bluuebunny/crossref_metadata_2025 huggingface dataset:
Rheovasographic Evaluation of Peripheral Blood Circulation at Lengthe­ning of Lower Extremities in Children
Authors: Vinokurova T. S , Garkavenko Yu. E
Published: October 2020

Rheovasography was applied for the evaluation of blood circulation in the femur and crus before and after restoration of lower extremity length. There were 51 children, aged 5—18, with acquired pathology of proximal (39 patients) and distal (12 patients) metaepiphysis of femur. Positive dynamics in regional blood circulation was noted both in proximal and distal extremity segments at 1—5 years follow up after lengthening
Development and Perfection of Pediatric Traumatologic and Orthopaedic Service in Russia
Authors: Malakhov O A , Pozdnikin Yu I , Solov'eva KS , Malakhov O A , Pozdnikin Yu I , Solov'eva K S
Published: October 2020

Dynamics of the indices of injuries, congenital and acquired diseases of loco-motor system as well as invalidism rate in Russian children during the period from 1992 to 2002 are presented. The organization of specialized traumatologic and orthopaedic care at all medical institutions are analyzed, positive and negative aspects is detected. Perspective directions of activity of public health administrations, scientific as well as treatment-and prophylactic institutions are suggested.
Experimental Substantiation of the Study of Fascial Grafts for the Extremity Reconstruction
Authors: Fedotov E Yu , Golubev V G , Natsvlishvili Z G , Khokhrikov G I , Fedotov E Yu , Golubev V G , Natsvlishvili Z G , Khokhrikov G I
Published: October 2020

The results of the anatomic and angiographic study of the radial and anterior serratus muscle fascial grafts on 30 cadavers are presented. Basing on the results of the work it is possible to conclude that potential introduction of this plastic material into clinical practice for the extremity reconstruction is desired, ft is the first time that the technique of the radial fascial graft harvesting is described in details. Angiographic results showed good blood supply of the isolated fascial grafts.
Practical Application of Concept "Damage Control" in Treatment of Long Bone Extremity Fractures in Patients with Poly­trauma
Authors: Sokolov V. A , Baylik E. I , Ivanov P. A , Garaev D. A
Published: October 2020

On the base of experience in treatment of 646 patients with polytrauma (1995—2004) the necessity to use damage control was for the treatment of long bone fractures was proved. The principle of damage control assumes subdivision of surgical treatment of patients with severe polytrauma into two steps. At the I st step only minimum traumatic procedures were performed. At the 2 nd step major surgical interventions were performed. According to trauma severity and individual response all patients were divided into four groups: stable, borderline, unstable and critical. In patients with stable and borderline conditions major surgical procedures did not result in aggravation of patient's state, therefore one-step surgical treatment was used. In patients with unstable and critical conditions no surgical methods of fixation of long bone fractures were applied at the I st step. In the last two groups definitive fracture fixation were performed at the 2' d step within 4—14 days after injury. The application of damage control allows improving the results of treatment, reducing the rate of complication and lethal outcomes in patients with severe polytrauma.
Biomechanic and EMG Examination of Gait in Patients with Sequelae of Cervical Spine and Spinal Cord Injury
Authors: Mironov E. M , Vitenzon A. S , Gritsenko G. P , Petrushanskaya K. A
Published: October 2020

Biomechanic and innervation structure of gait in patients with sequelae of cervical spine and spinal cord injury was considered. It was shown that the main indices of gait (mean speed of movement, rate, step length) had deteriorated, stability during the gait (increased duration of bearing and double-bearing phase) was decreased, amplitude of angular movements in leg joints was decrease, reduction and deformity of the components of main vector of bearing reaction took place. Electric activity of the majority of lower extremity muscles was decreased and its maxi­mum was translated to the right along the time axis. It was shown that the shift of muscle activity maximum was caused by translation of vertical load into the middle part of bearing phase on account of use of an additional support (stick, crutches). It was noted that deterioration of all gait indices especially the decrease of mean speed of movement depended on aggravation of the pathology. Biomechanic and neurophysiologic interpretation of data obtained was presented.
Peculiarities of Treatment of Patients with Complicated Compression Fractures of Thoracic and Lumbar Spine Vertebral Bodies on the Background of Osteoporosis
Authors: Vetrile S T , Kuleshov Aleksandr Alekseevich , Darchiya L Yu , Vetrile S T , Kuleshov A A , Darchiya L Yu
Published: October 2020

Experience in surgical treatment of 11 patients (1998-2008) with complicated compression fractures of the thoracic and lumbar spine vertebral bodies on the background of osteoporosis has been presented. Mean age of patients was 58 years (from 37 to 74 years). The treatment consisted of the adequate decompression of spinal canal followed by correction and multilevel fixation of the spine with CDI system. Decision on the fixation extent was made with regard for the degree of bone mineral density and vertebral body injury. Follow up period made up 1-10 years. Long term treatment results were assessed clinically and roentgenologically. Correction of kyphosis was noted in all cases. In the late period slight loss of the achieved correction (within 12°) was observed but the patients did not complained of spinal pains. In patients operated on in early terms (up to 2 months) after neurologic complications development the more rapid regress of neurologic symptoms was noted. It was shown that differentiated approach to the choice of surgical technique enabled to achieve favorable results.
Efficacy of Acetabulum Transposition at Treatment of Dysplastic Coxarthrosis in Children and Adolescents
Authors: Kamosko Mikhail Mikhaylovich , Kamosko M M
Published: October 2020

Experience in treatment of 254 children of higher forms age and adolescents with dysplastic coxarthrosis (278 joints) is presented. It is shown that in cases of single-step reduction of hip dislocation with following rigid immobilization as well as inadequate application of intraarticular interventions the more early development and rapid progression of degenerative-dystrophic changes in the hip joint is typical. In the overwhelming majority of cases transposition of the acetabulum following triple pelvic osteotomy enables to achieve the regress of clinical manifestations and degenerative-dystrophic changes in patients with I and II stages of dysplastic coxarthrosis. Efficacy of intervention to a considerable extend depends upon the initial state of the hip joint.
Joint Replacement in Femoral Neck Fractures
Authors: Klyuchevskiy V V , Gil'fanov Sergey Il'suverovich , Danilyak V V , Belov M V , Khudaybergenov M A , Klyuchevskiy I V , Klyuchevskiy V V , Gilfanov S I , Danilyak V V , Belov M V , Khudaibergenov M A , Klyuchevskiy I V
Published: October 2020

Results of joint replacement in femoral neck fractures have been analyzed. During the period from 1994 to 2003 total hip replacement was performed to 399 patients with subcapital fractures including 372 patients in whom the operation was performed as a primary intervention. From 2002 to 2004 the total number of 290 hemiarthroplasty operations with use of module native implant was performed in 286 patients aged 76-101 years. In total joint replacement group intrahospital lethality made up 2% due to the following causes: pulmonary thrombembolia - 3 cases, acute cardiac insufficiency - 1 case, deep decubitus ulcers resulting in sepsis - 2 cases, polyorganic insufficiency on the background of severe concomitant pathology - 1 case. In the early postoperative period the following complications were noted: implant dislocation (5.2% of cases), intraoperative femoral fracture (3.5%). Infectious complications developed in 2 patients and in both cases removal of the implant was required. With mean-term follow-up native implants showed mean-term survival of 92-94% in 272 patients. Mean evaluation by Harris was the following: biometric «Sinko» and «ESI» implants - 83.1 points, PF «Sinko» implants - 89.3 points, combination of «Mathys» friction pair with native femoral component - 91.2 points. «Mathys» implants showed 94.6 points. Results of ЯРТЕЗ joint replacement were evaluated during the period from 1 to 3 years in 183 patients. Intrahospital lethality made up 1.8%. Excellent and good results were achieved in 53.7% of patients. Revision was required in 1.5% of cases. As concluded total hip replacement in femoral neck fracture was the effective treatment technique. It was reasonable both cement and cementless fixation with various implants for the optimum choice of implant in every specific patient. Use of modern module implants enabled to expand the indications for application of arthroplasty in elderly patients.
Spontaneous Resorption of Bones in Children (12 cases)
Authors: Snetkov A I , Frantov Anton Rudol'fovich , Morozov A K , Berchenko G N , Batrakov S Yu , Kotlyarov R S , Anisimov M V , Snetkov A I , Frantov A R , Morozov A K , Berchenko G N , Batrakov S Yu , Kotlyarov R S , Anisimov M V
Published: October 2020

Experience in observation and treatment of 12 patients aged 5-18 years with spontaneous bone resorption is presented. Clinical and roentgenologic picture, results of modern examination methods (computed tomography, angiography) and histologic examination are considered. Indications to the treatment of patients with spontaneous bone resorption are determined. Surgical treatment should be performed in the phase of process stabilization while surgical intervention in the active phase of the disease results in the process progression.
Tribochemical Component of Oxidizing Stress Development at Joint Replacement. Part I. Determination of Radical-Forming Ability of Wear Particles from Various Orthopaedic Materials
Authors: Bulgakov V G , Gavryushenko N S , Shal'nev A N , Tsepalov V F
Published: October 2020

Using the model reaction of cumene oxidation the radical-forming ability of wear particles of some orthopaedic alloys and corundum ceramics were studied. It was revealed that wear particles from different alloys catalyzed cumene oxidation whereas particles of corundum ceramics were inert. Cobalt alloy wear particles were much more active as compared with the titanium alloy and stainless steel particles. Production of cobalt alloy by laser sintering reduced the radical-forming ability of its wear particles. Activity of cobalt wear particles was preserved for a long time after their formation and could considerably strengthen the development of oxidizing stress at joint arthroplasty. Detection of catalytic activity of orthopaedic alloys' wear particles requires studying of the influence of free radicals generated by tribochemical reaction upon implant components and biological tissues.
Ultrasound Study of Radial Nerve Projective Anatomy Relative to Lateral Humerus Aspect
Authors: Zolotov A S , Ovcharov P A , Zolotova Yu A
Published: October 2020

Location of radial nerve relative to lateral humerus was studied using US scanner in 17 volunteers (7 men, 10 women) aged 19-54 years. Conditional humerus length (acromion-olecranon distance) ranged from 31 to 39 cm. Radial nerve transacted lateral humeral diaphysis 11.3±1.9 cm (from 8 to 15 cm) proximal to lateral humeral epicondyle. Distance between lateral humeral epicondyle to radial nerve made up 31.9% of humerus conditional length. Awareness of obtained data may be helpful at performance of surgical intervention on the humerus.
Pathogenetic Approach to Treatment of Conservatively Irreducible Anterior Shoulder Dislocation
Authors: Yarmolovich V A , Kezlya O P
Published: October 2020

Approaches to the treatment of conservatively irreducible fresh anterior shoulder dislocations were considered. Experience in treatment of 5 patients with such injuries was presented. In case of deep impression of humeral head with its inclination into the anterior edge of the scapular glenoid cavity the authors used elaborated by them extension method of reduction that enabled to refusing the conventional step-by-step technique of irreducible dislocation treatment, to perform successful closed reduction in 3 out of 5 patients and to shorten the duration of treatment considerably.
Reconstructive Operations in Static Foot Deformity
Authors: Kopysova V A , Kaplun V A , Gorodilov V Z , Tsyganov A A , Ten V B , Egorov A G
Published: October 2020

In 92 patients with static foot deformities of II-IV degrees 159 operations were performed. Surgical treatment had for an object to eliminate first ray adduction and stabilize of forefoot. Follow-up within 1-5 years after operation showed that in static platypodia of II degree the resection of exostosis in combination with subcapital wedge-shaped resection of first metatarsal did not prevent the recurrence of great toe valgus deviation. The more effective method was operation by Shede-Brandes and corrective osteotomies of first metatarsal methaphysis using bone graft or porous implant. Fixation of fragments was performed by S-shaped bow with shape memory. In static platypodia of III degree good long-term functional result was achieved after double osteotomy by Logroscino. In patients with static platypodia of IV degree good results were achieved in combination of Logroscino operation with synostosis of first-second or first-third metatarsals by tightening bow with shape memory foot.
Total Hip Arthroplasty with Some Home-Produced Implants
Authors: Nazarov Evgeniy Aleksandrovich , Ryabova M N , Seleznev A V , Nazarov E A , Ryabova MN AV , Seleznyov A V
Published: October 2020

Outcomes of total hip arthroplasty performed using home-produced «Sfen-C», «Isko-Rudn» implants for cemented fixation and «Fenix», «Compomed» for non-cemented fixation were studied in 156 patients with degenerative-dystrophic joint lesions (174 operations). Dynamics of peri-implant bone mineral density (comparative standard computed roentgenodensitometry), roentgenologic parameters of the operated joint (computed roentgenometry), weight bearing function of the lower extremities after arthroplasty (stabilometric analysis) were evaluated. Reasonability of application of home-produced implants «Sfen-C», «Isko-Rudn» and «Compomed» was substantiated. Recommendations on implant Fenix use limitations were given.
Risk Factors for Venous Thromboses Development in Knee Joint Arthroplasty
Authors: Agadzhanyan V V , Vlasov Sergey Valer'evich , Safronov N F , Vlasova I V , Agadzhanyan V V , Vlasov S V , Safronov N F , Vlasova I V
Published: October 2020

Retrospective analysis of case histories of 125 patients (36-77 years) after total knee arthroplasty for III-IV stage of gonarthrosis was performed. On 4-5 day after operation deep vein thrombosis was diagnosed in 30 (23.6%) patients. It was stated that additional factors which trustworthily influenced the risk factors of thromboembolic complications development were the following: application of tourniquet to the femur for more than 1 hour; application of tourniquet to the patients with initial venous pathology (varicosis of vena saphena magna and vena saphena parva, consequences of thrombophlebitis); obesity of II-III degree in women. No reliable influence of various methods of anesthesia and infusion therapy upon the risk of thrombosis development was detected. Obtained data confirm the necessity to perform compulsory examination of lower extremities veins in patients prior to knee joint arthroplasty and take additional measures on thrombosis prevention in high risk groups. Observance of the proposed antithrombotic protocol in the postoperative period prevents vein thrombosis progression, thrombus fragmentation and floating as well as promotes accelerated recanalization of thrombotic veins.
Influence of Intravenous Photohemotherapy on Tissue Microcirculation in Patients with Chronic Posttraumatic Osteomyelitis
Authors: Izumrudov M R , Krupatkin Aleksandr Il'ich , Levin G Ya , Mitrofanov V N , Sidorov V V , Izumrudov M R , Krupatkin A I , Levin G Ya , Mitropfanov V N , Sidorov V V
Published: October 2020

In patients with chronic posttraumatic octeomyelitis of crus bones the influence of intravenous quantum photohemotherapy of ultraviolet diapason on microcirculation was studied. Efficacy of ultraviolet blood irradiation was assessed by laser Doppler flowmetry with optic tissue oxymetry canal. It was shown that treatment had positive effect on the main indices of microcirculftory bed, promoted activation of blood regulation in microvessels and certain increase of oxygen consumption by tissues. Increase of inflammatory activity was noted in no one out of 19 treated patients.
Use of Reconstructive Microsurgery Technologies in Complicated Knee Joint Arthroplasty
Authors: Tikhilov R M , Kochish Aleksandr Yur'evich , Rodomanova L A , Kutyanov D I , Afanas'ev A O , Tikhilov R M , Kochish A Yu , Rodomanova L A , Kutyanov D I , Afanas'ev A O
Published: October 2020

Results of surgical treatment of 19 patients in whom total knee replacement was performed in combination with various reconstructive microsurgical operations were analyzed. It was shown that application of microsurgical technologies provided new potentialities in total knee arthroplasty first of all in atypical and complicated cases. Advantages of step-by-step treatment presupposing firstly the restoration of integument in the knee joint region followed by its total arthroplasty were revealed.
On Pathogenesis of Recurrent Club Foot
Authors: Kosov Igor' Semenovich , Kozhevnikov O V , Mikhaylova S A , Kralina S E , Kadzhaya L K , Kosov I S , Kozhevnikov O V , Mikhailova S A , Kralina S E , Kadzhaya L K
Published: October 2020

Complex study of motor skills in children with congenital club foot was performed at CITO laboratory of clinical physiology and biomechanics, and clinic of pediatric orthopaedics. Subjects for electrophysiological and biomechanical examination were 34 patients with congenital unilateral club foot (19 boys and 15 girls) aged from 3 to 16 years. Intact extremity indices were used for comparison. Study in open biokinematic contour mode on the affected side showed decrease in voluntary bioelectric activity of anterior tibial muscle by 34-60% and gastrocnemius muscle by 7-19%. Spectrum analysis of EMG and computed mechanography showed the decrease of tonic fibers activity in peroneal muscles of the lower leg with its increase in posterior group of muscles. Stabilometry and study of gate parameters on the affected side showed synergetic type of anterior and posterior muscles interaction with preservation of antagonistic type in the normal extremity. Suprasegmentary pattern of affection (lesion) was detected by method of stimulation electromyography. The data obtained confirm the influence of pathologic motor skill on the development of deformity recurrences at surgical treatment of children with congenital club foot.
Subtalar Arthroeresis in Posterior Tibial Tendon Dysfunction
Authors: Tamoev Sargon Konstantinovich , Zagorodniy N V , Protsko V G , Sultanov E M , Khamokov Z Kh , Dubovik G O , Tamoev S K , Zagorodniy N V , Protsko V G , Sultanov E M , Khamokov Z Kh , Dubovik G O
Published: October 2020

The purpose of the study was to evaluate the efficacy of subtalar arthroeresis for II stage tibial tendon dysfunction by Johnson and Storm classification. From November 2007 to August 2009, 18 patients with that pathology were operated on. After implantation of Kalix® II endorthesis the plasty of posterior tibial tendon was performed. The results were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) scores system. After treatment average estimate by AOFAS increased from 47.2 before operation to 79.0 after surgery, pain index from 16.3 to 30.0, foot function from 28.7 to 41.6, foot position from 2.6 to 8.4. According to X-ray data the longitudinal arch angle decreased by 14.3° at an average and talar-calcaneal angle by 8°. Study results showed that technique of subtalar arthrodesis was effective enough for correction of flat foot resulted from II stage posterior tibial tendon dysfunction. Combination of that technique with tendon plasty ensured the full-value reconstruction of the foot.
Long-Term Result of Complex Treatment for Recurrent Congenital Club Foot (Case Report)
Authors: Kralina Svetlana Eduardovna , Kralina S E , Kadzhaya L K , Kadzhaya L K
Published: October 2020

An example of successful complex treatment of 8 years old patient with severe recurrent club foot is presented. Treatment included surgical restoration of osteoarticular interrelations in the foot and elimination of muscle imbalance. For the restoration of shin muscles' reciprocal interrelations and formation of proper motor skill, training of muscles according to the method of functional biocontrol was applied. Treatment result was assessed after 3 years: no deformity relapse was observed, function of the extremity was completely compensated.
Stabilizing Potential of Modern Internal Metal Constructions for Osteosynthesis of Metadiaphysial and Diaphysial Femur Fractures (experimental study)
Authors: Rekvava Georgiy Roinovich , Gavryushenko N S , Lazarev A F , Kuz'menkov Konstantin Aleksandrovich , Rekvava G R , Gavryushenko N S , Lazarev A F , Kuz'menkov K A
Published: October 2020

Study of fixation potential of various fastening elements of modern intramedullar and external metal constructions, strength characteristics of internal fixatives at different levels of the femur as well as their stabilizing potential in metadiaphysial and diaphysial femoral fractures was performed on 39 unfixed human cadaveric femur specimens under experimental modeling conditions using universal testing machine w+b (walter + bai ag) LFV-10-T50 (Switzerland). It was shown that in metadiaphysial and diaphysial femoral fractures fixation with modern intramedullar and external metal constructions not always met the requirements of biomechanical conception of fragments' fixation. Constructions that ensure the highest fixation stability in femoral fractures at different levels were defined.
Use of Autologous Stromal Marrow Cells for Surgical Treatment of Congenital Crus Bones Pseudoarthrosis in Children
Authors: Mironov S P , Omel'yanenko N P , Kozhevnikov O V , Il'ina V K , Ivanov Aleksey Valer'evich , Mironov S P , Omel'yanenko N P , Kozhevnikov O V , Il'ina V K , Ivanov A V
Published: October 2020

First experience in application of cultivated autologous stromal marrow cells for the stimulation of reparative bone regeneration in zone of crus bones pseudoarthrosis resection was presented. There were 4 patients, aged 16 months - 9 years. Results obtained showed significant stimulated influence of autologous stromal marrow cells on activity of osteoreparation and healing of bone fragments. Signs of consolidation were noted 3 months after operation. Duration of apparatus fixation ranged from 5 to 7.5 months. At 5 years follow-up no consolidation of bone fragments without bone callus formation was detected in all patients. No recurrence of pseudoarthrosis and disturbance of medullar canal were noticed
Pathological Knee Joint Synovial Folds in Children and Adolescents (diagnosis, arthroscopic treatment)
Authors: Merkulov V N , Berchenko G N , Chikvatiya Levan Vakhtangovich , El'tsin A G , Minnikov D S , Avakyan A P , Merkulov V N , Berchenko G N , Chikvatiya L V , El'tsin A G , Mininkov D S , Avakyan A P
Published: October 2020

Basing on the analysis of 817 arthroscopic interventions on the knee in children and adolescents with various knee joint pathology it was detected that pathology of synovial folds was one of the main causes of knee pain and discomfort in that group of patients. Pathological pattern of synovial folds was visualized in 127 patients. Treatment of this pathology requires knee arthroscopy for verification of preliminary diagnosis made by results of clinical and radiologic examinations, determination of the stage of various folds pathologic process as well as elaboration of surgical tactics.
Chemical Composition of Solitary Bone Cysts Contents in the Process of Combined Treatment Using Transosseous Osteosynthesis
Authors: Luneva Svetlana Nikolaevna , Stogov M V , Mitrofanov A I , Luneva S N , Stogov M V , Mitrofanov A I
Published: October 2020

Treatment results were analyzed for 22 patients, aged 5-27 years, with long bone cysts. Combined treatment (transosseous osteosynthesis and drug punctures) was used in all cases. Activity of alkaline and acid phosphatase total proteolytic activity, total protein content in blood serum and cyst contents was determined in dynamics. Biochemical examination of solitary bone cysts contents showed that their qualitative composition was identical to chemical contents of blood serum. During treatment osteolytic activity of cyst contents decreased considerably with reduction of low molecular and rise of high molecular components that evidenced of «structurization» cyst cavity.
Use of Brace Therapy in Patients with Idiopathic Scoliotic Spine Deformities
Authors: Tesakov Dmitriy Kimovich , Tesakov D K
Published: October 2020

Efficacy of brace therapy was studied in 976 patients with idiopathic scoliosis (IS) aged, 5 to 17 years. The principal curvature made up from 18° to 160°. Chкneau braces were used as orthoses. Treatment course was divided into the period of adaptation to brace wearing, period of primary correction, period of brace retention and period of follow up after brace treatment completion. Achieved results showed that in IS brace treatment provided good corrective and stabilizing effect upon scoliotic spine deformity. Clinically it enabled to eliminate completely, diminish or stabilize deformity manifestations of orthopaedic disease. In severe forms of IS it enabled to control the pathologic process conservatively until the spine growth completion.
Peculiarities of Arterial Architectonics in the Posterior Foot Segment
Authors: Privalov Anatoliy Mikhaylovich , Fomin N F , Emel'yanov V G , Koryshkov N A , Zaytsev O V , Privalov A M , Fomin N F , Emel'yanov V G , Koryshkov N A
Published: October 2020

Peculiarities of arterial blood supply in the posterior segment of the foot were studied on 20 lower extremities of 15 cadavers. Zones with feeble-marked blood supply were detected and rational surgical approaches to the posterior foot bones and joints within those zones were suggested. Fifty nine surgical interventions were performed via suggested approaches: subtalar joint arthrodesis - 47 (79.6%), metal osteosynthesis of the calcaneous - 7 (11.9%), operation for plantar fasciitis - 3 (5.1%), resection of calcaneous neoplasms - 2 (3.4%). Good clinical result was achieved in 86% of cases.
Effect of Tourniquet upon Development of Intra- and Postoperative Complications in Total Knee Replacement in Patients Treated with Pradaxa
Authors: Girkalo Mikhail Vladimirovich , Puchin'yan D M , Voskresenskiy O Yu , Derevyanov A V , Mandrov A V , Girkalo M V , Puchinyan D M , Voskresenskyi O Yu , Derevyanov A V , Mandrov A V
Published: October 2020

Results of comparative study of intra- and postoperative blood loss, rate of thromboembolic complications at total knee replacement with and without tourniquet application on the background of anticoagulant therapy with Pradaxa. It was shown that application of pneumatic tourniquet considerably decreased blood loss during the most laborious steps of operation but did not decreased the total blood loss and simultaneously increased the risk of thromboembolic complications development in the early postoperative period. Anticoagulant therapy including oral Pradaxa 220mg/day provided the convenience for the patient to continue thromboprophylaxis after discharge that greatly increased its efficacy.
Principles for Surgical Treatment of Long Bones Fractures Complicated by Purulent Infection
Authors: Amiraslanov Yusif Abul'fatovich , Zhukov A O , Borisov I V , Ivanov A P , Amiraslanov Yu A , Zhukov А O , Borisov I V , Ivanov A P
Published: October 2020

Modern concept for the treatment of long bones fractures complicated by purulent infection is presented. The main principles of this concept are the determination of volume and pattern of bone and soft tissue injury, radical debridement, stable bone fragments' fixation, use of primary and early reconstructive-restorative operations for substitution of bone and soft tissue defects. Treatment results for 268 patients (289 extremity segments) have been analyzed. Applied method of grouping patients with complicated long bone fractures by the pattern and volume of injury enables to determine the volume of debridement, terms and steps of osteosynthesis and reconstructive-plastic operations. Good and satisfactory results have been achieved in 88% of cases.
Musculoskeletal Diseases as Social and Economic Problem
Authors: Mironov S. P , Es'kin N. A , Andreeva T. M
Published: October 2020

Dynamics of musculoskeletal diseases incidence among adult population for the period 2006— 2010 is presented . Social and economic significance of orthopedic pathology is shown. Main directions for specialized care quality improvement are proposed.
Use of Enoxaparin and Dabigatran for Thrombosis Prevention After Total Knee Replacement
Authors: Murylev V. Yu , Rukin Y. A , Elizarov P. M , Zhuchkov A. G , Terentiev D. I
Published: October 2020

Comparative analysis of dabigatran etaxilate and enoxaparin sodium use for prevention of vena cava inferior system thrombosis in patients after total knee replacement in early postoperative period was performed. In 74 patients (1 st group) dabigatran etaxilate and in 127 (2 nd group) enoxaparin sodium was used as a preventive measure. The rate of thrombosis made up 1.35% and 2.4% in the first and second groups, respectively. No significant difference in the volume of perioperative blood loss between the groups was noted. No other hemorrhagic complications were observed. It was shown that in more convenient peroral administration the dabigatran etaxilate efficacy and safety was comparable to enoxaparin sodium.
Use of Multilayer Thin-Film Coatings for Complete Restoration of Integument in Its Deep Damage (Experimental Study)
Authors: Nikityuk I. E , Petrash V. V , Kubasov V. A
Published: October 2020

The effect of multilayer thin-film wound coatings upon regeneration of skin in its deep damage was studied 18 Chinchilla rabbits. Full-layer skin wounds 40 x 40 mm were inflicted on the back of the animals. In experimental group of animals the wounds were closed by multilayer coatings consisting of 50 aluminum metalized lavsan films. In control group one layer coating with thin aluminum plate was used. In all control animals the pyonecrotic wound processes developed within 1 — 2 weeks after intervention. In experimental rabbits the wound healing process showed no clinical signs of inflammation. In 6 weeks a full value regenerate in the zone of deep skin damage was formed. Its thickness and structure was typical of normal skin. Principle of multilayer coatings is perspective for the elaboration of coatings at treatment of deep and small wounds of various etiology when high quality of dermal regenerate is required.
The analysis of rendering of specialized medical care by the patient with damages and hand diseases to the city of Moscow and ways of its optimization
Authors: Egiazaryan K. A , Magdiev D. A
Published: October 2020

In article the analysis of a condition of rendering of the specialized help by the patient with damages and hand diseases is carried out. In particular the structure and volume of rendered specialized medical care by such patient in the conditions of offices of surgery of a hand of City clinical hospitals № 4 and 6 of Department of health care of the city of Moscow during the period from 2006 to 2011 are studied. The reasoned arguments about expediency of creation of the Moscow City Center of Hand Surgery.
Total Arthroplasty of 1st Metatarsophalangeal Joint. Short-Term Results
Authors: Petrosyan A. S , Zagorodniy N. V , Yolkin D. V , Protsko V. G , Zakharyan N. G , Mazalov A. V , Grigor'ev V. V
Published: October 2020

During the period from April to December 2011 seventeen total arthroplasties of 1 st metatarsophalangeal joint for III—IV stage deforming osteoarthrosis was performed to 11 patients (7 men, 4 women) aged 39—68 years. In 9 cases bone cement was used for implant fixation, in the rest of cases — press-fit technique. In 3 cases Goman operation was simultaneously performed on 2—3 toes, in 1 case Weil osteotomy was performed. Treatment results were assessed by AOFAS scale. Mean follow up term made up 8.6 months. Excellent and good results were achieved in 8 (72.7%) patients, satisfactory — in 2 (18.2%), poor — in 1 (9.1%) patient. Total arthroplasty of 1 st metatarsophalangeal joint is an alternative to arthrodesis and enabled to restore both joint function and stability.
Use of Tranexamic Acid at Knee Joint Arthroplasty
Authors: Vlasov S. V , Pronskikh A. A
Published: October 2020

Results of comparative study of the efficacy and safety of intraoperative application of tranexam versus autoplasma in patients with planned surgical blood loss and high risk of venous thrombosis development has been presented. One hundred seven patients admitted for total knee replacement were divided into 2 groups. In the main group (55 patients) intraoperative intravenous infusion of 10 mg/kg tranexam were used. In the control group (52 patients) intraoperative hemodilution with autoplasma was performed. Hemostasis indices (APTT, INR, SFMC, D- dimer) and lysis index were studied before surgery and in postoperative period. Ultrasound scanning of lower extremity veins was performed before surgery and in 4—5 days after intervention. The volume of intraoperative blood loss in two groups did not differ. In the postoperative period the drainage blood loss in the main group was more than twice lower as compared to the control group (p=0,037). In postoperative period statistically significant increase in SFMC and D-dimer indices was noted in both groups. However after tranexam application the increase in fibrin lysis products content was reliably less marked than in control group. US investigation of lower extremities showed distal veins thrombosis in 2 patients from control group and no cases of thrombosis in the main group.
Potentialities of Computed Navigation at Primary Total Knee Replacement
Authors: Kavalerskiy G. M , Murilev V. Y , Rukin Y. A , Lichagin A. V , Elizarov P. M
Published: October 2020

During 2007—2012 total knee replacement with computed navigation was performed to 449 patients, aged 32 to 84 years. Indications to the application of that method were the deformities of lower extremities in frontal plane over 15°; inability to use intramedullary guides; rough changes in range of movements. In the majority of cases (478, 93.2%) devices with posterior stabilization were used. Postoperatively mechanical axis of the extremity was evaluated by X- rays, functional results — by Oxford scale. Mean follow up made up 29.5 months. Two years and over after surgery mean point by Oxford scale was not below 40. Use of computed navigation enabled to insert the implant components more accurately, to determine the correct balance of ligamentous system and to decrease the complication rate.
Low Invasive Approaches at Treatment of Patients with Severe Concomitant Injury and Dominant Chest Injury
Authors: Tseimakh Ye. A , Levin A. V , Gontarev I. N , Zimonin P. E , Tolstihina T. A
Published: October 2020

For the purpose of increasing the efficacy of complex treatment of 72 patients (main group) with severe concomitant injury and dominant chest injury low invasive treatment, i.e. local differential fibrinolytic therapy, valvural bronchoblocking, videothoracoscopy was applied. One hundred twelve patients (comparative group) were under traditional treatment (blind drainage of pleural cavities, thoracotomy, etc). Unilateral thoracic injuries were detected in 165 (89.7%) patients, bilateral — in 19 (10.3%). In 141 (76.6%) patient chest injuries were accompanied by subcutaneous and intercondylar emphysema. Elaborated treatment and diagnostic tactics as well as differentiated approach to the use of low invasive techniques enabled to increase the number of recovered patients — 61 versus 54 patients from comparative group (p
Version of Tenodizing Operation in Patients with Recurrent Shoulder Dislocation
Authors: Sysenko Yu M , Samusenko Dmitriy Valer'evich , Sysenko Yu M , Samusenko D V
Published: October 2020

Description of a patent technique for surgical treatment of patients with recurrent shoulder dislocation by creation a ligament that fixes the humerus head is presented. Peculiarities of patients' management in the postoperative period and the order of Ilizarov apparatus dismantling are shown. Use of that technique for the treatment of 32 patients enabled to achieve good results (no relapse) in 96.9% of cases.
Complex Functional Evaluation of Long-Term Results of Femoral Neck and Head Revascularization in Degenerative Dystrophic Hip Joint Diseases
Authors: Nazarov Evgeniy Aleksandrovich , Papkov V G , Seleznev A V , Musaeva R F , Nazarov E A , Popkov V G , Seleznyov A V , Musaeva R F
Published: October 2020

Long-term results (7 to 26 years) after femoral neck and head revascularization were analyzed for 41 patients with degenerative dystrophic hip joint diseases: 27 patients with aseptic femoral head necrosis (AFHN), 9 patients with coxarthrosis, 5 - with cystoid remodeling of adjacent surfaces. Results were assessed by Harris scale. Degree of functional changes in hip joints was determined using computed stabilometry. Indirect proof of implanted vascular bundle vitality were radiologically, CT and MRI detected canals in the femoral neck and head that where the implants had been inserted. It was shown that revascularization was most effective (100 points by Harris scale) in patients with early (pre-radiologic) stage of AFHN and in patients with cystic remodeling.
Disturbances of Microcirculation and Antioxidant Potential as a Consequence of Ferrum Exchange in Traumatic Disease
Authors: Ivanov Aleksey Valer'evich , Orlov Yu P , Lukach V N , Pritykina T V , Ivanova A M , Ivanov A V , Orlov Yu P , Lukach V N , Protykina T V , Ivanova A M
Published: October 2020

Study of ferrum metabolism was performed in 30 patients with traumatic disease, i.e. fractures of the femur, pelvic bones, ribs accompanied by massive muscular hematomas. It has been detected that in severe bone injury besides extravascular hemolysis the intravascular hemolysis, that affects the ferrum metabolism, takes place. Excess of free ferrum activates free radical oxidation processes and results in reduction of total antioxidant activity that is proved by lability of Fe2+ - induced hemiluminescence indices as well as causes the disturbance of blood rheology that influences the course of traumatic disease. Results of experimental study on 30 male Wistar rats in which the conditions of I stage of traumatic shock were created showed that administration of Desferal contributed to blood viscosity improvement.
Surgical Methods for Treatment of Patients with Ankle Joint Injuries
Authors: Kaplun V. A , Kopysova V. A , Martel I. I
Published: October 2020

From 2001 through 2010 one hundred eighty six patients were treated for I-III degree pronation (134) and supination (52) ankle joint injuries. In 150 (80.6%) patients (main group) fixation of bone fragments and tibiofibular syndesmosis were performed using tightening anchors with shape memory effect and in 36 (19.4%) from control group conventional osteosynthesis techniques were applied. Consolidation of bone fragments and restoration of injured extremity function was achieved in 141 (94.0%) and 15 (41.7%) patients from the main and control groups, respectively. Long term results were analyzed at terms 3 — 5 years for 80 patients from the main and 22 patients from the control group: statistically significant disorders and degenerative changes in the ankle joint were detected in 5 (6.3%) and 8 (34.4%) patients, respectively. Comparative analysis of different techniques for bone fragments fixation and tibiofibular syndesmosis showed that elastic-strained osteosynthesis with tightening anchors was as effective as conventional techniques and transosseous osteosynthesis by Ilizarov and even exceeded those methods by terms of limb function restoration.
New Functional Classification of Severe Hand Injuries (FU-classification)
Authors: Afonina E. A , Golubev I. O , Pshenisnov K. P
Published: October 2020

New functional classification of severe hand injuries is suggested. Concept of hand functional unit of the hand, i.e. finger segment containing joint, blood vessels and all surrounding soft tissues, is introduced. New functional classification of severe hand injuries is related to the algorithm of patient’s treatment depending on the level ofpreserved functional units. Division of the hand into functional units and primary evaluation of every unit condition enables to choose surgical treatment tactics directly after injury as well as to prognosticate the outcome.
Efficacy of Spine Segments Radiofrequency Denervation
Authors: Nazarenko G. I , Cherkashov A. M , Kuzmin V. I , Nazarenko A. G , Gorokhov M. A , Sharamko T. G
Published: October 2020

Early and long-term results of radiofrequency facet destruction for 245 patients with cervical, thoracic and lumbar spondyloarthrosis were presented. One hundred six patients (control group) were treated conservatively. Treatment results were assessed by pain syndrome intensity using pain audit. One year after operation good result was observed in 62 (32%) out of 195 patients and satisfactory results — in 117 (60%) patients. That method enabled to eliminate considerably vertebrogenic pain localized in one dermatome when conservative treatment failed. Our experience showed that radiofrequency facet nerves destruction was safe and did not result in soft tissue injuries. All that enabled patients to return to work at maximum short terms.
Standard Acetabular Component or Antiprotrusion Consolidating Design?
Authors: Zagorodniy N. V , Kagramanov S. V , Nikolaev I. A , Bukhtin K. M
Published: October 2020

The purpose of the study was determination of optimum technique for acetabular component revision depending on the volume of bone tissue deficit. Between 1992 and 2012 a total number of 843 partial or total revision hip replacement surgeries were performed. In 664 cases the indication for revision surgery was instability of acetabular component. Depending on the design of implant used (polyethylene cement cups, consolidating constructions, cementless cups) all patients were divided into 3 groups. Subsequently each group was divided into subgroups depending on the acetabular defect degree (by Paporsky classification). It was shown that for provision of maximum implant surveillance and reduction of the risk of most common operative complications the early clinical and radiologic detection of developing acetabular instability and revision performance was essential. In cases of delayed revision operation and significant bone tissue deficit it is reasonable to perform revision surgery using consolidating construction with additional bone defect plasty.
Comparative Clinical and Economical Analysis of Drugs for Primary Prevention of Thrombotic Complications after Orthopaedic Operations
Authors: Kulinchik T. V , Rebrova O. Yu , Margieva A. V , Avksent’eva M. V
Published: October 2020

Cost minimization analysis was performed on the basis of the efficacy and safety evaluation of dabigatran etexilate (DE, Pradaxa®) versus other common anticoagulants (AC). Total costs including laboratory and instrumental examinations, consultations related to venous thromboembolism (VTE) and post-operative anticoagulation therapy were calculated by the data of 828 individual registration cards. All patients were divided into 2 groups: 761 patients (91.9%) after total hip and knee arthroplasty (1 st group) and 67patients (8.1%) after other orthopaedic operations (2 nd group). In 1 st group costs for drug prophylaxis of VTE and total costs per patient were significantly lower (by 1196.66 and 432.41 rbl, respectively) when DE was used as compared to AC application. After other orthopaedic operations reliable differences neither in costs for drug prophylaxis of VTE nor in total costs per patient were detected. However the significance of obtained results was limited by the number as well as the differences in initial condition of patients.
Revision Total Knee Arthroplasty due to Allergic Reaction to Cobalt
Authors: Zagorodniy N. V , Bukhtin K. M , Kudinov O. A , Chragyan G. A , Berchenko G. N , Nikolaev I. A
Published: October 2020

Clinical observation of patient undergone two revisions total knee arthroplasty was presented. The cause of revisions was clinical manifestation of inflammatory but no classic signs of infection were detected intraoperatively. Cupping of inflammatory was succeeded after insertion of implant coating by nitride ceramics. Possible inflammatory development as allergic reaction to cobalt was discussed.
First Experience in Thoracoscopic Sympathectomy at Treatment of Patients with Vast Posttraumatic Upper Extremity Defects Using Free Flaps
Authors: Golubev I. O , Krupatkin A. I , Maximov A. A , Ruzmichev V. A , Merkulov M. V , Bushuev O. M , Shipyaeva G. N , Kutepov I. A
Published: October 2020

Two clinical observations of patients with severe upper extremity injury sequelae are presented. Examinations included clinical and ultrasound methods, MRT-angiography, ENMG. Trophic status and microcirculation were studied using computer thermography as well as laser Doppler Flowmetry. Thoracoscopic clipping of sympathetic ganglions at the Th3-Th4 levels were performed in 7 weeks and 3 months following microsurgical forearm reconstruction. Sympathectomy provoked significant microcirculation activation and as a consequence improvement of extremity trophic status including distal region
Transfemoral Approach at Revision Hip Arthroplasty
Authors: Zagorodniy N. V , Nuzhdin V. I , Bukhtin K. M , Kagramanov S. V
Published: October 2020

Results of 41 revision hip arthroplasties (41 interventions) via transfemoral approach were analyzed. That approach was used in stem fracture — 12 (29.26%) cases, cement removal — 20 (48.78%) cases and removal of partially ingrown cementless stem — 9 (21.95%) cases. Techniques of window, oblique, longitudinal oblique osteotomy and resection of greater trochanter were applied. As compared with standard revision intervention the duration of operation was about 40 minutes longer (159 min versus 125 min) and blood loss increased almost for 1 liter (2240 ml versus 1510 ml). Intraoperative complications were registered in 5 (12.20%) patients including 1 case of transverse femur fracture at oblique osteotomy (2.44%), 1 case of femur fracture at window osteotomy (2.44%), 2 cases of greater trochanter fracture (4.88%), 1 case of femoral cortical perforation by the cutter at distal stem fragment removal (2.44%). Excellent and good results were obtained in 30 (73.17%) patients. Indications to every type of transfemoral approach are presented.