bluuebunny/crossref_metadata_2025 huggingface dataset:
Microsurgical Reconstruction of Soft Tissues in Elbow Arthroplasty
Authors: Kalantyrskaya V. A. , Golubev I. O. , Afonina E. A.
Published: October 2018

Case report on a patient with severe traumatic elbow joint destruction in whom consecutive restoration of common integument (with free Latissimus dorsi musculocutaneous flap) and elbow arthroplasty were performed is presented
Modern Potentialities of Acetabular Osteosynthesis
Authors: Solod E. I. , Lazarev A. F. , Gudushauri Ya. G. , Kakabadze M. G. , Sakharnykh I. N. , Stoyukhin S. S.
Published: October 2018

Analysis of long term (1-10 years) results for 64 patients aged 17-70 years with various types of acetabular fractures both isolated and in combination with multiple and concomitant injuries was performed. Operations were performed by low invasive technique using 7.3 mm diameter screws with flattened thread and threaded end 2.8 mm diameter. Excellent results by Harris scale were achieved in 45 (70%), good - in 12 (19%), satisfactory - in 7 (11%) patients. Advantages of single-step percutaneous osteosynthesis of acetabulum with fixation of other segments in multiple injuries are noted.
Pathohistologic Changes in Hip Tissues and Clinical-Morphologic Correlations in Diseases Complicated by Femoroacetabular Impingement Syndrome
Authors: Grigorovskiy V. V. , Filipchuk V. V. , Kabatsiy M. S.
Published: October 2018

The purpose of the work was to detect clinical-morphologic correlative dependences in patients with clinically marked femoroacetabular impingement (FAI) syndrome basing on the study of pathomorphologic changes in hip joint tissues, semiquantitative quantification of pathologic changes intensity, frequency analysis of their occurrence in nosologic groups of comparison. Study was performed on specimens of hip joint tissues - femoral head, acetabulum, acetabular labrum and joint capsule, resected during indicated corrective surgeries for femoral head aseptic necrosis and juvenile epiphysiolysis. Clinical-morphologic study revealed various pathologic changes: dystrophic-destructive, ischemic-necrotic and productive-inflammatory. In patients with FAI syndrome clinical and morphologic correlative dependences varied by absolute value, sign and degree of reliability of association coefficient parameters, i.e. groups of patients with certain nosologic units retained the peculiarities of rate and characteristics proportions in correlative dependences
New Method for 3D-Testing of Spinal Stabilizer Muscles
Authors: Mironov S. P. , Tsykunov M. B.
Published: October 2018

Data on testing of spinal stabilizer muscles using isokinetic dynamometer are presented. It is shown that achieved test results enable to detect muscular imbalance even at subclinical level and to elaborate individual rehabilitation programs.
Congenital Abnormalities (developmental defects) and Musculoskeletal System Deformities in Children
Authors: Baindurashvili A. G. , Solov’Yova K. S. , Zaletina A. V. , Lapkin Yu. A.
Published: October 2018

Data of RF Health Ministry official statistics, Federal Genetic Register and Congenital Defects Monitoring Center, and St. Petersburg Diagnostic (Medical Genetic) Center were analyzed. It is stated that within XVII Class of ICD-10 “Congenital abnormalities (developmental defects), deformities and chromosomal disorders” congenital malformations (developmental defects) and musculoskeletal system (MSS) deformities make up 20 - 22% and handicapped children account for 25 - 28%. The rate of MSS abnormalities diagnosed in maternity hospitals is 4.0 - 4.4 per 1000 of newborns. Rate and structure of MSS malformations in newborns and handicapped children was studied and compared. The number of handicapped children with various forms of MSS congenital developmental defects changes with age that reflects both progression of disease and deformity relapse as well as treatment efficacy. Rate indices and data on the structures of various forms of congenital developmental defects may be used for disability prognostication when planning the requirements in treatment and rehabilitation.
Clinical Analysis of Gait and Assessment of Surgical Treatment Outcomes in Children with Neurogenic Feet Deformity
Authors: Kosov I. S. , Merkulov V. N. , Imyarov Sh. D. , Mikhailova S. A.
Published: October 2018

Clinical analysis of gate in children with neurogenic feet deformities before and 1 year after musculotendinous transposition was performed. Study was performed using programmable hardware complex combined with dynamometric platform and electromyelograph. Temporal, kinematic and kinetic parameters of a stride cycle were determined. Degree of walking asymmetry was evaluated using asymmetry parameter. Besides the pattern of joint mobility disturbance and degree of muscular function loss or decrease were taken into account. Complex clinical analysis of walking enabled to detect and worked out in details the disturbances of injured extremity function before surgery as well as to establish the improvement of weight bearing ability of the injured extremity, decrease in compensatory overload of the collateral healthy extremity and lowering of asymmetry parameter after surgery.
Direct Causes of Death in Road Traffic Accident Victims and Evaluation of the Efficacy of Three-Level Trauma Centers Activity in Chelyabinsk Region
Authors: Moskvichyova M. G. , Shishkin E. V.
Published: October 2018

Data on direct causes of death in road traffic accident (RTA) victims for Chelyabinsk region is presented for 2 periods, i.e. before (2008-2010) and after (2011-2013) organization of trauma center. Comparison of the level and structure of RTA death causes in two three-year periods showed no significant differences. Evaluation of the efficacy of trauma centers activity (2011 - 2013) that render medical care to RTA victims with multiple and concomitant injuries is performed. During three-year period of trauma centers activity the number of road traffic deaths resulted from multiple and concomitant injuries increased by 17.22%. No statistically significant changes in the rate of three main causes of RTA related death (multiple and concomitant injuries, head and chest injuries) were noted during the study period. Achieved results confirm the necessity to elaborate and introduce the monitoring that will enable to evaluate the efficacy and quality of trauma centers activity at all steps of medical care rendering including patients’ transportation.
Disturbance of Extensor Mechanism after Primary and Revision Knee Arthroplasty
Authors: Kavalerskiy G. M. , Murylyov V. Yu. , Kholodaev M. Yu. , Rukin Ya. A. , Elizarov P. M. , Rubin G. G.
Published: October 2018

Rate of extensor mechanism complications after primary and revision knee arthroplasty reaches 12 %. Description and systematization of such complications by literature data is given. Our experience in treatment of 12 patients with such complications after primary knee and in 5 patients after revision knee arthroplasty that made up 1.0 and 13.9% of all interventions, respectively, is presented. Registered complications include para-patellar scars and ossification impingement (4), patellar lateralization (5), patellar dislocation (1), patellar tendon rupture (7). Treatment results in patients after primary arthroplasty are better than after revision intervention - 83.3 and 40% of positive results, respectively. It is shown that high rate (42.9%) of patellar tendon rupture are associated with deep periprosthetic infection. Besides, autoplasty with m. gracilis and m. semitendinosus shows its inefficiency in treatment of such complications.
Clinical and Organization Approaches to Application of Innovative Medical Technologies at Rendering High-Tech Medical Care
Authors: Shalygina I. A. , Pakhomov I. A. , Sadovoy M. A. , Prolhorenko V. M. , Mamonova E. V.
Published: October 2018

Rendering of high-tech medical care (HTMC) is one of the priority directions of the Ministry of Health of the Russian Federation. Search of new organizational approaches, elaboration and perfection of medical technologies, introduction of new materials continue. The purpose of the study was to evaluate the expediency of biodegradable constructions use at rendering HTMC to traumatologic and orthopaedic patients. Treatment results for 56 patients with various feet pathology (calcaneus fractures, feet joints deforming arthrosis, Hallus valgus) were analyzed retrospectively. In control group ( n =28) metal constructions and in the main group (n=28) biodegradable constructions were used for bone fragments fixation. In two groups surgical treatment results were comparable, however treatment of patients from the main group was accompanied by significant social and economic effect due to more effective work of the bed as no construction removal was performed and no expenditures for patient’s stay at the hospital and intensive care unit were required. All that contributed to the improvement of patients’ life quality.
Experimental Modelling of the Processes for Connective Tissue Reparative Regeneration under Unfavorable Conditions
Authors: Vlasov M. V. , Bugrov S. N. , Bogos’Yan A. B. , Musukhina I. V.
Published: October 2018

The purpose of the work was to elaborate experimental model for transverse tenotomy with intersection of facial membranes and mesenteric vessels as well as to study the process of connective tissue reparative regeneration under created conditions. Experiment was performed on 25 chinchilla rabbits of both sexes, aged 1 month with weight 1376 ± 124.8 g. Processes of Achilles tendon reparative regeneration was studied on days 15, 21, 30, 60 and 90 after operation. Histomorphologic study showed that within 30 days after tenotomy the substitution of defect zone with friable, reach in cells and gradually maturating fibrous tissue took place. By the end of day 60 a considerable part of the defect was substituted by dense fibrous connective tissue assumed a scar pattern. On day 90 after tenotomy a reverse development of the defect zone with focal substitution of dense fibrous tissue by friable unformed connective tissue containing histiocytes, lymphoid cells and inclusions of fatty tissue foci was observed. At that term histologic structure of the specimen showed its relatively low mechanical strength. The achieved data enabled to demonstrate that performance of tenotomy with traumatization of peritendinous tissues adversely affected the dynamics and pattern of reparative processes in the tendinosus defect zone.
Initial Steps of Distraction Osteosynthesis
Authors: Mironov S. P. , Omel’Yanenko N. P. , Karpov I. N. , Ivanov A. V. , Khlystova A. V.
Published: October 2018

Analysis of literature data dedicated to the study of distraction osteosynthesis is presented. In accordance with the ideas of the mechanisms of reparative regeneration in distraction osteosynthesis, the main factors responsible for the triggering of reparative regeneration are artificially created tissue “deficit” and tension-stress effect on the vascular network that was formed during the latent period. Consecutive local effect of growth factors and other peptide regulators provides sufficient level of reparative osteogenesis within the whole distraction period. The volume and quality of newly formed bone tissue depend upon the spatial and temporal characteristics of distraction as well as on the potentialities of concrete individual.
Magnetic Resonance Imaging of the Whole Body (DWIBS). Potentialities and Perspectives for Application in Bone Pathology
Authors: Morozov A. K. , Makhson A. N. , Karpov I. N.
Published: October 2018

The purpose of the study was to determine the role and place of whole body MRI with DWIBS in diagnosis of human loco-motor system oncologic pathology. Two hundred fifty six patients with presumptive diagnosis of oncologic disease were examined. Obtained signal was evaluated by true signal intensity scale in minimal examination volume (voxel), either drawn through the volumetric lesion or in an isolated area of arbitrary shape. Study results were verified using standard MRI protocols (T1, T2, STIR), contrast enhancement, MSCT, radionuclide and morphologic examination. High sensitivity of the technique to pathologically changed tissues with reduced water diffusion coefficient was demonstrated. Magnetic resonance diffusion-weighted whole-body imaging with DWIBS may be recommended as noninvasive screening technique for the diagnosis of both primary and secondary (metastases) oncologic process.
S.S. Rodionova
Authors: Article Editorial
Published: October 2018

.
Modeling of a Different Volume Spinal Cord Injury in Rats and Methods for Evaluation of Lost Functions Restoration
Authors: Mironov S. P. , Kolesov S. V. , Stepanov G. A. , Sazhnev M. L. , Gubin S. P. , Ionin Yu. V. , Motin V. G. , Panteleev A. A.
Published: October 2018

The method for modelling of a different volume spinal cord injury to study potentialities for its regeneration is presented. The work was performed on 80 laboratory rats divided into 5 groups according to the volume of inflicted injury. Original instrument with restrictors for the infliction of the accurate and measured by volume spinal cord injuries was elaborated. The degree of function restoration was evaluated by the results of visual assessment of the movements in animals’ hind paws, records of induced potentials of the cerebral cortex region and by BBB scale. In every separate group the obtained indices were distributed uniformly that indicated justifiability and reproducibility of the elaborated model of incomplete spinal cord injury.
Surgical Stabilization of the Chest in Multiple and Floating Rib Fractures
Authors: Benyan A. S.
Published: October 2018

One of the complicated problems at the interface of thoracic surgery and traumatology is the treatment of multiple and floating rib fractures. Its urgency is determined by the high rate of complications and level of mortality. Analysis of surgical stabilization techniques in multiple and floating rib fractures is performed. Both the methods of historical significance and widely used at present are described. Data on the efficacy of various stabilization techniques are presented.
Scoliosis and Syringomyelia
Authors: Mikhailovskiy M. V. , Stupak V. V. , Belozyorov V. V.
Published: October 2018

High rate of both scoliotic deformities in patients with syringomyelia (up to 74.4%) and syringomyelia in patients with scoliosis (up to 9.7%) explains the interest of specialists to the patients with combination of such diseases. The literature review covers the modern approaches to the diagnosis and treatment, the problems in determination of treatment tactics, particularly the priority of neurosurgical intervention and intervention for scoliosis correction.
Surgical Treatment of Proximal Humeral Fractures with Short Straight Intramedullary Nail
Authors: Bondarenko P. V. , Zagorodniy N. V. , Gil’Fanov S. I. , Semenistyi A. Yu. , Semenistyi A. A. , Loginov A. N.
Published: October 2018

Long term surgical treatment results were studied for 30 patients (10 male and 20 female) with two- and three-fragment proximal humeral fractures with short intramedullary nail. Mean age of patients was 68.8 (37-84) years. All patients were examined clinically and roentgenologically. In postoperative period secondary varus deformity was observed in18 (60%) patients and made up 4.3° at an average. Roentgenologic signs of delayed fracture consolidation due to the loss of reposition and decrease of neck-shaft angle under 120° were observed in one case. Evaluation by ASES scale made up 90.73±7.01 points, by SST scale - 10.47±1.41 points. Treatment results for three-fragment fractures were not as good as for two-fragment ones however the difference was not statistically significant ( p >0.05). Obtained data showed the high efficacy of short straight intramedullary nail application in two- and three-fragment proximal humeral fractures.
Indirect Electroimpulse Myostimulation and Its Role in Treatment of Patients with Shin Bone Fractures
Authors: Obolenskiy V. N. , Karpenko A. V. , Zagorodniy N. V.
Published: October 2018

Prospective randomized controlled study to evaluate the efficacy of electric muscle stimulation (EMS) of calf muscles in prevention of venous thromboembolic complications (VTEC), shortening of treatment and rehabilitation terms in patients with shin bones fractures was performed. The study included 60 patients, aged 19-67 years, with isolated shin bones fractures. All patients were admitted at early (from 0.5 to 3 hours) terms after injury. For final fixation either intramedullary or plate osteosynthesis were used. All patients were on anticoagulant therapy for VTEC prevention. In the study group ( n =30) 2 séances of EMS, 3 hours each, were performed daily from the first day of hospitalization. In 30 patients from the control group EMS was not performed. It was shown that application of EMS ensured the shortening of treatment and rehabilitation terms, better quality of life and enabled to avoid VTEC development. Achieved preliminary data are indicative of the expediency of EMS application in traumatologic patients at early hospital stage.
Different Variants of Osteoblastoma Course in Children (Clinical, Roentgenologic, Morphologic Comparison)
Authors: Snetkov A. I. , Morozov A. K. , Berchenko G. N. , Batrakov S. Yu. , Kravets I. M. , Frantov A. R.
Published: October 2018

Osteoblastoma is a benign bone forming well vascularized tumor with unlimited growth potential. Experience in diagnosis and treatment of 85 children, aged 5 - 18 years, with osteioblastoma is presented. All patients were treated at CITO department of childhood bone pathology and orthopaedics during the period from 1985 to 2015. In 8 patients the course of the disease was aggressive. Results of clinical, roentgenologic and morphologic comparison as well as the analysis of literature data enables to demonstrate the validity of distinguishing the aggressive type of osteoblastoma that is characterized by peculiarities of clinical course and requires special approach to its treatment.
Results of Thoracoplasty via Small Incisions with Fixation of Sternocostal Complex by Shape Memory Metal Plate in Funnel Chest Deformity
Authors: Korolyov P. A. , Kozhevnikov O. V. , Rudakov S. S. , Kolerov M. Yu. , Lysikov V. A.
Published: October 2018

Long-term results of radical thoracoplasty via small incisions with fixation of sternocostal complex by shape memory metal plate were studied. Total number of 263 patients, aged 2.5 - 45 years, with funnel chest deformity (FCD) were operated using that technique. Out of them 118 patients were under 18 years and 145 - over 18 years. In adult patients in children good results were achieved in 97.7% and 90.5% of cases, respectively. During the process of plate removal in children it was possible to correct residual chest deformity and achieve good results. In childhood radical thoracoplasty is indicated only to the patients with severe 2-3 stages of FCD and “least” FCD forms should be corrected at the mature age.
Variants of Neurotization in Injuries of Brachial Plexus and Nerves of Upper Extremity
Authors: Zhuravlev S. A. , Golubev I. O.
Published: October 2018

The most commonly used variants of neurotization on the upper extremity in various injuries of peripheral nerves or brachial plexus and results of their application are presented. Pledge of successful neurotization is thorough knowledge of topographic anatomy of peripheral nerve branches, skills in precision surgical technique and adequate postoperative rehabilitation.
Student Years of N.N. Priorov (in commemoration of the 130th anniversary of birth)
Authors: Baitinger V. F. , Kurochkina O. S. , Delich I. B.
Published: October 2018

Student years of the Honoured Science Worker of RSFSR, Academician of the Academy of Medical Sciences (AMS), Soviet trauma- and orthopaedic surgeon, the founder of the Central Institute of Traumatology and Orthopaedics N.N. Priorov are presented. The atmosphere of student life with its everyday troubles, living conditions, university studies, lack of money, unemployment, revolutionary sentiments and yearning of young people for knowledge as well as the desire of teachers to share their experience to young generation is shown.
Hip Arthroplasty in Patients with Femoral Neck Pseudarthrosis
Authors: Kavalerskiy G. M. , Murylyov V. Yu. , Rubin G. G. , Rukin Ya. A. , Elizarov P. M. , Muzychenko A. V.
Published: October 2018

Hip arthroplasty outcomes for 202 patients, aged 40-88 years, with femoral neck pseudarthrosis were analyzed. All patients were divided into 3 groups depending on the type of treatment (surgical or conservative) and terms of the removal of previously implanted metal constructions (before or during surgical procedure). Good and satisfactory results by Harris hip score were achieved in 94.6% of observations. The reasons of postoperative complications were considered for every group of patients. It was stated that in 30 (14.9%) cases the formation of pseudarthrosis resulted from ungrounded use of osteosynthesis in Garden III and IV fractures.
Elaboration of Universal Approaches to the Treatment of Long Bone Osteomyelitis on the Basis of Reinforced Local Antibacterial Carriers
Authors: Dzyuba G. G. , Reznik L. B. , Erofeev S. A. , Odarchenko D. I.
Published: October 2018

Treatment results are presented for 86 patients with long bone osteomyelitis of different genesis (hematogenous, posttraumatic, postoperative). To determine the location of the implant the Cierny-Mader classification was used. In the main group (n=46) debridement of the osteomyelitic focus and placement of local reinforcing antibacterial polymethyl methacrylate implant with pathogen-specific antibiotics were performed. In the control group (n=40) traditional treatment techniques were used. Application of the proposed technique enabled to achieve 1.9 times decrease of infection relapse, to minimize the risk of pathological bone fractures due to its internal reinforcement and to achieve early functional restoration of the extremity.
Complex Diagnosis in Surgical Treatment of Peripheral Nerves Injuries of the Extremities
Authors: Ninel’ V. G. , Aitemirov Sh. M. , Korshunova G. A. , Norkin I. A.
Published: October 2018

The purpose of the work was to evaluate the role and potentialities of complex diagnosis in surgical treatment of peripheral nerve trunk injuries of the extremities. Complex examination including electroneuromyography, ultrasonography and contrast neurography was performed in 109 patients with injuries of peripheral nerves of the extremities. Examination results enabled to elaborate the algorithm of diagnosis and differential surgical treatment tactics for surgical treatment of peripheral nerves injuries. Management of patients in accordance with proposed algorithm allowed to improve surgical treatment results significantly - by 21%.
Surgical Treatment of Severe Congenital Scoliosis
Authors: Snetkov A. A. , Kolesov S. V. , Sazhnev M. L. , Shaboldin A. N.
Published: October 2018

Retrospective analysis of treatment results for 36 patients (31 females, 5 males) aged 2 - 31 years with congenital scoliosis was performed. Malformation of vertebrae was present in 23 patients, disorder of segmentation - in 9, combined anomalies - in 4 patients. Posterior fusion was performed in 15, combined anterior and posterior fusion - in 7, removal of the semivertebra - 13, and VEPTR technique - in 1 patient. Treatment results were assessed by roentgenographic data and the results of SRS-24 questionnaires. Follow up period made up from 1 to 7 years. Differentiated approach to treatment enabled to create conditions for the proper development of the spine and formation of adequate frontal and sagittal balance as well as to increase patient’s self-appraisal and daily activity.
Organizational of Mechanisms of Innovation Management and Their Realization in Public Health (on the example of the Tsiv’yan Novosibirsk Research Institute of Traumatology and Orthopedics)
Authors: Totskaya E. G. , Sadovoy M. A.
Published: October 2018

The main directions in innovations of the largest scientific and research institute in Siberian region are presented. Organizational mechanisms of management in the field of treatment and diagnostic technologies are substantiated. Their influence on the indices of medical organization activity including the quality as well as the availability of specialized and high-tech medical care is demonstrated. The ways of public health service improvement on the basis of principally new methodological approaches to the management in expert level medical organizations are defined.
Treatment of Knee Medial Osteoarthrosis Using Open Corrective Osteotomy of the Tibia
Authors: Prizov A. P. , Kopylov A. A. , Epstein A. A. , Lazko F. L. , Kubashev A. A. , Belyak E. A. , Zagorodniy N. V. , Kulikova O. I.
Published: October 2018

Treatment results using high open corrective tibial osteotomy with tricalcium phosphate block (OTIS 50) and fixation by angle-stable mini plate (OTIS C PLUS) are presented for a 47 years old female patient with 3rd stage gonarthrosis. Evaluation of functional condition was performed by Joseph and Kaufman scale that made up 72 and 95 points before and 3 years after surgery, respectively. Control knee arthroscopy and histologic examination results showed partial restoration offibrous hyaline cartilage in the injured knee compartment.
Morphologic Substantiation of Distraction as a Preparatory Step for Bioactive Interphalangeal Hand Joint Arthroplasty in Fibrous Ankylosis
Authors: Bugrov S. N. , Davydenko D. V. , Shirokova N. Yu. , Novikov A. V. , Petrov S. V.
Published: October 2018

The work is dedicated to the study of the morphologic peculiarities of proximal interphalangeal joint capsule before and after distraction in order to substantiate the use of distraction technique as a preparatory step for proximal interphalangeal hand joints bioactive arthroplasty in fibrous ankylosis. The study was conducted on the samples of small fragments of proximal interphalangeal hand joint capsule (11 patients) before distraction and 2 months after distraction apparatus removal. Control group (conventional norm) was presented by 6 autopsy samples. Light microscopy using standard staining methods and immunohistochemical examination were performed. Activation of angiogenesis processes, i.e. 3.5 times increase of vascular bed, 3.4 times growth of mature labrocytes number, both partially and maximum degranulated, as compared with the nondistracted tissue and control group. Direct correlation between the growth of mature labrocytes number and fibroblasts, and the quantity of newly formed vessels per unit of tissue area was detected. Distraction enables to raise the vitality and resistance of pathologically changed joint tissues to damaging factors (hypoxia), activates functional status of joint surrounding tissues and could be considered as a preparatory step for fibrotically ankylosed interphalangeal hand joints bioactive arthroplasty.
State of Synovial Medium in Patients with Degenerative Dystrophic Changes of Knee Joint Accompanied by Articular Surface Defects
Authors: Matveeva E. L. , Gasanova A. G. , Chegurov O. K.
Published: October 2018

The purpose of the work was to determine the concentrations of mineral elements in subchondral bone and synovial fluid of patients with degenerative dystrophic knee joint diseases accompanied by articular surface defects. Subchondral bone and synovial fluid were used as a study material. Analysis of mineral content indices included the determination of calcium, phosphate, magnesium and chlorides concentrations by spectrophotometry. It was shown that the indices of basic electrolytes, i.e. of calcium and phosphate ions, in bone and synovial fluid did not correlate with each other and changed in different directions. Calcium content decreased in the bone while phosphate ions - in synovial fluid.
Treatment of Comminuted Intraarticular Fracture of Distal Radius with Arthroscopic Reposition of Fragments under External Fixation
Authors: Dubrov V. E. , Grechukhin D. A. , Maksimov B. I. , Shantrukov P. A.
Published: October 2018

Introduction. Use of arthroscopically assisted reduction of bone fragments in comminuted intraarticular fractures of the distal radius (DR) remains ambiguous.

The purpose of the study was to determine the expediency and efficacy of arthroscopy in surgical treatment of comminuted DR frac- tures especially under conditions of wrist joint (WJ) external fixation.

Patients and methods. Sixty eight patients (mean age 38±14.1 years) with comminuted intraar- ticular DR fractures (type B3-C3 by AO/ASIF) were operated on. In 34 out of them arthroscopic support of osteosynthesis was used. Treatment results were assessed in 3, 6 and 12 months by DASH questioner, X-ray examination data, grip strength and range of motion in WJ.

Results. It was stated that WJ arthroscopy improved the diagnosis of joint injuries (injury of tri- angular fibro-cartilage complex was diagnosed in 29 (83.5%), scapholunate ligament - in 12 (35.5%), lunotriquetral ligament - in 4 (11.8%) cases) and the quality of bone fragments reposition (displacement of intraarticular fragments over 1 mm after primary reposition was arthroscopically diagnosed in 21 (61.8%) cases, statistically significant improves the early postoperative (first 3 months after surgery, p<0.05) but did not affect the long term treatment results.
State of Specialized Trauma and Orthopaedic Care in the Russian Federation
Authors: Es’Kin N. A. , Andreeva T. M.
Published: October 2018

The state of specialized outpatient and hospital care to patients with injuries and orthopaedic pathology is analyzed. Dynamics of the traumatism and musculoskeletal system rates for in 2011- 2015 is presented. The measures for the perfection of specialized care to trauma and orthopaedic patients are proposed.
On Preparation of Illustrations for Scientific Publications on Traumatology and Orthopaedics
Authors: Ivanov P. A. , Nevedrov A. V. , Kalenskiy V. O. , Bondarev V. B. , Zadneprovskiy N. N.
Published: October 2018

Inadequate attention is paid to the preparation of quality illustrations for scientific publications on traumatology and orthopaedics. Review of the quality of 1221 pictures in three typical journals shows that the majority of patients’ photographs are made against the bad background, with presence of foreign objects, and the photos are made from the angle that does not allow making a reliable picture of function restoration. X-ray examination results and intraoperative photographs are not without disadvantages. Recommendations that can considerably improve the quality of the presenting illustrations and its informational content are given.
Surgical Treatment of C2 Odontoid Process Intussusception in Combination with Type I Chiari Malformation
Authors: Shkarubo A. N. , Kuleshov A. A. , Chernov I. V. , Shakhnovich V. A. , Mitrofanova E. V. , Vetrile M. S. , Lisyanskiy I. N. , Gromov I. S.
Published: October 2018

Type I Chiari malformation is often accompanied by congenital developmental abnormalities such as platybasia, basilar impression and C2 odontoid process retroflexion that may cause anterior compression of brainstem structures and upper cervical segments of spinal cord. Formerly the conventional method was posterior decompression even in presence of anterior brainstem compression. This article presents on a kinetic example the tactics of one-step treatment of patients with type I Chiari malformation accompanied by basilar impression and C2 odontoid process retroflexion via transoral approach only that was used for both decompression and C1-C2 segment anterior stabilization. Surgical intervention enabled to achieve the decompression of brainstem structures and upper cervical segments of spinal cord, normalization liquor dynamics and subsequent redislocation of cerebellar tonsils to normal position (above the Chamberlain line).
Russian Version of HSS Knee Replacement Expectations Survey: Language and Cultural Adaptation
Authors: Cherkasov M. A. , Ibiev A. S. , Saraev A. V. , Kornilov N. N.
Published: October 2018

Purpose . To perform language and cultural adaptation of the Hospital of Special Surgery (HSS) Knee Replacement Expectations Survey and evaluate its reliability.

Material and methods . To preserve the HSS validity its language and cultural adaptation was performed in several steps: (1) direct translation, (2) synthesis of the intermediate version, (3) back translation, (4) expert commission review and creation of the 2nd intermediate version, (5) pre-testing and formation of a final version, study of reliability with evaluation of Cronbach’s alpha and intra class correlation coefficient (ICC). Total number of 35 patients (mean age 54.2 years) with terminal-stage gonarthrosis who were admitted for total knee arthroplasty (TKA) participated in the study.

Results . Cronbach’s alpha and intra class correlation coefficient (ICC) for the translated and adapted version of HSS Knee Replacement Expectations Survey made up 0.871 and 0.82 (95% confidence interval 0.725-0.897) that was indicative of high correlation between Russian version and the original.

Conclusion . Russian version of HSS Knee Replacement Expectations Survey is a reliable tool and can be used for the evaluation of patient expectations prior to TKA.
Influence of Implant Acetabular Component Orientation on Hip Stability
Authors: Shubnyakov I. I. , Boyarov A. A. , Tikhilov R. M. , Denisov A. O. , Efimov N. N.
Published: October 2018

Introduction.Acetabular component malposition at total hip arthroplasty is a common situation that may affect the frequency of dislocation and the rate of implant friction unit wear. The purpose of the study was to determine the influence of different factors on the variability of acetabular component orientation and evaluate the role of orientation in dislocation development.

Patients and methods.Total number of patients made up 1408. Out of them 695 patients were operated on at RSRITO named after R.R. Vreden using standard approaches (group 1), 184 - using low invasive approach (group 2) and 55 patients were admitted with implant head dislocation (group 4). At City St. Petersburg hospitals 474 patients (group 3) were operated on. Orientation of acetabular component (inclination and anteversion angles) was evaluated on digital pelvis and plain hip roentgenograms. Dispersion unifactorial analysis was used to evaluate the dependence of the precision of acetabular component positioning upon the surgeon’s experience, patient’s body mass index, type of surgical approach and the use of guide for acetabular component implantation.

Results.Within the first postoperative year the rate of femoral component dislocation in group 1 made up 0.9%. Within the Lewinnek safe zone 76.6% of acetabular components were implanted with the use of a guide and 71.8% without. The rate of dislocation in group 2 made up 71.8% and 63.4% of components were implanted within the safe zone. In group 3 the intra-hospitalization dislocation developed in 1.9% of patients and satisfactory positioning relative to Lewinnek safe zone was achieved in 68.2% of cases. The risk factors for acetabular component malposition included high body mass indices, use of low invasive approach and insufficient experience of the operating surgeon. No direct influence of acetabular component orientation upon the femoral component dislocation was detected.

Conclusion. Further studies directed to the more detailed analysis of additional factors that either directly or indirectly affect the implant function and to the optimization of surgical technique that would enable the reproducibility of total hip arthroplasty results are required.
Early Results of the Study of Reparative Peculiarities of Various Osteoplastic Materials in Experimental Bone Defects
Authors: Egiazaryan K. A. , Lazishvili G. D. , Akmataliev K. I. , Ettinger A. P. , Rat’Ev A. P. , Volkov A. V. , Korobushkin G. V. , Polivoda M. D.
Published: October 2018

Purpose. To determine the optimum osteoplastic material for activation of reparative osteogenesis and substitution of traumatic defects in metaepiphyseal spongy bone tissue.

Material and methods.Comparative experimental morphological study was performed on 12 matured male Chinchilla rabbits with body weight 2500-2800g. A model of critical defects of spongy bone tissue was used. Bone defects were filled with 3 types of osteoplastic material: composite calcium sulphate bone cement; xenogenous hydroxyapatite-based material with granulated paste of synthetic peptides (P-15); β-tricalcium phosphate-based material with gauging liquid (calcium phosphate bone cement).

Results.Implantation of calcium sulphate bone cement showed rapid osteogenesis stimulation at terms 1.5 months and reduction of newly formed bone tissue mass by 3rd month due to active resorption of the residual material. Implantation of hydroxyapatite-based material with P-15 resulted in osteogenesis stimulation on its surface however because of its mechanical instability and absence of active resorption of that material only a moderate formation of bone trabeculae was observed. At implantation of β-tricalcium phosphate-based material an active resorption of osteoplastic material, formation of trabecular system and its reorganization into trabecular network of femoral metaepiphyseal spongy bone accompanied by the formation of mature bone trabeculae was noted by month 3.

Conclusion. Mechanical stability of osteoplastic material and subsequent gradual resorption as well as formation of mature bine trabeculae indicates the efficacy of β-tricalcium phosphate-based material.
OPTIMIZATION OF DIAGNOSIS AND TREATMENT FOR PERIPROSTHETIC KNEE INFECTION
Authors: Shpinyak S. P. , Barabash A. P. , Barabash Yu. A.
Published: October 2018

Purpose of study: to analyze the modern approaches to classification of large joints periprosthetic infection (PPI) and evaluate the results of revision surgical interventions in patients with deep PPI of the knee. Patients and methods. One hundred fifty three patients, 51 men and 102 women (mean age 57.3±12.4 years), with deep PPI were operated on. Treatment tactics was determined by the term after primary operation. In early PPI (n=31) sanitation interventions with implant preservation and in late PPI (n=122) – two step interventions with long period between the operations (over 4 weeks) were performed. Results. Follow up made up from 2 to 5 years. Sanitation interventions with implant preservation were successful in71% of patients. In group of patients with late PPI satisfactory results were achieved in 89.6% of cases. On the basis of the obtained data the variants of diagnosis and treatment tactics optimization as well as its adaptation to domestic public health system were proposed.
RISK FACTORS AND POTENTIALITIES OF DISLOCATION PREVENTION AFTER TOTAL HIP ARTHROPLASTY
Authors: Stafeev D. V. , Efimov N. N. , Sorokin E. P. , Chugaev D. V. , Gudz A. I. , Boyarov A. A.
Published: October 2018

The literature review is dedicated to the problem of femoral component dislocation after primary and revision total hip arthroplasty. Modern data on surgeon-dependent and -independent risk factors for this complication development are analyzed. Potentialities for dislocation prevention using constrained liners and dual mobility system are considered.
Comparative Analysis of Changes in the Desmal and Chondral Structures of Spinal Motion Segment at Various Methods for Posterior Spine Fixation in Experiment
Authors: Krivoshein A. E. , Konev V. P. , Kolesov S. V. , Byval’tsev V. A. , Kaz’min A. I.
Published: October 2018

Purpose:to elaborate the criteria for the assessment of the degree of spinal motion segment degradation at various methods for posterior spine fixation in experiment.

Material and methods. The study included mongrel dogs with body mass of 12±1.5 kg aged 21±3 months. Transpedicular lumbar spine fixation was performed with either rigid titanium alloy rods (1st group, n=5) or dynamic nitinol rods (2nd group, n=5). X-ray examination and morphologic study of the structural elements of spinal motion segment (SME) were performed to all animals in 3, 6, 12, 18 and 24 months after surgery.

Results. Functional examination showed that in both groups the range of motion made up 18±1.2° preoperatively. In the 1st group of animals the range of motion in the operated SME made up 0±0.03°. In the second group the range of motion was preserved throughout the experiment and averaged 15±1.3° that made up 78.9% of the preoperative range. In both groups the disc height at the fixation level was constant throughout the experiment and made up 0,3±0.003 cm pre- and postoperatively. Obtained roentgenologic and morphologic data indicated that posterior dynamic spine fixation with nitinol rods ensured more balanced distribution of loads on the supportive elements of the construction and enabled prevent the development of the adjacent segments degeneration. Based on the study results the criteria for the assessment of the degree of the facet joints and discs degradation were formulated.
Positioning of Custom-Made Acetabular Components at Revision Hip Arthroplasty: Do They Really Match as “a key and a lock”?
Authors: Kovalenko A. N. , Tikhilov R. M. , Bilyk S. S. , Shubnyakov I. I. , Cherkasov M. A. , Denisov A. O.
Published: October 2018

Purposes are to determine1) what frequency and what degree is of custom acetabular implants malposition in comparison with planned position, 2) what the reason of malposition is and 3) what the malposition consequences we can wait for.

Patients and methods. The observation group included 20 patients (18 women and 2 men) with severe ac-etabular defects. Mean age of patients made up 53 (22-72) years. Position of the implants was compared with the parameters of preoperative planning using 5 postoperative CT indices (inclination, anteversion of semi-spherical part of the implant, spatial location of the rotation center in three axes). More than 10° deviation for inclination or anteversion and 5° dislocation of the rotation center in any axis was considered as a malposition of the component.

Results. Only 5 of 20 constructions matched conditionally permissible limits by all the parameters. Most often excessive dislocation of the rotation center in lateral direction (10 cases) and excessive anteversion (9 cases) were observed. During 6 weeks follow up no complications related to the acetabular component position were recorded.

Conclusion. It was shown that at revision arthroplasty with custom-made implants the probability of implant malposition as compared to the preoperative plan. The main reason could be the complexity of intraoperative orientation under conditions of abnormal hip anatomy. Malposition of the implants beyond the stated values did not result in complications within the early postoperative period. The longer follow up is required for the assessment of the long-term results.
Comparative Characteristics of Osseointegration Processes of the Calcium Phosphate Coating Implants and Implants with Germanium Enriched Calcium Phosphate Coatings
Authors: Zelichenko E. A. , Guzeev V. V. , Koval’skaya Ya. B. , Gurova O. A. , Guzeeva T. I.
Published: October 2018

Introduction.Osseointegration process exerts considerable influence on the term of biological fixation of the implants and is an important parameter that is to be focused on at the implant placement.

Purpose: to conduct a comparative analysis of the osseointegration of the titanium alloy implants with different coatings for the determination of the optimum coating compound for osteogenesis.

Materials and methods. Comparative analysis of osteogenic properties of the implants with thermal chemical surface treatment, calcium phosphate coating and Germanium enriched (3% and 5%) calcium phosphate coatings applied by electrochemical technique was performed. Implant recipients were 29 not pedigree male cats aged 1.5 to 4.0 years with 2500 to 3400 g body weight. Experimental animals were euthanized in 90 days after surgical intervention.

Results.Histological study results showed that bone tissue regeneration was most active when implants with higher level (5%) of Germanium in calcium phosphate coating were used. Calcium phosphate coatings and Germanium enriched ones showed better osseointegration as compared to the implants with thermal chemical surface treatment.
Dynamics of the Formation of Protection for Circulatory Bed in Bone Regenerate
Authors: Shchyurov V. A. , Boichuk S. P. , Tarchokov V. T. , Mel’nikova L. V.
Published: October 2018

Evaluation of the bone regenerate maturation in 21 patients, aged 27 – 66 years, with closed shoulder fractures was performed in the course of treatment by Ilizarov technique according to the rate of blood supply velocity at functional load and by the value of that load. Examination was performed in 1 and 2 weeks as well as in 1 and 2 months after fixation. Within the first 2 weeks the bone fragments micro mobility at 10 kgF axial load on the extremity made up 194±42 µm. Subsequently as the regenerate became compact the bone fragments micro mobility decreased up to 53±13 µm (p≤0.02). During the fixation period the load tolerance increased from 5 to 15 kgF. The threshold of load tolerance was detected by the occurrence of unpleasant feelings the regenerate zone and increased rate of blood circulation in the vessels. At the end of fixation period the rate of blood circulation was decreased by 2 times and practically did not change at increasing loads confirming the formation of the protection system for circulatory bed in the bone regenerate.
First Experience of Ankle Joint Arthroplasty in a Giant Cell Tumor of the Tibial Epiphysiometaphys: Case Report and Literature Review
Authors: Snetkov A. I. , Berchenko G. N. , Frantov A. R. , Batrakov S. Yu. , Kotlyarov R. S. , Kravets I. M.
Published: October 2018

Case report for the 18 years old female patient with a giant cell tumor of the distal articular end of the right tibia is presented. The surgical intervention included segmental resection of the articular end of the right tibia and substitution of the defect with the custom-made ankle endoprosthesis. The follow up period made up 4 years. The range of motion in the right ankle joint was satisfactory, no relapse occurred and the implant components were stable.
Potentialities of Endovascular Surgery in Traumatology and Orthopaedics
Authors: Prozorov S. A. , Ivanov P. A.
Published: October 2018

The review presents the main trends for the use of roentgen-endovascular surgery that allow to improve the treatment results in trauma and orthopaedic patients.