bluuebunny/crossref_metadata_2025 huggingface dataset:
Windows and Doors as Border Symbols of Home Space
Authors: Andrushchenko Stepan , Gromova Natalia
Published: October 2020

The article deals with the ritual significance of some traditional Ukrainian dwellings architectural elements, such as windows and doors. This theme is not completely studied at the scientific literature, because scientists mainly describe the external characteristics of architectural forms and only rarely mention their symbolic meaning. So, this article is based on the analysis of many examples of Ukrainian folklore, first of all lyric and calendar songs, legends and fairytales, as well as the rituals describing, taken by cultural anthropologists and folklorists from the 19th century.

During the study the authors find out, that windows and doors in Ukrainian traditional culture were perceived as complex elements, because they were both part of the dwelling complex and had a symbolic meaning and special functions in rituals and folklore.

Having lots ot similar features, the ritual meaning of windows and doors at the same time have some differences. Doors, first of all, served as an entrance and an exit, so their basic function was to pass in the house, to let out from it and to provide protection; instead, the window provided a visual connection to the outside world.

The general sacred value of the studied objects was their role as a symbolic border between «own» and «alien» space. This provided a connection between the inhabitants of the house and the outside world and protected the interior home space from real and mythological threats from the outside. Windows and doors in traditional culture had to provide the transparency of limits. As a result, the studied architectural elements of the dwelling have been given the status of particularly dangerous points of contact with the outside world. It was signified in the relevant beliefs of our ancestors. People must cross the threshold without stepping on it, it was impossible to sit on it, it was impossible to stand on it during the thunder. As it was mentioned above, windows and doors served as the limit between «own» and «alien» space, therefore they could not only let the souls of the dead in the house on some calendar holidays, but they also protect house from unwanted arrival of different demonological creatures (witches, mermaids, living dead, etc.), for what on windows and doors, above them and under them were put various amulets.

Sacralized locuses of home space have become elements of calendar, family, magic rituals that have accompanied a person in traditional society from birth to death.
Cheatings around the money counterfeiting in Russian and Austro-Hungarian empires in the XIX and XX Centuries
Authors: Boiko-Gagarin Andrii
Published: October 2020

The period during which the Ukrainian lands were ruled by the Romanov and Habsburg monarchy dynasties within the Russian and Austro-Hungarian empires was also a noticeable problem of the existence of counterfeit money in the circulation, as well as fraudulent processes related to or involved in counterfeiting. The article deals with the special cases of fraud and cheatings that took place around the process of counterfeiting and sale of the money forgeries in the Ukrainian lands during their stay included in the Russian and Austro-Hungarian empires, based on the little-known and previously unpublished sources of study. Particularly interesting are cases of fraud around the sale of counterfeit credit bills, where trusted scammers were offered to buy high-quality counterfeit money at a discounted price, with only such pieces of paper where the top and bottom sides contained genuine banknotes when issuing such an illegal transaction. With the increase in the number of counterfeits of Russian credit bills detected, since the first quarter of the XIX century, the investigation has established the fact that counterfeits were imported from England, where a factory for the production of counterfeits was organized in London. Information about the counterfeiters has gained such publicity, and rumors about the stuffing of counterfeit English banknotes throughout Russia have become so entrenched in the imagination of the population that they have spawned a new kind of fraud – offering to buy high-quality «English» counterfeits for easy sale. The counterfeiting was also the manufacture of the postage stamps, the illicit manufacture or erosion of the repayment of which was pursued by the state. Traditional crime against the money supply, which by the time of the late modern times was directly equated with counterfeiting, was the cutting the edge of coins in various ways. With the introduction of new money into circulation, fraudsters often used this kind of deception on the part of the trusted population, like paying by old coins telling they are the new ones. Often, reports of counterfeiting are accompanied by information about fantasy technologies, not only in the focus of the special devices, but also in the equipment of the premises. Interesting evidence of fraud and fraud involved in counterfeiting can be attributed to «shuler» coins, the two sides of which are identical, which served to deceive gullible gamblers.
Clinical Efficacy of Minimally Invasive Transpedicular Stabilization for Thoracic and Lumbar Vertebrae Fractures
Authors: Byval’tsev V. A , Kalinin A. A , Budaev A. E
Published: October 2020

Clinical efficacy of percutaneous transpedicular stabilization for the treatment of patients with A2 and A3 traumatic compression thoracic and lumbar fractures was performed. The study included 25 patients with mean age 34 (29-42) years. The male-female ratio was 2:1. Severity of pain syndrome by analog visual scale (VAS), quality of life by Oswestry Disability Index (ODI), duration of surgery and blood loss, patient outcome satisfaction by MacNab's criteria and rate of complications were assessed. Mean duration of surgery made up 120 (90-140) min, median blood loss - 50 (30-80) ml. Marked postoperative reduction of pain syndrome (p
Hip Arthroplasty in Patients with Femoral Neck Pseudarthrosis
Authors: Kavalerskiy G. M , Murylyov V. Yu , Rubin G. G , Rukin Ya. A , Elizarov P. M , Muzychenko A. V
Published: October 2020

Hip arthroplasty outcomes for 202 patients, aged 40-88 years, with femoral neck pseudarthrosis were analyzed. All patients were divided into 3 groups depending on the type of treatment (surgical or conservative) and terms of the removal of previously implanted metal constructions (before or during surgical procedure). Good and satisfactory results by Harris hip score were achieved in 94.6% of observations. The reasons of postoperative complications were considered for every group of patients. It was stated that in 30 (14.9%) cases the formation of pseudarthrosis resulted from ungrounded use of osteosynthesis in Garden III and IV fractures.
Elaboration of Universal Approaches to the Treatment of Long Bone Osteomyelitis on the Basis of Reinforced Local Antibacterial Carriers
Authors: Dzyuba G. G , Reznik L. B , Erofeev S. A , Odarchenko D. I
Published: October 2020

Treatment results are presented for 86 patients with long bone osteomyelitis of different genesis (hematogenous, posttraumatic, postoperative). To determine the location of the implant the Cierny-Mader classification was used. In the main group (n=46) debridement of the osteomyelitic focus and placement of local reinforcing antibacterial polymethyl methacrylate implant with pathogen-specific antibiotics were performed. In the control group (n=40) traditional treatment techniques were used. Application of the proposed technique enabled to achieve 1.9 times decrease of infection relapse, to minimize the risk of pathological bone fractures due to its internal reinforcement and to achieve early functional restoration of the extremity.
Thromboprophylaxis after Arthroplasty in Practice of Outpatient Trauma and Orthopedic Physician: is it necessary?
Authors: Firsov S. A , Matveev R. P , Shevchenko V. P , Tumorin L. S
Published: October 2020

Analysis of the safety and efficacy of the currently marked oral anticoagulants in patients after large joints arthroplastyat outpatient step was presented for the first time in Russian clinical practice. Total number of 5025 patients after total knee and 5216 patients after total hip arthroplasty were examined. All patients were divided into 3 groups depending on prescribed anticoagulant (dabigatran, rivaroxaban or apixaban). Duration of therapy with corresponding drug after hip and knee arthroplasty was initiated after surgery and made up 35 and 45 days, respectively. Deep vein US examination was performed to all patients in 3 and 6 months after discharge. In patients on dabigatran the rate of clinically significant deep vein thrombosis development was lower than in patients on rivaroxaban and apixaban, and made up 5% vs 7.7 and 16%, respectively. Rate of nonfatal pulmonary embolism (PE) was comparable. Relapse of deep vein embolism development was diagnosed only in patients who received rivaroxaban. A suggestion on the expediency of a longer thromboprophylaxis after surgical interventions on large joints was made that would require extensive studies.
Orthopaedic and Neurologic Aspects of Early Coxarthrosis Development in Children with Hip Dysplasia
Authors: Bakhteeva N. Kh , Korshunova G. A , Zotkin V. V , Norkin I. A
Published: October 2020

Comparison of clinical-roentgenologic and electroneuromyographic data was performed for 29 patients, aged 3 - 16 years, at different stages of conservative and surgical treatment for hip joints dysplasia. First group included 18 patients with complicated clinical course; second - 11 patients with favorable process of joint formation. Functional activity of motor neurons, spinal cord and peripheral nerves conductivity was assessed. It was shown that in patients from the 1st group the ENMG indices were statistically significantly lower than in healthy children ( р
Stabilizing Potential of Fixion Nail with Plastic Deformation for Fixation of Simulated Diaphyseal Bone Fractures (Experimental Study)
Authors: Yamkovoi A. D , Gavruyshenko N. S , Zorya V. I
Published: October 2020

Type A fractures by AO classification were simulated on eight human cadaveric specimens (2 shoulder segments, 3 femur and 3 crus segments). Fixion nails with plastic deformation were used for fixation. The magnitude of force resulting in bone fragments displacement was determined using universal machine at CITO test laboratory. On the basis of the obtained results the recommendations on the potential load in early postoperative period were given.
Factors Affecting theTerms of Fracture Consolidation
Authors: Matsukatov F. A , Gerasimov D. V
Published: October 2020

Dependence of the consolidation of spiral tibial fracture treated with transosseous osteosynthesis upon the initial transverse fragments dislocation, patient’s age, remoteness of injury, reposition accuracy and fixation stability was analyzed. Priority factors that will allow realizing the maximum potentialities of the technique are determined.
Prevention of Thromboembolic Complications afterSurgical Treatment for Lower Extremity BoneFractures: Experience in Rivaroxaban Use in ClinicalPractice
Authors: Kaplunov O. A , Biryukov S. N , Nekrasov E. Yu
Published: October 2020

Comparative evaluation of rivaroxaban (main group, n=37) and enoxaparin (control group, n=29) safety in thromboprophylaxis at closed lower extremity bone fractures treatment was performed. All patients were operated on at terms from 8 to 12 day after injury using external fixation devices. The volume of intra- and perioperative blood loss in the groups did not differ significantly ( p >0.05). The rate of symptomatic thromboembolic complications, i.e. calf deep vein thrombosis confirmed by clinical data, was significantly lower in patients from the main group (2.7%) as compared to the control group (6.8%; p
Analysis of the Experience of Carbon Nanostructured Implants Use in Traumatology and Orthopaedics
Authors: Borzunov D. Yu , Shevtsov V. I , Stogov M. V , Ovchinnikov E. N
Published: October 2020

Analysis of the carbon nanostructured implants (CNI) safety and efficacy for the treatment of bone pathology was performed at different clinics of the Russian Federation. Devices showed their efficacy at substitution of intervertebral disc and vertebral body defects as well as at plasty of long bone defects of various etiology. The rate of effect absence did not exceed 6.1%. No serious adverse effects were recorded. It is concluded that CNI possesses the number of characteristics (osteoinduction, bioinertia, safety) that allow using it in traumatology and orthopaedics.
New Approaches to Systematization and Treatment of Impression Monocondylar Tibial Plateau Fractures
Authors: Gilev M. V , Volokitina E. A , Antoniadi Yu. V , Kutepov S. M
Published: October 2020

Treatment results for 109 patients (mean age 56 ± 1.7 years) with monocondylar impression tibial plateau fractures (ITPF) are presented. Patients from the control group (n=63) were operated on during the period from 2008 to 1010, patients from the main group (n=46) - from 2011 to 2013. Patients from the main group were treated with regard for injury localization relative to plateau center according to proposed operational classification of impression fractures (by CT data) and algorithm to choose the osteosynthesis technique depending on the anatomic and morphologic peculiarities of the intra-articular injury. In patients from the main group the evaluation by Rasmussen scale 36 months after intervention showed excellent results in 15 (38.4%), good - in 22 (56.4%), satisfactory - in 5 (12.8%) of patients, no poor results were recorded, and in patients from the control group - in 6 (11.5%), 8 (15.3%), 36 (69.3%) and 3 (5,8%) patients, respectively. Three (7.6%) complications (secondary displacement of fragments (2), knee contracture (1)) were observed in the main group, and 11 (20.9%) in the control group (20.9%) - local infectious inflammatory process (4), secondary displacement of plateau fragments (6), condylar sag (1). Perfected tactics of treatment of patients with ITPF enabled to achieve 3.48 times more excellent and good results (p
Auto Preservation and Use of Auto Rib at Two-Step Surgical Treatment of Spine Deformities
Authors: Kolesov S. V , Sazhnev M. L , Snetkov A. A , Kaz’min A. I
Published: October 2020

The possibility of preservation and use of a resected rib for dorsal fusion at final correction of spinal deformity was studied. Treatment results for 80 patients aged 15 to 45 years, with severe spine deformity (scoliosis or kyphoscoliosis) were analyzed. In all patients two step surgical interventions was performed. Either transpedicular or hybrid (screws and sublaminar cerclage) fixation of the vertebral column were performed in 37 and 43 cases, respectively. After ventral release the resected ribs were stitched to subcutaneous fatty tissue and preserved until the time of final dorsal correction. The follow-up period made up 1 - 2 years. Fusion formation and autograft reconstruction was confirmed by radiologic methods. It was shown that rib auto preservation technique was a simple one, did not require special preservation conditions and allowed to preserve sufficient volume of autograft for final spinal deformity correction.
Effect of Baby Walkers on the Development of Locomotor Skills in Infants
Authors: Sharov A. N , Krivova A. V
Published: October 2020

A retrospective cohort study of the effect of baby walkers on the locomotor skills in children was performed. The study included 358 infants aged 11 to 15 months. To simplify the calculation we introduced the “walkers-day” index that was equal to 1 hour of walkers use per day for 1 month. The delay of non-assisted locomotion for 0.33 months (10.04 days) was observed in all walkers’ users and for 0.43 months in babies who used walkers within the interval of 1-21 “walkers-days”. It was stated that use of walkers was a risk factor of walking inability at the age of 11-12 months (Pearson coefficient (C) = 0.110, p
Optimization of Approaches to the Prevention of Thromboembolic Complications after Total Hip Arthroplasty
Authors: Borisova L. V , Nikolaev N. S , Dobrovol’skaya N. Yu , Vuimo T. A , Orlova A. V , Kachaeva Z. A , Didichenko S. N
Published: October 2020

To choose the optimum scheme of anticoagulant therapy for the prevention of thromboembolic complications after total hip arthroplasty 86 patients were examined. The patients were randomly divided into 3 groups. In group 1 (n=29) prevention of thromboembolic complications was performed by subcutaneous injection of enoxaparin (40 mg) started 12 hours before the surgery. In group 2 (n=28) enoxaparin (40 mg) was started 12 hours after surgical intervention. In those groups thromboprophylaxis with enoxaparin was continued during hospitalization period and at discharge the patients were given recommendations to take dabigatran etexilate up to 35 days. In group 3 (n=29) patients received oral dabigatran etexilate, 110 mg 1 - 4 hours after surgery, followed by 220 mg once-daily both at hospital and out-patient stage of treatment. The average duration of hospitalization made up 8.9±1.2 days. Minimum fibrinogen and D-dimer levels as well as maximum APTT values were observed in patients from group 3 on the 5th postoperative day. Thromboelastogram showed that on day 5 both plasma and platelet hypocoagulation were most expressed in 3rd group. Preoperative thrombodynamics showed high rate of clot growth and high percentage of spontaneous clots formation in all three groups that assumed initial hypercoagulation with maximum decrease of the frequency of spontaneous clots formation against the background of dabigatran prophylaxis. The lowest number (3,4%) of thromboembolic complications, i.e. distal thromboses, were observed in patients from dabigatran etexilate group. Assessment of anticoagulant prophylaxis costs showed a clear advantage of the 3rd group.
Modern Methods of Visualization in Diagnosis, Staging and Elaboration of Treatment Tactics for Primary Malignant Bone Tumors. Part I
Authors: Machak G. N , Morozov A. K , Snetkov A. I , Karpov I. N , Kochergina N. V , Bludov A. B , Ryzhkov A. D
Published: October 2020

At present the oncologists have great potentialities in diagnostic techniques that enable to determine not only the structural but functional characteristics of the tumor as well. The use of modern technologies of medical visualization for diagnosis, determination of the disease stage and effectiveness of neoadjuvant chemotherapy in patients with bone sarcomas of high degree (G3-G4) malignancy is presented.
Early Diagnosis and Treatment of Patients with Mucopolysaccharidosis IV and VI
Authors: Mikhailova L. K , Sokolova T. V , Polyakova O. A
Published: October 2020

Mucopolysaccharidosis (MPS) is an orphan pathology characterized by polymorphism of clinical manifestations and development of typical skeletal changes. However in early childhood the clinical picture is not clear that leads to misdiagnosis and results in inadequate management of patients including unjustified surgical intervention. Early clinical and roentgenologic changes specific to mucopolysaccharidosis IV and VI that enable to suspect the pathology development, to perform required examination with compulsory confirmation by DNA testing results and prescribe vital enzyme replacement therapy as soon as possible are presented. Early diagnosis and initiation of etiotropic treatment and timely correction of the occurring pathology ensure prevention of fatal complications.
Use of Rivaroxaban for Prevention of Venous Thromboembolic Complications in Elderly Patients after Hip Arthroplasty
Authors: Afanas’ev A. P , Kardanov A. A , Karandin A. S , Korolev A. V
Published: October 2020

Results of retrospective analysis of the efficacy and safety of venous thromboembolic complications prevention using anticoagulants (low-molecular-weight heparins and rivaroxaban) in elderly (over 75 years) patients after hip arthroplasty are presented. Ninety four patients were divided into 2 groups (n=47) depending on the applied anticoagulant. Follow up period was 6 months after hospitalization. Asymptomatic thrombosis was diagnosed by duplex ultrasonography only in 1 (2.1%) patient from low-molecular-weight heparin group. No one case of either bleeding or hemorrhage was recorded. It is stated that rivaroxaban ensured effective thromboprophylaxis and safety after hip arthroplasty in elderly patients when no restrictions related to the use of low-molecular-weight heparin injections are present.
Efficacy and Safety of Two-Level Brachial Plexus Block at Locking Intramedullary Shoulder Osteosynthesis
Authors: Dubinenkov V. B , Lyuboshevskiy P. A , Larionov S. V , Koryshkov N. A , Shushpanova E. V
Published: October 2020

Results of the comparative study of the efficacy and safety of one- and two-level brachial plexus block (BPB) at locking intramedullary shoulder osteosynthesis are presented. Fifty five patients (mean age 43.4±3.2 years) with humeral diaphysis fracture were operated on. In the main group of patients (n=28) two-level BPB was performed: interscalene block was combined with supraclavicular brachial plexus block and superficial brachial plexus block (SBPB). In control group (n=27) one-level interscalene and superficial BPB and SBPB were performed. Severity of pain syndrome was assessed by visual analog scale. It was shown that two-level BPB ensured better anesthetic, postoperative analgesic effect and higher percent of successful regional anesthesias as well as decreased the requirement in narcotic analgesics on the first postoperative day. The number of complications did not differ significantly between the groups.
Effect of Postoperative Wound Drainage on the Frequency of Red Blood Cells Transfusion after Primary Hip Arthroplasty
Authors: Grechanyuk N. D , Zver’kov A. V , Ovsyankin A. V , Zhiburt E. B
Published: October 2020

The effect of postoperative wound drainage on the frequency of red blood cells transfusion after primary hip arthroplasty was assessed. Prospective comparative study included 632 patients. The patients were divided into 2 groups depending on whether the postoperative drainage was performed (1st group) or not (2nd group). Duration of surgery, volume of intraoperative blood loss, the level of hemoglobin before surgery and during the first postoperative day, frequency and volume of red blood cells transfusion during the whole period of hospital treatment was evaluated. In group 1 donor red blood cells transfusion was required in 1.3%, in group 2 - in 0.8% of cases (p>0.05). No data on the effect of postoperative wound drainage upon the frequency of red blood cells transfusion after primary hip arthroplasty was obtained.
Surgical Treatment of Femoral Neck Fractures with Dynamic Derotation Оsteosynthesis
Authors: Dubrov V. E , Yudin A. V , Shcherbakov I. M , Ragozin A. O , Matveev A. L , Zyuzin D. A , Saprykina K. A
Published: October 2020

Fracture of the femoral neck is a common injury of the human skeleton. High rate of postoperative complications induces to the search of optimum osteosynthesis technique. Treatment results for 259 patients (182 females, 77 males, mean age 72 years) with femoral neck fractures were analyzed. In study group (n=114) a dynamic derotation osteosyntesis and in control group (n=145) - DHS, a bundle of V-shaped curved pins, cannulated screws were used. Mathematic modelling of bone-implant system in different variants of derotation fixator screws position under load was performed. Use of dynamic derotation constructions in Garden 1 and Garden 2 femoral neck fractures ensured a consolidation of fractures in all clinical observations, in Garden 3 fractures - in 46.4%. Early dosage weight bearing not exceeding 60% of the body weight did not result in either fragments displacement or raise of the rate of femoral head avascular necrosis development. In patients under 60 years it is preferably to use dynamic derotation constructions with 4 screws placed in the femoral neck.
Full -Function Restoration of Achilles Tendon with Nanofibrous Implant (experimental study)
Authors: Senotov A. S , Ol’khov A. A , Sklyanchuk E. D , Fadeeva I. S , Fadeev R. S , Fesenko N. I , Prosvirin A. A , Lekishvili M. V , Gur’ev V. V , Iordanskiy A. L , Akatov V. S
Published: October 2020

Creation of implants for the restoration of ligaments and tendons in their complete/massive injury is an urgent task. The efficacy of the restoration of completely resected Achilles tendons after implantation of a new material consisting of absorbable pledged threads Dar-Vin USP 5/0 and conductive nonofibrous scaffolds of polyhydroxybutyrate placed around the threads into the zone of defect was studied in Wistar rats. Either nanofibrous implant (experiment) or pledged threads (control 1) were placed into the zone of completely resected Achilles tendon (control 1), or the postresection wound was sutured without placement of any material (control 2). It was stated that from 2nd to 13th week after implantation of nanofibrous implant the animals from the experimental group used their hind paws in full volume. In control groups 1 and 2 the animals moved with difficulties. In the experimental group of animals in 6 and 13 weeks after implantation a soft tissue regenerate connecting the calcanean tuber and gastrocnemius muscle was present with the absence of gastrocnemius muscle contracture as compared with the control groups. Histologic examination showed the similarity of the regenerate on nanofibrous implant with the native Achilles tendon. Thus, the suggested implant ensured functional and morphologic restoration of totally resected Achilles tendon in rats and can be considered as a perspective prototype of new materials initiating effective regeneration of ligaments and tendons in their massive injuries.
Elaboration of New Treatment Methods for Spinal Cord Injuries Using Magnetic Nanoparticles in Combination with Electromagnetic Field (Experimental Study)
Authors: Kolesov S. V , Panteleev A. A , Sazhnev M. L , Kaz’min A. I
Published: October 2020

The latest studies on the use of magnetic nanoparticles (MNP) in biological systems prove their high biocompatibility and possibility to interact with various types of cells including the neurons. This may serve as a basis for potential restoration of the neuronal network after nerve tissue integrity damage. The purpose of the study was to determine the influence of MNP on the restoration of hind paws function in experimental animals after spinal cord transection (by 50, 80 and 100%) under the influence of a magnetic field. Magnetic nanoparticles were inserted into the injury zone via plastic catheter. The degree of function loss and its subsequent restoration was assessed by BBB Locomotor Scale and induced potentials on the first postoperative day and then weekly within one month. Statistically significant (p
Draft Recommendations. Pharmacotherapy for the Prevention of Repeated Fractures in Patients with Osteoporosis after Surgical Treatment of Pathologic Proximal Femur Fracture
Authors: Mironov S. P , Rodionova S. S , Torgashin A. N
Published: October 2020

Treatment of pathologic proximal femur fractures complicating the course of systemic osteoporosis is most often limited by surgical intervention as until now trauma and orthopaedic surgeons have no concrete recommendations on pharmacologic correction of metabolism disorders typical to the pathology, that aggravate in the postoperative period due to operative trauma. Proposed draft recommendations are a part of National clinical recommendations “Treatment for pathologic fractures of skeleton bones complicating the course of osteoporosis”. This issue of recommendations is only applicable to pharmacotherapy directed to the correction of bone tissue remodeling with regard for the fracture localization and volume of surgical intervention. Present recommendations are intended for the improvement of patients’ life quality, reduction of present and future losses from pathologic fracture as well as the prevention of repeated fractures.
Legg- CalvePerthes Disease: Etiology, Pathogenesis Diagnosis and Treatment
Authors: Kozhevnikov O. V , Lysikov V. A , Ivanov A. V
Published: October 2020

Etiology, pathogenesis, diagnosis and treatment for Legg-Calve-Perthes Disease were studied. Basic methods of conservative and surgical treatment were presented. For the elaboration of more effective treatment techniques the better understanding of the pathogenesis of femoral head deformation is required.
Mathematic Modelling of Stress in Healthy Knee Joint and After Arthroplastywith Different Typesof Endoprostheses
Authors: Smetanin S. M , Kavalerskiy G. M
Published: October 2020

Purpose of study. To study stressed-deformed state of the healthy knee joint and after arthroplasty using endoprostheses with either preservation or substitution of the posterior cruciate ligament by the method of numerical mathematical modelling. Materials and methods. Peculiarities of stress distribution in bones were determined on three mathematical models - healthy knee joint and joint after arthroplasty using endoprostheses with either preservation or substitution of the posterior cruciate ligament at the set load (80 kg) in straightened leg and either 45° or 90° knee flexion. Results. In healthy knee joint with a straightened leg the stress in the tibia is 2.3 times higher than in the femur. With knee flexion the stress in bone tissue increases and this increase is more intensive in the femur. After arthroplasty using endoprosthesis with substitution of the posterior cruciate ligament the stress in the tibia and femur is higher at all flexion angles as compared to arthroplasty using endoprosthesis with posterior cruciate ligament preservation Conclusion. The obtained data may be used for mathematical substantiation of the advantage of endoprosthesis with preservation of the posterior cruciate ligament and in complex with the data of national and international registers will enable to optimize the treatment tactics in patients to whom knee arthroplasty is indicated.
Characteristics of Pain Syndrome in Patients with Lumbosacral Discogenic Pathology in Post- OPERATIVE PERIOD
Authors: Gospod A. O , Krupatkin A. I , Kuleshov A. A , Sokolova T. V
Published: October 2020

Purpose of study. Evaluation of the pain sources and comparative analysis of chronic pain syndrome peculiarities in patients with various types of disc herniation before and after surgical intervention at lumbosacral level. Patients and methods. The study included 80 patients (20-60 years old) with discogenic pathology at lumbosacral level. The type and size of herniation was assessed by MSU classification. Every patient went through a complex evaluation of low back pain sources, pain syndrome characteristics and personality before and on day 10 after surgery. Results. The most common cause of pain was a musculoskeletal syndrome that was more pronounces in the older (41-60 years) group. Neither correlation between the degree of degenerative dystrophic changes and type and size of discogenic pathology, nor the relation between the disc herniation size and type and neurologic symptoms development was detected. The relation between the intensity and other characteristics of pain syndrome and type of disc herniation was not detected too. Analysis of pain syndrome characteristics and mechanisms in complex with the assessment of pain sources revealed the group of patients with high pain and emotionally affected indices before and after surgical intervention and mild vertebrogenic and other pain sources. That group made up 13% of the total number of patients; the majority of them (75%) were females (mean age 37.8±5.0 years) and in 50% of cases the herniation size and localization corresponded to type 2A. Taking into consideration a high degree of disability and other pain indices in postoperative period we do not recommend surgical intervention in this group of patients. Conclusion. Management of patients with lumbosacral intervertebral disc herniation requires the evaluation of all pain sources and pain syndrome aspects.
Early Results of the Study of Reparative Peculiarities of Various Osteoplastic Materials in Experimental Bone Defects
Authors: Egiazaryan K. A , Lazishvili G. D , Akmataliev K. I , Ettinger A. P , Rat’ev A. P , Volkov A. V , Korobushkin G. V , Polivoda M. D
Published: October 2020

Purpose. To determine the optimum osteoplastic material for activation of reparative osteogenesis and substitution of traumatic defects in metaepiphyseal spongy bone tissue. Material and methods. Comparative experimental morphological study was performed on 12 matured male Chinchilla rabbits with body weight 2500-2800g. A model of critical defects of spongy bone tissue was used. Bone defects were filled with 3 types of osteoplastic material: composite calcium sulphate bone cement; xenogenous hydroxyapatite-based material with granulated paste of synthetic peptides (P-15); β-tricalcium phosphate-based material with gauging liquid (calcium phosphate bone cement). Results. Implantation of calcium sulphate bone cement showed rapid osteogenesis stimulation at terms 1.5 months and reduction of newly formed bone tissue mass by 3rd month due to active resorption of the residual material. Implantation of hydroxyapatite-based material with P-15 resulted in osteogenesis stimulation on its surface however because of its mechanical instability and absence of active resorption of that material only a moderate formation of bone trabeculae was observed. At implantation of β-tricalcium phosphate-based material an active resorption of osteoplastic material, formation of trabecular system and its reorganization into trabecular network of femoral metaepiphyseal spongy bone accompanied by the formation of mature bone trabeculae was noted by month 3. Conclusion. Mechanical stability of osteoplastic material and subsequent gradual resorption as well as formation of mature bine trabeculae indicates the efficacy of β-tricalcium phosphate-based material.
Bacteriostatic Characteristics of Bone Substituting Constructors Obtained from Composite Materials Based on Natural Polymers, Calcium Phosphates and Vancomycin
Authors: Karalkin P. A , Sergeeva N. S , Komlev V. S , Sviridova I. K , Kirsanova V. A , Akhmedova S. A , Shanskiy Ya. D , Kuvshinova E. A , Fedotov A. Yu , Teterina A. Yu , Barinov S. M , Kaprin A. D
Published: October 2020

Introduction. The local delivery of therapeutic antibiotic concentrations to the zone of surgical intervention in bone pathology enables either to prevent or significantly decrease the rate of osteomyelitis development. It that study the efficacy of vancomycin inclusion and release from three dimensional constructors based on sodium alginate, gelatin and octacalcium phosphate and vancomycin intended for bone defect substitution was studied. Materials and methods . Prototyping of 3D constructors was performed by extrusion 3D printing. Various concentrations of vancomycin were added as an additional component at the stage of preparation of hydrogel (“ink”) for printing. Physical testing of the constructors included electron microscopic evaluation of their microstructure and porosity as well as the study of mechanical strength for compression and stretching. Functional activity of printed constructors with respect to the test strain S. aureus ATCC 6538-P was assessed by a disc-diffusion method in vitro and on the model of infected excision skin wound in rats - in vivo. Results . Analysis of the kinetic curves showed that the principal release of the drug in the model liquid took place within the first day. The total volume of the bound and released vancomycin made up approximately 20% of the calculated initial amount for all three concentrations. Formation of the marked growth inhibition zone of S. aureus strain in presence of vancomycin rich constructors was demonstrated in vitro. Insertion of constructors into the zone of infected skin defect resulted in a decrease of inflammatory processes severity and rate as well as accelerated the terms of complete wound healing. Conclusion. Study results showed the principle potentiality of bone substituting implants 3D-printing using multicomponent hydrogel compositions without change of separate components characteristics.
Influence of Radiofrequency Desrtruction on the Nerve Tissue Morfology in Experiment
Authors: Sharamko Taras G. , Kuleshov A. A , Cherkashov A. M , Kuz’min V. I , Yudakova M. E , Gorokhov M. A
Published: October 2020

Introduction. Clinical efficacy of radiofrequency destruction (RFD) for the treatment of vertebrogenic pain syndrome and pain in coxarthrosis is confirmed by multiple studies. However the matter on morphologic changes in the nerve and surrounding tissue after directed local radiofrequency effect. Materials and methods. The study was performed on autopsy material - fragments of tibial nerve from 6 patients with lethal outcomes. Radiofrequency destruction was performed according to a standard protocol: within 90 sec under 80 C°. The sections were stained with hematoxylin and eosin by Bilshowski-Gros method. Results. It was shown that RFD causes the coagulation lesions of the nerve tissue such as spiral deformation, axon fragmentation and nerve fibers dissociation. Conclusion. The data obtained may serve as a morphologic basis of RDF clinical efficacy. The presence of undamaged Schwann cells allows assuming the tropism of the effect upon the nerve tissue.
Potentialities of 3D-Visualization in Preoperative Planning of Primary and Revision Total Hip Arthroplasty
Authors: Sadovoy M. A , Pavlov Vitaliy V. , Bazlov V. A , Mamuladze T. Z , Efimenko M. V , Aronov A. M , Panchenko A. A
Published: October 2020

A variant of preoperative planning for revision interventions on a hip joint named “Method of layer by layer 3D visualization of the defect zone” is suggested. The method is realized via three consecutive steps with the ultimate aim to obtain data on the real acetabular defect geometry and bone tissue density. Using that method 9 patients (mean age 60±2 years) with pelvic bones defects were examined preoperatively. Based on the evaluation results of bone tissue condition in the defect zone the model and size of individual augment within the limits of weight bearing bone were corrected, the points of augment and acetabular component fixation were determined.
Experience in Use of Modified McLaughlin Procedure for Neglected Locked Posterior Subluxation of the Humeral Head
Authors: Belyak Evgeniy A. , Prizov A. P , Lazko M. F , Grigor’ev I. V , Zagorodniy N. V , Lazko F. L
Published: October 2020

Treatment results for 7 patients who were operated on for neglected locked posterior subluxation of the humeral head with reverse Hill-Sachs lesion during 2013-2016 are presented. Surgical intervention included the open reduction of subluxation and transposition of thelesser tubercle of the humerusto a defect zone. Mean followup period was 14±3 months. Range of motion in shoulder joint and its function were restored almost completely with only small restriction in external rotation. No recurrence of subluxation was observed. All patients returned to professional and day-to-day activity.
Risk Factors and Potentialities of Dislocation Prevention after Total Hip Arthroplasty
Authors: Stafeev Dmitriy V. , Efimov N. N , Sorokin E. P , Chugaev D. V , Gudz A. I , Boyarov A. A
Published: October 2020

The literature review is dedicated to the problem of femoral component dislocation after primary and revision total hip arthroplasty. Modern data on surgeon-dependent and -independent risk factors for this complication development are analyzed. Potentialities for dislocation prevention using constrained liners and dual mobility system are considered
Chronic Patellar Instability: Anatomic Precondition and Approaches to Surgical Treatment
Authors: Avdeev Aleksandr I. , Kuznetsov I. A , Shulepov D. A , Salikhov M. R
Published: October 2020

The literature review is dedicated to the problem of recurrent patella dislocation treatment. The key anatomic predispositions to patellar instability development are presented. The principles on which the techniques for surgical treatment of recurrent patella dislocation have been developed and used since the early 19th century are described. Thirty years’ experience in use of various surgical techniques for patellar stabilization that show both obvious advantages and certain disadvantages is generalized. Actual problems and issues of recurrent patella dislocation surgical treatment are reflected.
Comparative characteristics of osseointegration processes of the calcium phosphate coating implants and implants with germanium enriched calcium phosphate coatings
Authors: Zelichenko Elena A. , Guzeev V. V , Koval’skaya Ya. B , Gurova O. A , Guzeeva T. I
Published: October 2020

Introduction. Osseointegration process exerts considerable influence on the term of biological fixation of the implants and is an important parameter that is to be focused on at the implant placement. Purpose: to conduct a comparative analysis of the osseointegration of the titanium alloy implants with different coatings for the determination of the optimum coating compound for osteogenesis. Materials and methods. Comparative analysis of osteogenic properties of the implants with thermal chemical surface treatment, calcium phosphate coating and Germanium enriched (3% and 5%) calcium phosphate coatings applied by electrochemical technique was performed. Implant recipients were 29 not pedigree male cats aged 1.5 to 4.0 years with 2500 to 3400 g body weight. Experimental animals were euthanized in 90 days after surgical intervention. Results. Histological study results showed that bone tissue regeneration was most active when implants with higher level (5%) of Germanium in calcium phosphate coating were used. Calcium phosphate coatings and Germanium enriched ones showed better osseointegration as compared to the implants with thermal chemical surface treatment.
Reverse total shoulder arthroplasty in proximal humeral fractures
Authors: Petrosyan Armenak S.
Published: October 2020

Primary reverse total shoulder arthroplasty was performed in 13 patients, aged 65 - 83 years, with three- and four-part (by Neer classification) proximal humeral fractures. Rotator cuff injuries and shoulder contractures of various degrees were present in all patients. Surgical technique and postoperative rehabilitation program were described in details. Treatment results were assessed roentgenologically by Constant-Murley score in 6 months, 1, 2 and 3 years after intervention. Reverse total shoulder arthroplasty enabled to achieve good functional outcomes and considerable pain relief even in elderly patients with compound fractures and rotator cuff injuries.
First experience of ankle joint arthroplasty in a giant cell tumor of the tibial epiphysiometaphysis: case report and literature review
Authors: Snetkov A. I , Berchenko G. N , Frantov Anton R. , Batrakov S. Yu , Kotlyarov R. S , Kravets I. M
Published: October 2020

Case report for the 18 years old female patient with a giant cell tumor of the distal articular end of the right tibia is presented. The surgical intervention included segmental resection of the articular end of the right tibia and substitution of the defect with the custom-made ankle endoprosthesis. The follow up period made up 4 years. The range of motion in the right ankle joint was satisfactory, no relapse occurred and the implant components were stable.
Analysis of the conservative treatment efficacy in patients with subacromial impingement syndrome
Authors: Emel’yanenko Mikhail V. , Lazko F. L , Gazhonova V. E , Krivoshey I. V
Published: October 2020

Purpose: to evaluate the efficacy of the conservative treatment of patients with subacromial impingement syndrome (SIS) and supraspinatus muscle tendon (SMT) pathology using optimized clinical and beam algorithm. Patients and methods. Complex evaluation of the conservative treatment efficacy (physiotherapeutic treatment (PHT), exercise therapy (ET), shockwave therapy (SWT)) was performed in 128 patients - 67 (52.3%) men, 61 (47.7%) women with SIS. Mean age of patients was 59±8 years (24 - 82 yrs), follow up period - 9.6 ±5.6 months (maximum 18 mos). All patients underwent optimized complex clinical and beam examination. Treatment efficacy was evaluated in dynamics at terms 3, 6 and 9 months. Dynamics of pain syndrome and structural changes in STM regress was assessed depending on the type of treatment with calculation of correlation coefficient. Results. In 3 months positive effect of conservative treatment was noted in 67 (65%), in 6 months - in 78 (77%) and in 9 months - in 84 (82%) patients. High correlation of data obtained using the elaborated pain scale for a shoulder with the visual analogue scale data at treatment monitoring (r=0,89) as well as with the monitoring US data (r=0,94) was determined. The combination of SWT+ET+PHT or SWT+PHT showed good therapeutic effect in 3 months after treatment and by 6th month excellent result was recorded in 85% of cases. Due to the long rehabilitation period in operated patients in 3 and 6 months after intervention only the satisfactory result with mean point 3.02±0.12 and 3.52±0.14 respectively was achieved. Conclusion. Choice of treatment method should be based on the results of complex clinical beam examination. In patients with SIS and SMT pathology the most effective is a combined conservative treatment with SWT+ET+PHT or SWT+PHT. However a conservative treatment efficacy is significantly influenced by the SIS stage, anatomical structure of acromeonon as well as the type of SMT structural changes.
Risk factors of bone mineral density deficit and low-energy fractures in primary osteoporosis in men
Authors: Rodionova Svetlana S. , Khakimov U. R
Published: October 2020

Purpose: to evaluate the role of well-known factors on the formation of bone mineral density (BMD) and risk of fractures in primary osteoporosis in men. Patients and methods. The influence of well-known osteoporosis risk factors such as age, smoking, alcohol consumption, obesity, genetic disorders in genes encoding COL1A1, COL1A2 and VDR-receptor products, history of low-energy fractures in first-line relatives upon the BMD value and risk of fractures was evaluated in 231 patients with primary osteoporosis. All patients were divided into three age groups according to the following forms of osteoporosis: 17-20 years (n=26) - juvenile form, 21-50 (n=103) - idiopathic form, patients over 51 years (n=102). To assess the influence of study factors on the risk of fractures the patients were subdivided into 5 groups according to fracture localization. Results. The relationship between BMD deficit and mutations in homozygous form of gene rs2412298 (encodes collagen), and the tendency to a reliable increase of BMD deficit in L1 - L4 vertebrae under polymorphism in homozygous form of 1800012 gene was noted that might be evidence of their contribution to the development of primary osteoporosis in men. At the same time, smoking, alcohol consumption, age, mutations in homozygous form of gene rs2412298 and a history of low-energy fractures in first-line relatives increased the risk of low-energy fractures of the vertebral bodies and proximal femur.
Peculiarities of intramedullary nailing in treatment of extraarticular proximal tibial fractures
Authors: Semenistyi Anton A. , Litvina E. A , Fedotova A. G , Mironov A. N
Published: October 2020

From the biological and biochemical points of view closed blocking intramedullary osteosynthesis is an optimum technique for the treatment of extraarticular proximal tibial fractures. The disadvantage of the technique is the complexity of reposition achievement and maintenance. Great number of surgical methods and implants with different efficacy and safety has been proposed to solve these problems. The review presents the analysis of literature dedicated to different methods of reposition achievement and maintenance in intramedullary osteosynthesis of extraarticular proximal tibial fractures.
Vascularized bone grafts from the distal third of the femur. Present state of the matter
Authors: Kukin Il’ya A. , Golubev I. O
Published: October 2020

The basic types of the medial and lateral femoral condyle grafts are considered. The most common variants of these grafts application and the donor site complications are presented. Peculiarities of femoral distal third vascular topography and their frequency obtained in the course of anatomic studied.