroplasia at crus lengthening and in patients with congenital varus deformity in the process of correction were studied using US methods. Qualitative and quantitative US criteria that characterized normal, high and low reparative osteogenesis activity were presented. It was established that distraction regenerate with low level of osteogenesis was characterized by delayed organotypical reconstruction and disturbance of microcirculatory bed formation. The necessity of dynamic US examination during the whole period of treatment was shown.
Potentialities of Plastic and Reconstructive Microsurgery in Treatment of Patients with Pathology of Large Joints of Extremities
Authors: Tikhilov R. M , Kutyanov D. I , Rodomanova L. A , Kochish A. Yu
Published: October 2020

Potentialities of reconstructive and plastic microsurgery in patients with different pathology of large joints of the extremities were studied. Results of 265 microsurgical operations with pedicle flap (65.7%) and free tissue (34.3%) grafting were assessed. It was shown that use of microsurgical techniques provided reconstruction of full value para-articular soft tissues, increased range of joint movement and created the conditions for effective arrest of local inflammatory process. Besides, they possessed potentialities for the performance and increase of the efficacy in arthroplasty and some other high technology operations on large joints. The more distally the joint is located the higher is the need in reconstructive-plastic microsurgical operations and free tissue grafting on upper and lower extremities.
Use of Asymmetric TLIF Technique for the Treatment of Idiopathic Scoliosis
Authors: Baklanov A. N , Kolesov S. V , Shavyrin I. A
Published: October 2020

Purpose of the study was to determine the possibility of asymmetric transforaminal lumbar interbody fusion (TLIF) application for dorsal spine correction and fixation in patients with idiopathic scoliosis. Dorsal spine correction and fixation using technique of asymmetric transforaminal lumbar interbody fusion on the concave side of lumbar spine deformity was performed in patients, aged 14—58 years, with idiopathic scoliosis. Average preoperative deformity angle made up 78.25° versus 30.25° postoperatively; average correction was 61.6%. For TLIF performance combined implants, i.e. interbody titanium cages filled with autobone, were used. Use of asymmetric TLIF enabled to reduce the slope of lower instrumented vertebra and thus to perform the correction of spine frontal balance. Lordosing effect of cage improved the sagittal profile of the vertebral column while more rapid formation of lumbar corporodesis under conditions of interbody fixation prevented rods and screws fractures in the lower pole of metal constructions.
Use of High Frequency Coblation for the Treatment of Achilles Tendon Diseases
Authors: Mironov S. P , Orletskiy A. K , Vasil’ev D. O
Published: October 2020

Actuality of the work was conditioned by wide prevalence of Achilles tendon diseases and considerable number of unsatisfactory treatment results. First native experience in use of high frequency coblation for the treatment of patients with Achilles tendon diseases was presented. Intervention was performed in 26 patients with chronic Achilles tendon paratenonitis and tendinitis, and in 8 patients with tendoperiosteopathy of calcaneal tuber. In all cases treatment results were assessed as good: pain syndrome was completely arrested, restoration of tendon and calcaneal aponeurosis thickness and homogeneity as well as regress of fibrosis were observed. Neither intranor postoperative complications were registered.
Role of Lipid Peroxide Oxidation in Pathogenesis of Long Bone Pseudarthrosis
Authors: Urazgil’deev R. Z , Kesyan G. A , Varfolomeev V. N , Shtol’ko V. N
Published: October 2020

The study of peculiarities of lipid peroxide oxidation (LPO) and antioxidant defense in locomotor injuries was presented. There were 49 patients with complicated and uncomplicated ununited fractures as well as pseudarthrosis of ling bones. Control group consisted of 15 healthy persons. Primary products of LPO (diene coniugates (DC) and quantity of double bonds (DB) in unsaturated fatty acids (UFA) were determined in plasma. In patients with pseudarthrosis complicated by purulent inflammatory process content of DC and DB UFA were the highest. In patients with ununited fractures DC and DB were higher in comparison with patients with normal healing fractures. In tested group plasma lipids and erythrocyte osmotic resistance were decreased but ceruloplasmin was increased. Based on data obtained integral indicis for complex evaluation of patient status and possible complications were suggested.
NFLUENCE OF THE DEGREE OF CALCIUM SUBSTITUTION BY ARGENTUM IN TRICALCIUM PHOSPHATE ON ITS BIOLOGICAL PROPERTIES IN VITRO
Authors: Khon V. E , Zagorodniy N. V , Komlev V. S , Fadeev I. V , Bulgakov V. G , Sergeeva N. S , Sviridova I. K , Tolordava E. R , Didenko L. V
Published: October 2020

Results of in vitro study of argentum containing tricalcium phosphate (TCPh-Ag) are presented. It is shown that biomaterial does not possess radical forming activity. Argentum containing forms of TCPh render bacteriostatic effect upon Staphylococcus haemolyticus and Escherichia coli. Dose-dependent effect of TCPh-Ag in relation to antibacterial and cytotoxic properties is demonstrated. It is determined that TCPh with rated substitution 0.5 is characterized by moderate cytotoxicity with preservation of antibacterial properties.
Osteoplastic Substitution of Acetabular Defects at Revision Hip Arthroplasty
Authors: Zagorodniy N. V , Nuzhdin V. I , Nikolaev I. A , Kagramanov S. V , Komlev V. S
Published: October 2020

First experience in application of synthetic and natural osteoconductive biocompatible materials of calcium orthophosphates that gradually resorb and are substituted by newly formed bone tissue is presented. Those osteoplastic materials were used in 11 patients aged 45–78 years at revision hip arthroplasty due to unstable acetabular component. According to W. Paprosky classification II A type of acetabular defect was diagnosed in 2 patients, II B type — in 2, II C type — in 3, III A type — in 3 and type III B — in 1 patient. Volume of used material was determined by the size of bone defect and ranged from 10 to 50 g. At terms from 3 to 18 months satisfactory treatment result was observed in all patients. Control X-rays and computed tomograms showed that structure of remodeled bone tissue approximated to the acetabular structure and its’ density almost corresponded to pelvic bones density.
Surgical Treatment of Congenital Kyphosis
Authors: Kolesov S. V , Snetkov A. A , Sazhnev M. L , Shaboldin A. N
Published: October 2020

Surgical treatment results of 24 patients, aged 3 — 57 years, with congenital kyphotic deformities of thoracolumbar spine are presented. Disturbance of vertebrae formation was diagnosed in 13 patients, segmentation disorder — in 4, mixed abnormalities — in 1, nonclassifying abnormalities — in 3, congenital dislocations (subluxation) — in 3 patients. Neurologic disorders were observed in 12 patients. Five surgical techniques were used for the treatment of congenital kyphotic deformities: posterior fusion (8 patients), combined dorsal and ventral fixation (6), spinal cord decompression in combination with correction and stabilization (4), resection of hemivertebra (3), VCR (Vertebral Column Resection — 4). After surgical correction the angle of kyphotic deformity made up from 7 to 68° (mean 42°), degree of correction from 6 to 84% (mean 34%). Differentiated use of surgical techniques enables to achieve good treatment results, formation of proper frontal and sagittal balance as well as to create conditions for an adequate spine development.
Surgical Treatment of Severe Spine Deformity in Patients with Spinal Muscular Atrophy
Authors: Kolesov S. V , Kudryakov S. A , Shavyrin I. A , Shaboldin A. N
Published: October 2020

Two-step surgical treatment was conducted in a 17 year old woman with extremely severe kyphoscoliotic deformity on the background of spinal muscular atrophy. At first step a ring of haloapparatus was assembled and gradual halotraction was performed in an armchair within 21 days. Second step included dorsal correction and stabilization of scoliosis by hybrid fixation system at Th3-L4 level with pelvis fixation. As a result of surgical intervention a proper trunk balance was formed, pelvic deformity was diminished, selfservice and use of wheelchair in a sitting position was improved.
Surgical Treatment for Unstable Pelvic Ring Injuries
Authors: Donchenko S. V , Dubrov V. E , Slinyakov L. Yu , Chernyaev A. V , Lebedev A. F , Alekseev D. V
Published: October 2020

Treatment results for 67 patients (43 men, 24 women), aged 15–70 years, with unstable pelvic ring injuries are presented. In 15 cases conservative treatment (control group) and in 52 cases various surgical interventions (main group) were performed. In the main group of patients a strategy of two5step surgical treatment of the victims with multiple and concomitant injuries Damage control concept was applied. It included urgent stabilization of pelvic ring with external fixation devices and C-frame, bleeding arrest, final fixation within first 5–7 days after stabilization of patient’s condition. Restoration of the anterior semi5ring was performed using either external fixation device or a reconstructive plate. Stabilization of sacroiliac junction was per5 formed with cannulated screws. All patients were allowed to walk on crutches within 1–5 days after operation. In control and main groups the duration of hospitalization made up 43.7±2.5 and 25.7±3.1 days (p
Use of Spacers for the Treatment of Deep Periprosthetic Infection of Hip and Knee Joints
Authors: Murylyov V. Yu , Kholodaev M. Yu , Rukin Ya. A , Lychagin A. V , Karpov V. V , Rimashevskiy D. V , Elizarov P. M
Published: October 2020

Experience in treatment of 27 patients with deep periprosthetic infection is presented. In 17 patients infectious process was localized in the zone of hip implant, in 10 patients — in the zone of knee implant. Sanitation without implant removal was performed in 2 cases of early deep infection. Two-step revision arthroplasty was performed in 25 patients with late deep infection. First the implant was removed and spacer was inserted, then spacer was changed for a revision implant. In 12 patients individual articulating spacers with antibiotics were used. No relapse was noted in 23 patients at terms up to 58 months. Thus, two-step revision arthroplasty with application of spacers showed its high efficacy in treatment of patients with late deep periprosthetic infection.
Interdigital Hyperkeratosis of the Foot: Orthopaedic Approach to Surgical Treatment
Authors: Berezhnoy S. Yu , Protsenko A. I , Kostyukov V. V
Published: October 2020

Surgical treatment results for 27 patients with interdigital keratosis of the foot were analyzed. To determine the predisposing factors for keratosis development data of clinical and roentgenologic examination were used. In all cases transcutaneous technique that enabled to avoid surgical intervention directly on a pathologic focus was applied. Mean follow up period made up 6 months. It was shown that transcutaneous surgical intervention was an effective and reproducible method for interdigital keratosis treatment. That technique provided positive results with minimum risk of postoperative complications in the majority of cases and could be used at outpatient department.
Surgical Treatment of Talus Osteochondral Lesions with Platelet-Rich Plasma
Authors: Muradyan D. R , Kesyan G. A , Levin A. N , Kesyan O. G , Mazur A. V , Kravec I. M
Published: October 2020

Wide application of cell therapy particularly platelet enriched plasma (PRP) in modern orthopaedics enabled to improved treatment results in certain orthopaedic diseases and injury consequences. Treatment results for 7 patients (2 men and 5 women) with osteochondral lesions of talus (OLT) are presented. Mean age of patients was 26 years, mean duration of disease — 4 years. By Brendt and Harty roentgenologic classification I—II degree of OLT was diagnosed in 1 and III—IV degree — in 6 patients. In all patients mosaic chondroplasty of talus with implantation of PRP gel was performed. Postoperatively mean AOFAS index raised from 53 to 92. Follow up period made up around 2 years.
Efficacy and Safety of Two-Level Block of Brachial Plexus in Surgeries on Proximal Upper Extremity
Authors: Dubinenkov V. B , Lyuboshevskiy P. A , Larionov S. V , Zvorygina M. S , Koryshkov N. A
Published: October 2020

Study results for 71 patients (mean age 58.3±3.4 years) who were operated on for the injury of shoulder joint, upper and middle humerus are presented. Surgical intervention was performed under regional anesthesia. Block of superficial cervical plexus and intercostobrachial nerve was applied in all cases. Additionally in the main group (n=37) two-level block of brachial plexus (BBP): interscalene blockade in complex with supraclavicular one was used, in control group (n=34) — one-level block, i.e. either interscalene or supraclavicular was performed. Pain syndrome was assessed by visual analogue scale. It was shown that in surgical interventions on proximal upper extremity two-level BBP provided higher quality of anesthetic effect and postoperative analgesia, enabled to decrease the expenditure of opioid analgesics within the first postoperative day and, hence, the risk of related side effects development. Number of complications was not significantly different between the two groups.
Revision of Sivash Endoprosthesis 41 Years after Primary Operation
Authors: Zagorodiy N. V , Nuzhdin V. I , Bukhtin K. M , Kagramanov S. V
Published: October 2020

Clinical observation of a female patient who at the age of 16 underwent total hip replacement by Sivash implant due to congenital left hip dislocation is presented. The reason for revision intervention that was performed in 41 years after primary arthroplasty was the fracture of the implant stem. The stem was removed via 2 transfemoral approaches. Modular revision stem for distal fixarion was implanted. Treatment result is considered to be satisfactory: no pain is present and weight bearing ability is restored.
Efficacy of Various Arrangements of Pelvic External Rod Fixators in Polytraumatized Patients at Resuscitation Step
Authors: Ivanov P. A , Zadneprovskiy N. N
Published: October 2020

Application of external fixators (EF) in pelvic fractures is one of the important components of antishock therapy in patients with polytrauma. However various fixation techniques possess certain advantages and disadvantages. Comparative analysis of 4 most commonly used variants of pelvic EF mounting, i.e. classic - via upper flaring portion of the ilium, supra-acetabular, orthogonal - combination of screws passes through the wings and supra-acetabular region, and subcristal, that were applied in 32, 48, 13 and 3 patients, was performed. Results of the analysis showed that supra-acetabular pelvic fixation technique a preferable one due to its high efficacy and lower rate of complications as compared to other external fixation methods.