bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of Tactics for the Treatment of Patients with Congenital Shortening of Lower Extremities
Authors: Malakhov O A , Kozhevnikov O V , Zatona D B , Malakhov O O , Malakhov O A , Kozhevnikov O V , Zatona D B , Malakhov O O
Published: October 2020

Forty-three patients, 2.5-18 years aged, with shortening of lower extremity from 4 to 25 cm caused by congenital femur abnormality were observed at the Department of Pediatric Orthopaedics of CITO. Two patients with pathology of class 1-2 by Papas underwent extremity prosthetics only. In 4 patients with significant (15-20 cm) extremity shortening due to proximal femur defect or disturbance of its continuity similar to pseudoarthrosis prosthetics was performed after surgical stabilization of the hip joint. In the other patients surgical correction of extremity length discrepancy was used. Good results were achieved in 34 (79.1%) patients, satisfactory - in 8 (18.6 %) and unsatisfactory - in 1 (2.3%) patient.
Complex Conservative Treatment of Patients with Osteoarthrosis of Low Extremity Large Joints
Authors: Korableva N N , Dlinnykh N I , Enikeev M G , Shestikov D Yu , Pirozhenko S V , Krasnogorskiy A V , Khutyz T K , Korableva N N , Dlinnykh N I , Enikeev M G , Shestakov D Yu , Pirozhenko S V , Krasnogorskiy A V , Khutyz Т К
Published: October 2020

Results of treatment of 39 patients with hip and knee I-III osteoarthrosis are presented. Treatment consisted of irradiation of bioactive arthrospecific points with high energy Nd-laser followed by injections of drug cocktail into those points. No steroid drugs were used. The method could be used both as independent technique for rehabilitation treatment and preoperative management. It is shown that suggested method provides longer non-medicine remission as well as repeated remission in comparison with traditional conservative treatment.
Our Experience in Treatment of Patients with Patella Dislocation
Authors: Shevtsov V. I , Buravtsov P. P
Published: October 2020

The experience in surgical treatment of 33 patients with patella dislocation of various etiology and severity degree (38 dislocations) has been summarized. The methods of preoperative exam­ination and indications for the application of various treatment methods has been described. Two methods of patella dislocation elimination were used, i.e. myofascioplasty and reconstruc­tion of the knee joint extension apparatus with transposition of the patellar ligament medially. When indicated those methods were combined with correcting osteotomy, closed elimination of knee joint flexion contracture and shin subluxation using Ilizarov device. Postoperative fixation was performed with plaster bandage and various arrangments of Ilizarov apparatus. In the second case the possibility of early knee joint movements was provided and markedly faster restoration of joint functions was noted. Good results were achieved in 36cases, satisfactory results — in 2 cases.
Surgical Treatment of Infants with Tibia Malformation
Authors: Karimova L. F , Pozdeev A. P
Published: October 2020

The experience in surgical treatment of 36 children with various forms of congenital malfor­mation of the tibia (38 extremities) is presented. Use of complex surgical treatment enabled to create the optimum static and dynamic conditions for the extremity function with preservation of all its segments. In all forms of tibia malformation manifestation the foot deformities and flexion contractures have been corrected in early age (conservatively after 1 month, surgically — from 6—10 months).
Potentialities for Wrist Centering in Radius Defects in Children
Authors: Shvedovchenko I. V , Prokopovich V. S
Published: October 2020

Method of the wrist joint «folk» reconstruction using microsurgical grafting of 2 nd metatarsal bone has been suggested for the reconstruction of distal forearm in children with malformation or absence of the radius and talipomanus which has developed as a result of the abovementioned pathology. The graft includes the growth zone and this prevents the deformity recurrence.
Transosseous Osteosynthesis by Ilizarov for Treatment of Patients with Combined Femur and Shin Fractures
Authors: Karasev A. G
Published: October 2020

Treatment results of 76 patients with combined femur and shin fractures are presented. All patients were treated with transosseous osteosynthesis technique by Ilizarov. It has been shown that the technique enables to perform closed precise reposition of bone fragments, achieve the stable fixation for the whole period of treatment and mobilize patients on 2-3 day after operation. For proper formation of bone regenerate and rigid fragment consolidation it is neces- sary to disassemble the device gradually during the treatment process.
Low Invasive Internal Osteosynthesis in Fractures of Tibial Plateau
Authors: Zagorodniy N V , Lomtatidze E Sh , Nikitin Sergey Sergeevich , Semenistyy A Yu , Fedoruk G V , Volna A A , Frolov A V , Zagorodniy N V , Lomtatidze E Sh , Nikitin S S , Semenistyi A Yu , Fedoruk G V , Volna A A , Frolov A V
Published: October 2020

Outcomes of surgical treatment of 97 patients with intraarticular fractures of proximal tibial metaepiphysis were analyzed. In all patients internal osteosynthesis without arthrotomy and under either electro-optical transducer or arthroscopic control was performed. Cannulated screws and plates with angular stability were used for osteosynthesis. In fractures with impression of articular surface plasty of bone tissue defects using either autograft from the upper flaring portion of the ilium or -tricalcium phosphate was performed. In postoperative period partial weight bearing on the operated extremity was allowed starting from the 6th week. Complete weight bearing in fractures with impression was allowed in 10 week and in 6 weeks - in fractures without impression. Treatment results were followed up at terms from 6 to 70 months (mean - 35 months). Roentgenologic and functional evaluation was performed by Rusmussen and Resnik-Niwoyama systems. Achieved roentgenologic results were excellent in 57.7% of patients, good - in 24.7%, satisfactory - in 15.5% and unsatisfactory in 2.1% of patients. It was showed that at treatment of such fractures the application of modern fixators and arthroscopic control enabled to perform adequate reposition of the articular surface and visualize injuries of intraarticular structures. Plasty of subchondral bone defects and application of plates with angular stability eliminated the probability of secondary displacement of fragments thus creating the possibility of early functional treatment and rehabilitation.
Treatment of Patients with Clavicle Fractures and Their Sequelae on the Basis of Biomechanical Conception of Bone Fragments Fixation
Authors: Pichkhadze I M , Matsakyan Artak Matsakovich , Kuz'menkov K A , Zhadin A V , Tsiskarashvili A V , Pichkhadze I M , Matsakyan A M , Kuzmenkov K A , Zhadin A V , Tsiskarashvili A V
Published: October 2020

Basing on the results of theoretical analysis and experimental studies, biomechanical characteristics (resistance to displacement) of clavicle fragments of various length were determined. With regard for obtained data the requirements and indications to the application of various osteosynthesis techniques (transosseous, epiosseous, intramedullar) in different types of fractures were formulated. Treatment of clavicular fractures and their sequelae in accordance with biomecha-nical conception of fragments fixation was performed in 223 patients. Long term results were evaluated in 178 patients. Excellent results were achieved in 135 (75.9%) cases, good - in 26 (14.6%), satisfactory - in 10 (5.6%) and unsatisfactory - in 7 (3.9%) of cases. The results of the study showed that at observance of all biomechanical principles of bone fragments fixation it was possible to improve the outcomes of clavicular fractures treatment and to reduce the rate of complications considerably.
Potentialities of Surgical Treatment for Acetabular Fractures Using Low-Invasive Techniques
Authors: Solod Eduard Ivanovich , Lazarev A F , Lazarev A A , Gudushauri Ya G , Kakabadze M G , Roskidaylo A S , Dan I M , Solod E I , Lazarev A F , Lazarev A A , Gudushauri Ya G , Kakabadze M G , Roskidailo A S , Dan I M
Published: October 2020

Original technique of percutaneous osteosynthesis was applied for the treatment of 24 patients with acetabular columns fractures. The achieved results were compared to the results of osteosynthesis performed using open direct reposition of bone fragments (39 patients). The efficacy of low-invasive surgery in acetabular column fractures with regard to provision of fragments consolidation, prevention of femoral head aseptic necrosis development and achievement of early medical and social rehabilitation of patients was showed. Maintenance of fragments blood supply, use of minimal surgical approach and closed reposition are considered to be the progressive direction of internal osteosynthesis development.
Tactics of Surgical Treatment for Degenerative-Dystrophic Diseases of Lumbosacral Spine in Elderly and Senile Patients
Authors: Kavalerskiy G M , Makirov S K , Chenskiy M D , Boev M V , Cherepanov V G , Ternovoy K S , Lisitskiy I Yu , Amin F I , Korkunov A L , Sergeev O A , Kavalerskiy G M , Makirov S K , Chenskiy M D , Boev M V , Cherepanov V G , Ternovoi K S , Lisitskiy I Yu , Amin F I , Korkunov A L , Sergeev O A
Published: October 2020

Surgical treatment outcomes on 87 patients aged 60-83 years operated on for degenerative-dystrophic diseases of lumbosacral spine have been presented. Depending on the stage of pathologic process and compressive factor direction, different types of decompressive stabilizing surgical interventions were performed in compliance with the elaborated tactics of surgical treatment. Evaluation of the results showed significant decrease in pain sensations (by Visual Analog Scale) and increase in the indices of daily activity (by Oswestry Disability Index) both in early (under 3 months) and late (up to 36 months) postoperative periods, that led to significant improvement of the life quality in elderly patients. The achieved results confirmed the efficacy of the elaborated differentiated approach to surgical treatment of that group of patients.
Surgical Treatment of Patho- logic Cervical Vertebrae Fractures
Authors: Protsenko A I , Karanadze A N , Gordeev Gennadiy Gavrilovich , Fazilov Sh K , Nikuradze V K , Protsenko A I , Karanadze A N , Gordeev G G , Fazilov Sh K , Nikuradze V K
Published: October 2020

Experience in treatment of 32 patients with pathologic fractures of cervical vertebrae is presented. The fracture was preceded with vertebrae destruction caused by tumor metastatic spreading (18 patients), nonspecific spondylitis (12) and fibrocystic dysplasia (2). In all cases the injury resulted from sharp bending of the neck including 2 patients in whom the fracture developed during manual manipulation. Clinically the fracture was manifested by myelopathy of various degrees, pronounced local or radicular pain syndrome. In all patients substitution of the destructed vertebral body by the carbonic graft with collapanoplasty was performed. Pain syndrome was arrested in all patients; complete regress of myelopathy was achieved in 27 patients, the partial one - in 5 patients. Osteocarbonic block was formed in all cases, average duration of its formation made up 10 weeks.
Hip Joint Arthrography with Double Contrast in Children and Adolescents
Authors: Mayorov Aleksandr Nikolaevich , Morozov A K , Mayorov A N , Morozov A K
Published: October 2020

Experience in use of hip joint double contrast arthrography in 207 patients (236 joints), aged 2-14 years, with Perthes disease and various forms of hip dysplasia was analyzed. Basing on the study of contrast arthrograms the roentgenologic signs reflecting the joint state in the abovementioned pathology were detected and described. It was stated that the data of contrast examination enabled to work out in details the notion of hip joint pathology with regard for soft tissues condition and in some cases were the most important when choosing the treatment tactics. Diagnostic signs, which were to be taken into account while working out the surgical intervention protocol - that is of great practical importance, were determined.
Treatment of Congenital Hip Dysplasia in Early Childhood Using Periacetabular and Combined Wire Tunneling Technique
Authors: Shevtsov V I , Makushin V D , Chirkova Natal'ya Gennadievna , Shevtsov V I , Makushin V D , Chirkova N G
Published: October 2020

The influence of periacetabular and combined wire tunneling upon hip bones development in congenital hip dysplasia in 34 children, aged 8-36 months, was studied. Evaluation of the treatment results by dynamics of roentgenologic parameters showed that periacetabular and combined wire tunneling possessed a trophostimulating effect. Differentiated application of these techniques enables to avoid radical reconstructive operations on the ilium and femur in the early childhood or to delay their performance.
Outcomes of Surgical Treatment of Fractures in Concomitant and Multiple Injuries in Children
Authors: Musaev Tokhir Sidikovich , Tolipov N N , Masharipov F A , Musaev T S , Tolipov N N , Masharipov F A
Published: October 2020

Outcomes of surgical treatment of 72 children with concomitant (55) and multiple (17) injuries of locomotor system were analyzed. In 53 patients (group 1) surgical interventions for bone fractures were performed in early terms (within 3 days after trauma), in 19 patients (group 2) the interventions were postponed. In group 1 good and satisfactory result was achieved in 92% of patients (63 segments), in group 2 - in 85.2% of patients (23 segments). Duration of hospitalization made up in two groups 11.5 and 14.5 days, respectively. Application of pirod external fixation devices facilitated the treatment course due to the reduction of treatment duration and traumatization, as well as use of more simple technique of long bones and pelvis osteosynthesis.
Transthecal Anesthesia of Fingers
Authors: Zolotov Aleksandr Sergeevich , Popov R Yu , Zolotova Yu A , Zolotov A S , Popov R Yu , Zolotova Yu A
Published: October 2020

First experience in transthecal anesthesia application for the treatment of 62 patients with different fingers injuries was analyzed. That method showed its efficacy in 52 (83.9%) cases. The level of anesthesia on the palmar surface of the finger corresponded to the injection point, on the dorsal one - to the middle of the main phalanx. Incomplete transthecal block was observed in cases when the injuries or their sequelae resulted in disturbance of tendon sheath leak-proofness (or permeability) as well as in interventions on a thumb.
Primary Hip Replacement with Cementless «ESI» Implants
Authors: Nuzhdin Viktor Ivanovich , Kudinov O A , Erokhin P A , Shaternikov B N , Nuzhdin V I , Kudinov O A , Erokhin P A , Shaternikov B N
Published: October 2020

Comparative analysis of the outcomes of cementless implantation of total metal-polymeric structurized hip implants «ESI» of various generations was performed. Results of 1095 implantations (876 patients) performed during the period from 1995 to 2008 were evaluated. Follow-up was from 6 months to 12 years (mean term 7.3 years). Comparison of the results was performed between four groups differed by the modification of applied «ESI» implant. Characteristics for every of four «ESI» implant generations were presented. In the first group (1st generation of implants) assessment of treatment outcomes by Harris showed no excellent and good results, satisfactory results made up 4%, poor results - 96%. In the second group (2nd generation) excellent results were achieved in 3% of cases, good one in 18%, satisfactory - in 36% and poor result was noted in 43% of cases. In the third group (3rd generation) the results made up 27, 63, 8 and 2%, respectively. In group four (4th generation) excellent results made up 32%, good - 64%, satisfactory - 4% with no poor results observed.
Use of Alendronate in Postoperative Period for Prevention of Hip Implant Aseptic Instability
Authors: Rodionova Svetlana Semenovna , Turgumbaev T N , Rodionova S S , Turgumbaev T N
Published: October 2020

Assessment of the alendronate influence upon the course of adaptive remodeling of bone tissue adjacent to the implant was performed. Dynamics of mineral bone density (BMD) changes in Gruen zones was compared for 2 groups of female patients. The groups were similar by age, nosology. All operations were performed by the same surgical team with application of one type of implant (Zweymuller). During the first post-operative year patients from the study group (n=38) were taken alendronate (Fosamax-70) once a week and at least 1200 mg of calcium carbonate daily (either as calcium containing food products or calcium carbonate preparations). Patients from control group (n=94) were taken only calcium carbonate by the same scheme within the first postoperative year. It was detected that although by 6th postoperative month alendronate did not decraese BMD loss as compared to controls, within the interval of 6-15 months it significantly increased bone tissue mass accretion. In group of alendronate patients monthly accretion of bone tissue in some Gruen zones (except for R4) was twice and more higher than in control group. Fifteen months later patients from the main group showed BMD deficit only in R4 zone. In the rest of zones bone tissue mass exceeded the basic values and in the majority of zones that increase was trustworthy. In control group BMD deficit was preserved in two proximal zones (R6 and R7) and in zone R6 it even increased as compared to the results of the previous study (12 months after operation).
Internal Fixation for Unstable Pelvic Ring Injuries in Polytrauma Patients
Authors: Sokolov V A , Byalik E I , Fayn Aleksey Maksimovich , Evstigneev D V , Sokolov V A , Byalik E I , Fain A M , Evstigneev D V
Published: October 2020

During the period from 1997 to 2008 three hundred twenty two polytrauma patients with unstable pelvic ring injuries were operated on at the department of concomitant and multiple injury of Sclifosovskiy Scientific-Research Institute for Emergency Care. External fixation of pelvic ring fragments was the basic part of antishock therapy. Avulsion of symphysis pubis was treated using original pelvic plate. In multiple pelvic fractures two specially designed reconstructive plates were applied via 2 endopelvic mini approaches. Elaborated treatment tactics enabled to achieve good anatomical and functional results in the majority of patients.
On Possibility of Optimization of Bone Stress Remodeling in Knee Joint Arthroplasty
Authors: Reznik Leonid Borisovich , Turushev M A , Reznik L B , Turushev M A
Published: October 2020

Using standard photodensitometry bone remodeling was studied in proximal tibia and distal femur after total knee arthroplasty at terms up to 12 months. Out of 120 patients 60 patients (main group) received strontium ranelate (Bivalos) for 12 months after operation and in 60 patients (control group) drug correction was not performed. By the results of standard photodensitometry in both patient groups the density of radiographic image around the implant decreased by 22% at an average within the first 2 postoperative months and that was indicative of osteolysis activity. Later on during the period from 2 to 6 months after arthroplasty the increase of optic bone density was observed. By the end of 12 month in patients from the main group the optic bone density around the implant increased by 39.6% (to preoperative level) and by 25% in controls as compared with the level recorded in 2 months after surgery. Analysis of the total knee replacement by Lischolm scale showed that drug optimization of the processes of bone tissue remodeling enabled to shorten the terms of patients' rehabilitation and to decrease the rate of unsatisfactory results.
Transosseous Osteosynthesis with External Fixation Devices in Intraarticular Fractures of Knee Joint Area
Authors: Pankov Igor' Olegovich , Emelin A L , Pankov I O , Emelin A L
Published: October 2020

Peculiarities of transosseous osteosynthesis with pin-rod external fixation devices at treatment of various intraarticular fractures in the area of the knee joint are presented. Analysis of treatment outcomes for 108 patients with 110 fractures (18 fractures of femoral condyles and 92 fractures of tibial condyles) was performed. Excellent and good results were achieved in 83 (75.4%) cases. In polysegmental and impression-compression fractures of femoral and tibial condyles the treatment results were most often only satisfactory or unsatisfactory that was accounted for the severity of injury with massive destruction of the articular surfaces.
Experience in Clinical Application of Perftorane for Intensive Therapy in Patients with Severe Combined Injuries Resulted from Explosion in Coal-Mine
Authors: Mullov Aleksandr Borisovich , Mullov A B
Published: October 2020

Twenty victims with severe combined injuries caused by explosion in the coal-mine were included into the study. The components of such injuries were barotrauma, mechanical injury, skin and inhalation burns, carbon oxide poisoning intensified by syndrome of mutual aggravation. The ultimate cause of death was the affection of oxygen transport system. Temporary substitution of affected blood - lung system with oxygenated perftorane enabled to decrease considerably the lethality rate in miners with negative and doubtful survival prognosis. Efficacy of perftorane inclusion into intensive therapy was stipulated by its chemical inertness owing to which it can transport oxygen under conditions of blood poisoning by carbon oxide and unfit for breathing atmosphere in the mine after explosion.
Surgical Treatment of Long Bones Deformities in Exostotic Chondrodysplasia in Children
Authors: Bakhteeva N Kh , Rubashkin Sergey Anatol'evich , Tsareva E E , Zotkin A V , Bakhteeva N Kh , Rubashkin S A , Tsaryova E E , Zotkin A V
Published: October 2020

Surgical method for the treatment of children with shin bones deformities developed on the background of multiple osteocartilagenous exostoses has been proposed. The technique consisted of exostoses removal within normal tissues, performance of osteotomy on the deformity apex, formation of autograft followed by its insertion into zone of the defect for its closure by means of fixed rate distraction and correction of limb axis in the external fixation device. That technique was applied in 11 children. Good result was achieved in 87.2%, satisfactory - in 11.5%, poor - in 1.3% of cases. In control group (24 patients treated by conventional surgical methods) good results made up 62.5%, satisfactory - 25.0%, poor - 12.5%. Closure of the defect zone by formed cortical autograft enabled to shorten the bone consolidation terms in patients who were treated by the proposed technique by 12-14 days.
Choice of Antibacterial Agents for Prevention and Treatment of Infectious Complications in Traumatologic and Orthopaedic Patients by Microbiologic Monitoring
Authors: Pkhakadze Tamara Yakovlevna , Okropiridze G G , Malysheva E S , Pkhakadze T Ya , Okropiridze G G , Malysheva E S
Published: October 2020

Etiologic structure of infectious complications in traumatologic and orthopaedic patients has been studied at CITO named after N.N. Priorov during the period from 2005 to 2007. Using modern agents and techniques 6799 samples from 3023 patients were studied. Resistance of pathogenic microorganisms to the wide spectrum of antibiotics including the drugs of last gene-ration was studied. Basing on the study results the protocols for the application of modern antibiotics including protected aminopeptides, cephalosporins of third-forth generation including the protected ones, glycopeptides, oxazolidinones, aminoglycosides, fluoroquinolones, carbape-nemones have been elaborated and introduced into clinical practice.
Specialized Traumatologic and Orthopaedic Care for Outpatients with Injuries and Bone-Muscular Diseases
Authors: Mironov S P , Es'kin N A , Andreeva T M
Published: October 2020

Dynamics of traumatism and bone-muscular pathology among various population groups for the last 10 years is presented. Certain stabilization of injury rate in adults as well as continuous increase of injury rate in children and adolescents is noted. Rate of bone-muscular diseases is constantly increasing in all population groups. Principal ways for the perfection of outpatient trauma and orthopaedic care are proposed.
Total Hip Arthroplasty in Adolescents
Authors: Snetkov A I , Frantov A R , Gorokhov V Yu , Batrakov S Yu , Kolyarov R S
Published: October 2020

During the period from 1970 to 2009 at CITO Department of child bone pathology and adolescent orthopaedics total hip arthroplasty was performed in 36 patients aged 14-18 years including 7 patients with bilateral interventions. Main group consisted of patients with systemic hereditary skeleton pathology. Optimum implant designs with regard to anthropometrics and disease pattern were determined for adolescents. Algorithm of surgical interventions in patients with stable flexion-adduction contractures on the background of systemic skeleton pathology was elaborated. Treatment results were evaluated at terms from 1 to 20 years. Good and satisfactory results made up 91.6%
Tactics and Technique of Treatment of Large Extremity Segment Avulsion in Polytrauma Patients
Authors: Sokolov V A , Didenko O A , Byalik E I , Ivanov P A , Smirnov K S , Nevedrov A V
Published: October 2020

At department of concomitant and multiple trauma of Scientific Research Institute of Emergency Care named after N.V. Sklifisovskiy 177 patients with polytrauma were treated from 1999 to 2009. All patients had avulsions and crushes of large segments of extremity including crus (66 patients - 37%), thigh (44 patients - 25%), foot (41 patients - 23%), shoulder (14 patients - 8%) and forearm (12 patients - 7%). In 99 patients (control group) the treatment was performed according to routine protocol: amputation by the type of primary surgical treatment (PST), topical treatment of wounds using antiseptic and salve dressings, autodermoplasty after wound granulation. In 78 patients (test group) new tactics of treatment was applied. Terms of performance and volume of amputation were determined based on the principles of injury control. In stable condition of patients amputation within the limits of intact tissues with stump formation and suturing was performed. In avulsion of extremity at the superior third of crus the amputation by type of PST was applied for preservation of knee joint. Sawing tibia surface was covered by gastrocnemius muscle and local wound treatment was performed with hydrohelium dressings and vacuum systems. After wound preparation autodermaplasty was carried out. In severe condition of patients the amputation by type of PST was performed at any level of avulsion. After stabilization of patients state topical wound treatment or reamputation within the limits of intact tissues was performed. Use of new treatment tactics allows decreasing the rate lethality by 6% versus 11% in control group, shortening the terms for patients' preparation for injured bone osteosynthesis, decrease of hospital treatment duration and terms of preparation for prosthetics and significantly improving functional treatment results.
Rehabilitation of Patients with Initial Coxarthrosis after Revascularizing Femur Osteotomy
Authors: Zorya V I , Gur'ev V V , Sklyanchuk E D
Published: October 2020

In 128 patients with early coxarthrosis after revacularizing femur osteotomy complex rehabilitation including 2 stages, hospital and out-patient, was performed. Complex rehabilitation consisted of drug therapy and modern restorative treatment. It enabled to decrease destructive articular process and restore joint function in 90% of cases.
Neuro-Orthopedic Tactics for the Treatment of Vertebral Body Tumors Complica-ted by Spinal Cord Compression
Authors: Protsenko A I , Karanadze A N , Nikuradze V K , Fazilov Sh K , Gordeev G G
Published: October 2020

Treatment results were analyzed for 55 patients with primary and metastatic tumors complicated by paralysis and severe paresis. It was shown that in cervical spine tumors early decompression stabilization operations via anterior approach provided regression of neurologic deficits and significantly improved patients' quality of life. In thoracic spine tumors decompression laminectomy with posterior metalspondylodesis was performed. In the majority of cases (15 out of 20 patients) positive result was achieved in early postoperative period. Laminectomy with posterior spondylodesis was less effective as compared with operations via anterior approach: the later gives lower probability of regression of neurologic deficits as well as lower duration of life and worse life quality.
Use of Combined Corpodesis Technique in Degenerative Lumbar Spine Diseases
Authors: Dzhumabekov S A , Zagorodniy N V , Abakirov M Dzh , Sulaimanov Zh D
Published: October 2020

Efficacy of combined anterior corpodesis method elaborated by the authors (100 patients - main group) versus routine anterior corpodesis (98 patients - control group) in degenerative lumbar spine diseases has been analyzed. Combined method includes the use of selective approach to every spine segment and insertion of combined (intercorporal and interbody) autografts. Application of selective approach significantly decreases the operative trauma. Intercorporal insertion of autograft accelerates bone ingrowth, provides spine canal unloading, and excludes autograft migration. Additional interbody insertion of autograft strengthen fixation. In main group mean duration of bed rest was 7 days, in control group - 28 days, mean duration of hospital treatment was 14 and 56 days, respectively. Mean duration of working capacity restoration was 4-8 and 10-12 months, respectively. In main group the rate of complications was twice lower and hypostatic complications occurred rarely as compared to the control group. In main group good results were achieved 64%, satisfactory - 27%, unsatisfactory - 9%, in control group - 49, 38 and 13%, respectively.
Age Peculiarities of Clinical Manifestation and Development Dynamics of Spine Deformity in Idiopathic Scoliosis
Authors: Tesakov D K
Published: October 2020

Age terms of spine deformity primary manifestation were studied in 2006 patients with idiopathic scoliosis of various severity degrees. It was determined that first clinical signs of idiopathic scoliosis were revealed in children under 10 years, i.e. before the beginning of puberty. Analysis of data obtained enabled to detect the real share of various types of scoliosis deformity development for different terms of its first manifestation. This gives the possibility to consider the age of initial scoliosis deformity sing as a prognostic factor for the assessment of further orthopedic pathology development in concrete patients with idiopathic scoliosis.
Total Hip Arthroplasty with Bicon-Plus Cup in Patients with Dysplastic Coxarthrosis
Authors: Zagorodniy N V , Nuzhdin V I , Kagramanov S V , Chragyan Gamlet Ashotovich , Zagorodniy N V , Nuzhdin V I , Kagramanov S V , Chragyan G A
Published: October 2020

Results of 633 total hip arthroplasties using Zweymuller endoprosthesis with Bicon-Plus cup were studied in 532 patients with dysplastic coxarthrosis. The follow-up was up to 12 years. The peculiarities of that implant application were shown. Complications occurred were discussed. Excellent and good results by Harris score were achieved in 84.7% of cases, satisfactory in 15% and poor in 0.3% of cases.
Tribochemical Component of Oxidative Stress Development when Implantating of Artificial Joints. Part 2. Oxidative and Antiproliferative Effect of Wear Debris of Orthopedic Materials
Authors: Bulgakov Valeriy Georgievich , Il'ina V K , Gavryushenko N S , Shal'nev A N , Omel'yanenko N P , Bulgakov V G , Il'ina V K , Gavryushenko N S , Shal'nev A N , Omel'yanenko N P
Published: October 2020

Using modeling reaction with constant production of metal radical-generated wear debris it was determined increasing intensification of oxidative processes. Generated free radicals enabled to oxidize polymeric component of endoprostheses. Radical-generated wear debris significantly decreased the proliferative ability of human osteogenic cells. Inert ceramics particles showed antiprolifirative effect only in their high concentration. Those particles prevented growth
of osteogenic cells. Worsening in mechanical properties of polymeric implant components and disturbance of bone remodeling under radical-generated wear debris may be one of the causes of further development of implant loosening and its instability.
Complex Treatment of Patients with Osteoporosis Complicated by Vertebral Bodies Fractures
Authors: Astapenkov Danila Sergeevich , Astapenkov D S
Published: October 2020

Assessment of the efficacy of complex approach to the treatment of patients with osteoporosis complicated by pathologic vertebral body fractures was performed. Eighty seven patients were randomized into 2 groups. Main group (62 women) obtained complex treatment. In control group (25 female patients) the treatment measures were of fragmental pattern.Prior to and after treatment all patients were clinically examined including evaluation of pain intensity by visual analog scale and life quality by Karnovski scale, assessment of fractures by Riggs, Kleekoper and Genant, frontal lumbar spine densitometry (Lunar Prodigy 3, General Electric), study of resorption marker β-Cross-Laps ELISA. It was shown that complex treatment of that group of patients was more effective as compared with fragmental treatment. Algorithm for choice of techniques to influence the structure and mineralization of bone tissue was suggested
Parmacologic Correction in Experimental Osteoporosis and Osteoporotic Fractures
Authors: Faytel'son Aleksandr Vladimirovich , Dubrovin G M , Gudyrev O S , Pokrovskiy M V , Ivanov A V , Faitel'son A V , Dubrovin G M , Gudyrev O S , Pokrovskiy M V , Ivanov A V
Published: October 2020

Osteoprotective effect of enalapril and losartan was studied using experimental model of osteoporosis and osteoporotic fractures (222 female Wistar rats). It was detected that in rats after ovariectomy endothelial vascular dysfunction of microcirculation in bone tissue bed developed. Those changes caused osteoporosis and delayed experimental fracture healing. Enalapril and losartan prevented the decrease of microcirculation level in bone tissue that promoted slowing-down of osseous trabecula thinning, prevented microfractures and increased the healing rate of experimental fractures.
Some Aspects of Reparative Osteogenesis Optimization in Long Bone Fractures
Authors: Maslennikov Evgeniy Yul'evich , Taranov I I , Al'-Naddzhar T M , Vovchenko I B , Maclennikov E Yu , Taranov I I , Al-Naddzhar T M , Vovchenko I B
Published: October 2020

The aim of the examination was to study the influence of some proteolytic enzymes (cathepcin-D, neutral proteinaze of serine group) upon formation of bone regenerate in fractures. There were 138 patients with bone fractures: 80 fractures were fresh, 38 - nonunited, 20 - nonconsolidated. Periosteal and transfragmental tissues were studied. Those materials were obtained during osteosynthesis that was performed at different terms after trauma. Results obtained allowed to make a suggestion that acid and neutral peptide-hydrolases influence the osteosynthesis and degradation of macromolecular components of bone organic matrix during reparative osteogenesis. That allowed detecting the new ways for optimization of reparative processes in fractures.
First Experience in Application of Intraoperative Epidural Morphine Analgesia with Postoperative Ropivacaine Anesthesia in Children with III-IV Degree Scoliotic Deformity
Authors: Ukolov Konstantin Yur'evich , Ayzenberg V L , Arzhakova N I , Ukolov K Yu , Aizenberg V L , Arzhakova N I
Published: October 2020

First experience in aplication of intraoperative epidural morphine analgesia with postoperative ropivacaine anesthesia at correction of III-IV degree scoliotic deformity in children (25 patients) is presented. It is shown that epidural morphine analgesia on lumbar level as a component of combined anesthesia provides an adequate analgesia in during operation and creates an analgesic background for postoperative anesthesia with local anesthetics. Intraoperative high catheterization of epidural space by the proposed technique enables to avoid neurologic complications and provides the possibility of effective postoperative anesthesia with ropivacaine infusion within 3 days on the background of prolonged action of epidurally injected morphine. First xperience in application of the suggested technique shows that it is effective enough and helps this group of patients to endure an invasive operation with greater comfort.
Efficacy of Robotic Assistance Method for Stabilization of Lumbar-Sacral Spine
Authors: Konovalov N A , Shevelev I N , Kornienko V N , Nazarenko A G , Isaev K A , Asyutin Dmitriy Sergeevich , Konovalov N A , Shevelev I N , Kornienko V N , Nazarenko A G , Isaev K A , Asyutin D S
Published: October 2020

First experience in performance of spinal segments' stabilization using robotic assistance (SpineAssist, MAZOR Surgical Technologies, Caesarea, Israel) in Russia is presented. Between August 2009 and August 2010 twenty six surgical interventions using that technique were performed at Spinal Department of RAMS Institute of Neurosurgery named after N.N. Burdenko. Preoperative neuro-visualization included spondylography, MRI, CT with sections
Determination of Indications to Surgical Treatment and Choice of Surgical Approaches in Complicated Complex Acetabular Fractures
Authors: Beletskiy A V , Voronovich A I , Murzich Aleksandr Eduardovich , Beletskiy A V , Voronovich A I , Murzich A E
Published: October 2020

Experience in surgical treatment of 65 patients with complex fractures of the acetabulum is presented. All patients underwent open reposition with internal fixation of fragments by reconstructive plates. Basic moments of the performance of portals to acetabulum, steps of reposition and fixation in multi-segment comminuted fractures are described. Algorithm for determination of indications to surgical treatment of complex acetabular fractures was determined. Clinical and roentgenologic results were studied at terms from 1 to 9 years. Excellent results were established in 39.5%, good and satisfactory in 34.9%, poor in 25.6% of patients. It was shown that in complex bi-columned fractures the technique of open osteosynthesis was the most effective when used within the first 3 weeks after injury. Simultaneous use of anterior and posterior accesses considerably facilitated the performance of reposition and stabilization of multi-segment comminuted fractures and enabled to achieve favorable treatment results.
Role of High-Field Magnetic Resonance Imaging and Ultrasound Examination in Diagnosis of Knee Joint Injuries
Authors: Es'kin N A , Banakov V V , Tissen B T , Matveeva Natal'ya Yur'evna , Es'kin N A , Banakov V V , Tissen B T , Matveeva N Yu
Published: October 2020

Lecture is devoted to the issues of acute knee joint injury diagnosis. Potentialities of ultrasound method and magnetic resonance imaging in such of injuries are demonstrated. Accuracy and informativeness of each method is evaluated.
Role of Biomechanical Conception at Treatment of Consequences of Gunshot Fractures of Extremity Bones
Authors: Pichkhadze I M , Daneliya L M , Kuz'menkov Konstantin Aleksandrovich , Pichkhadze I M , Daneliya L M , Kuz'menkov K A
Published: October 2020

Treatment outcome for 60 patients (1992-2007) with consequences of gunshot fractures of extremity bones (74 segments) have been analyzed. Expediency of use of biomechanical classification and biomechanical conception of fragments fixation for creation of stable osteosynthesis in gunshot fractures has been substantiated. Dynamics of microflora changes in stable osteosynthesis has been presented. An advantage of application of Pichkhadze apparatuses of 1st and 3rd models in gunshot fractures has been noted. Treatment of gunshot fractures with regard for biomechanical conception of fragments fixation enabled to achieve excellent and good results in 93.3% of cases.
Methods of Reconstructive Surgical Treatment for Patients with Defects and Pseudarthroses of Femur
Authors: Kopysova Valentina Afanas'evna , Kaplun V A , Svetashov A N , Shashkov V V , Kopysova V A , Kaplun V A , Svetashov A N , Shashkov V V
Published: October 2020

Treatment results of 59 patients with femoral bone defects and diaphyseal pseudarthroses were analyzed. To substitute bone defects of more than 6 cm permeable porous endoprostheses were used. In patients with normotrophic and hypertrophic pseudarthrosis stable osteosynthesis with interfragmental compression of bone fragments by shape-memory-effect tightening bows was performed. In patients with atrophic pseudarthrosis bone plasty with autograft was applied. In all patients the weight-bearing ability of the affected limb was restored. Total restoration of function was achieved in 75.6% of patients.
Surgical Reconstruction of Forefoot with Fallen Arches in Combination with Hallux Valgus
Authors: Minasov B Sh , Gutov S P , Bilyalov Azat Rinatovich , Minasov B Sh , Gutov S P , Bilyalov A R
Published: October 2020

Tactics of surgical reconstruction of the forefoot with fallen arches in combination with hallux valgus has been described depending on the deformity severity. Original techniques for myotenoplastic reconstruction of the forefoot that enable to restore muscular balance as well as to eliminate forefoot deformity and hallux valgus are proposed. In 235 patients (329 feet) ana-lysis of long term results of surgical correction using radiologic examination and AOFAS criteria showed high efficacy of the proposed technique. Durable preservation of the achieved correction was noted.
Surgical Treatment of Hallux Valgus with Application of External Fixation Device
Authors: Bagirov A B , Alinagiev B D , Teymurkhanly Fakhri Ogly , Baev V P , Bagirov A B , Alinagiev B D , Teimurkhanly F A , Baev V P
Published: October 2020

The experience in treatment of hallux valgus is presented. There were 90 patients, aged 19-77, 199 feet. Seven patients had first degree of deformity, 24 patients - second degree and 59 patients - third degree. Surgical treatment was performed in the period from 2004 to 2009. Depending on the deformity degree various types of osteotomy were applied followed by biomechanically stipulated fixation of bone fragments with small-sized rod and pin-rod external fixation devices. In all patients stable elimination of valgus deformity was achieved. Excellent long-term results were obtained in 67,5% of cases (112 feet), good results in 29,5% (45 feet) and satisfactory results in 3% (5 feet). Neither long-term failed results nor complications were observed. Advantages of surgical treatment of forefoot deformity with external fixation device are the restoration of foot anatomical shape and function in stable fixation of osteotomic fragments without limitations of active functional load on the operated foot.
Use of Vicrуl Rapide in Hand and Upper Extremity Surgery
Authors: Zolotov Aleksandr Sergeevich , Zolotova Yu A , Zolotov A S , Zolotova Yu A
Published: October 2020

Quick-Absorbable Suture Vicryl Rapide was used at surgical treatment of 112 patients with various injuries and diseases of the hand and upper extremity for wounds closure. Wounds were closed by intradermal (34 patients) and external (78) sutures. Time of ligatures resorption and loss of strength as well as local response of tissues to suture material were analyzed in post-operative period. Complications that developed in 2 (1.8%) cases were not specific to Vicryl Rapide. External knots of intradermal suture were easily removed in all patients on day 14 after surgery. In 72 patients with external sutures complete loss of ligatures strength was noted during the period from 13th to 21st postoperative day (mean in 15.8±2.3 days). No local tissue reaction was observed. In external sutures the time of ligatures resorption and loss of strength was slightly higher than indicated in instruction. Use of Vicrуl Rapide in hand and upper extremity surgery is effective and safe.
New Potentialities in Surgical Treatment of Proximal Humerus
Authors: Solod Eduard Ivanovich , Lazarev A F , Gudushauri Ya G , Kakabadze M G , Roskidaylo A S , Lazarev A A , Solod E I , Lazarev A F , Gudushauri Ya G , Kakabadze M G , Roskidailo A S , Lazarev A A
Published: October 2020

Original method of stressed osteosynthesis for the treatment of proximal humerus is proposed. Primary tension of Y-shaped pin fixative and secondary tension that is created at its intramedullar insertion and blocking enable to achieve stable fixation of fragments without inflicting additional intraoperative injury in patients of any age and independently of their general condition. Preservation of blood supple in fragments, low traumatic osteosynthesis, and possibility of patients' early rehabilitation define the prospective of this technique for the treatment of patients with fractures on the background of osteoporosis. The importance of drug therapy for osteoporosis in the early postoperative period is shown. Experience in treatment of 62 patients aged from 23 to 78 years is presented. Control group included 30 patients with similar fractures who were treated using osteosynthesis. In the main group good results were achieved in 82.3% of patients, satisfactory - in 17.7%, no poor results were observed. In control group good results made up 40%, satisfactory - 56.7%, poor 0 3.3%.
Reconstructive Operations in Malunited Fractures of Distal Radius Epimetaphysis
Authors: Mel'nikov Viktor Sergeevich , Korshunov V F , Mel'nikov V S , Korshunov V F
Published: October 2020

Experience in surgical treatment of 112 patients with malunited fractures of distal radius epimetaphysis is presented. Indication to surgical intervention was fragments consolidation with displacement that was accompanied by marked wrist joint deformity and hand function disturbance. In all patients osteotomy and bone plasty were performed followed by application of distraction device. In the postoperative period dosed distraction of bone fragments up to their complete reposition and rehabilitation treatment was performed. Long term results were assessed for all 87 patients: good result was achieved in 67 (77%), satisfactory - in 17 (19.5%) and poor - in 3 (3.5%) patients.
Russian Version of Oswestry Questionnaire: Test Validity and Reliability
Authors: Cherepanov Evgeniy Arkad'evich , Cherepanov E A
Published: October 2020

The purpose of the study was the evaluation of Russian Oswestry questionnaire (disability index) version 2.1a reliability. Evaluation was performed on the basis of prospective cohort examination of 101 patients. All patients were questioned at the time of first examination, within 2-5 days after first visit and after completion treatment. Repetition of results, internal consistency of the test, correlation with visual analog scale (VAS) and SF-36 questionnaire subscales were studied. Repetition of results made up 0.96, Cronbach's a coefficient - 0.919, correlation with VAS - 0.668. Adapted of Russian Oswestry questionnaire version 2.1a is a valid and reliable tool. It is recommended for application in practical and scientific work for the evaluation of vital activity disturbances in patients with low back pains. The study was approved by Prof. J. Fairbank, the author of Oswestry questionnaire.