bluuebunny/crossref_metadata_2025 huggingface dataset:
Restoration of Foot Shape and Function in Calcaneous Deformities and Defects
Authors: Samusenko Dmitriy Valer'evich , Neretin Andrey Sergeevich , Samusenko D V , Neretin A S
Published: October 2020

Methods and outcomes of treatment of calcaneous deformities and defects (102 patients, 112 feet) of different etiology are presented. Treatment technique was extrafocal compression-distraction osteosynthesis by Ilizarov. Condition of the foot was monitored using radioisotopic, biomechanical and radiologic examinations. Anatomic and functional results of treatment depended upon the severity of the initial pathologic changes in bone and soft tissues, presence of concomitant osteomyelitis in the remission phase as well as on gait stereotype and biomechanical relation of the overlying segments. Preference of transosseous osteosynthesis by Ilizarov for the treatment of calcaneous defects and deformities accounted for the possibility of dosed correction and functional loads as well as by the favorable effect on bone tissue blood supply.
Application of Stabilometry at Orthopaedic Clinic in Lower Extremity Joints Pathology
Authors: Nazarov Evgeniy Aleksandrovich , Seleznev A V , Ryabova M N , Nazarov E A , Seleznyov A V , Ryabova M N
Published: October 2020

Weight bearing response in patients with degenerative-dystrophic diseases and sequelae of hip, knee and ankle injuries was studied using the elaborated hardware-software stabilometric comp-lex Appliance for Registration and Analysis of Distribution of Loads to Lower Extremities. Evaluation of the efficacy of conservative and surgical treatment was performed. New data on stabilometric status of patients after hip joint arthroplasty and ankle arthrodesis were obtained.
Plasty with Pedicle Muscular Flaps at Treatment of Infectious Complications after Stabilizing Operations on the Spine
Authors: Lisitskiy I Yu , Boev M V , Evsyukov A A
Published: October 2020

Experience in use of transferred pedicle muscular flaps for the treatment of 7 patients with infectious complications after previously performed stabilizing operations on the spine is presented. Revision interventions showed failure of implanted transpedicular constructions on the background of osteomyelitis with vast infected cavities. To compensate for vast wound defects with soft tissue deficit that remained after removal of stabilizing systems and necrectomy plasty with transferred muscular flaps was performed. Primary wound healing was achieved in all cases. At follow up from 1 to 4 years relapse of pyo-inflammatory process in the zone of intervention was detected in no one case.
New Measures for Prevention of Intra- and Postoperative Complications at Total Hip Replacement
Authors: Akhtyamov I F , Garifullov G G , Kovalenko A N , Kuz'min I I , Rykov A G
Published: October 2020

The reasons of intraoperative and early postoperative complications i.e. implant dislocation and periprosthetic fractures, after hip replacement were analyzed and ways of their surgical prevention were elaborated. After 497 operations dislocation of the femoral component was detected in 24 (4,8%) cases including 15 - in the early postoperative period. The main reason of complication was inobservance of the prescribed motion activity regimen in the first postoperative days. In primary joint replacement periprosthetic fractures occurred in19 (3,8%) cases: in 15 (3%) cases the fracture developed intraoperatively and in 4 (0,8%) cases - after patients' discharge from the hospital. Application of the elaborated techniques of surgical prevention enabled to minimize the risk of such complications.
Efficacy of Tranexamic Acid Application for Blood Loss Reduction in Total Hip Arthroplasty
Authors: Tikhilov R M , Shubnyakov I I , Mokhanna M I , Pliev D G , Myasoedov A A , Tsybin A V , Ambrosenko A V , Bliznyukov V V , Chiladze I T , Shulepov D A
Published: October 2020

Prospective study of tranexamic acid use results (native preparation Tranexam) in primary total hip arthroplasty was performed during the period from March to October 2009. The study involved 159 patients (55 men, 104 women) with various hip joint pathology (79 patients - main group, 80 patients - control group). Mean age of patients made up 55.7 years (17 - 80 years). In patients from the main group 15 mg/kg Tranexam was injected just prior to operation with reinjection of the same dose in 6 hours. In control group etamsylate (750 mg 30 minutes prior to incision with reintroduction in 4 - 6 hours, daily dose up to 1500 mg) was applied. The results of the analysis showed reliable (p
Modern Technique for Proximal Femur Osteosynthesis at Reconstructive Operations on Hip Joint in Children
Authors: Mironov S P , Kozhevnikov O V , Ivanov A V , Gavryushenko N S , Zatona D B , Kralina S E , Azimov Sh T
Published: October 2020

Set of instruments and metal fixatives for osteosynthesis in corrective operations on proximal femur in patients aged 1-15 years was elaborated at CITO. Comparative experimental strength tests showed the advantages of suggested metallic fixatives over existed analogs (fixatives from DON set and Blount plate). Cannulated system for angular metal fixatives application provided for proper setting of the construction, shortened the duration of surgical intervention and decreased operative trauma. That set was used for the treatment of 169 children with various types of hip joint pathology. Average duration of surgical intervention made up
45 min. (versus 95 min. at routine surgical technique). Bone fragments displacement, loss of correction, instabi-lity of osteosynthesis and other complications were not observed at follow up less than 1 year.
Closed Intramedullar Osteosynthesis in Surgical Treatment of Children with Diaphyseal Femur Fractures
Authors: Rozinov V M , Yandiev S I , Burkin I A
Published: October 2020

Outcomes of surgical treatment for diaphyseal fractures of the femur were analyzed in 270 (278 interventions) out of 509 patients being admitted to the clinic since 1999. In overwhelming majority of patients (226 children) closed intramedullar fixation of bone fragments (231 operations) was performed. Closed intramedullar osteosynthesis was performed using flexible and rigid rods including the locking ones. Elastic-stable osteosynthesis is indicated for the treatment of under school age children with type A1, A2, A3, B1, B2, B3, C2 fractures as well as junior school age children with type A1, A2, B1, B3, C2 fractures. Presented technique can be considered as a gold standard in this group of patients. Closed intramedullary osteosynthesis by rigid rod without locking is the optimum technique for the treatment of junior and senior school age children in bearing injuries of types A3 and B2. Method of choice in senior school age children with A1, A2, B1, B3, C1, C2 and C3 fractures is closed intramedullar osteosynthesis with locking rod. Preliminary extrafocal fixation in multiple and open injuries creates optimum conditions for delayed intramedullar osteosynthesis.
Hirudotherapy in Bone and Joint Pathology in Children and Adolescents
Authors: Maiorov A N
Published: October 2020

Experience in hirudotherapy application was analyzed in 1049 patients aged 3-18 years with bone and joint pathology. Recommendations on technique of hirudotherapy use in certain pathology are presented. Study results showed that secretion of medicinal leech saliva reliably decreased oxyproline content in blood serum of patients with Perthes disease. Electromyography showed that hirudotherapy reliably improved electrophysiological state of muscles responsible principle hip joint movements. Side effects and complications resulted from hirudotherapy were carefully analyzed. The ways of their prevention are given.
Mistakes and Complications at Treatment of Diaphyseal Shin Bones Fractures with "Repofix" Apparatus for External Transosseous Reposition and Fixation of Bone Fragments
Authors: Oganesyan O V , Anisimov E C
Published: October 2020

Data on 280 patients with diaphyseal fractures of shin bones been treated at CITO and other clinics using Oganesyan Repofix apparatus for external transosseous reposition and fixation of bone fragments were analyzed. It was shown that in 57 cases certain mistakes and related complications were detected at different treatment steps. Recommendations on the prevention
of such complications were given. Awareness of potential mistakes and complications will help
to avoid them and thus to increase the treatment efficacy.
Intra- and Periarticular Fractures of the Distal Shin Bones Segment: Peculiarities of Osteosynthesis using Tightening Clamps with Shape Memory
Authors: Kaplun V A , Kopysova V A , Selivanov D P , Remorenko A V
Published: October 2020

Tightening clamps with shape memory effect were used for interfragmental compression and fixation of bone fragments in 93 patients with intraarticular, periarticular and bifocal fractures of shin bones. In 16 patients with bifocal fractures osteosynthesis of tibial diaphysis was performed using intramedullar rod and osseous plates. Following intramedullar osteosynthesis fixation of the injured extremity with plaster splint was performed in 47 cases. In 46 patients longitudinal splinting of shin bones was performed by transosseous apparatus. Within the rehabilitation period chondroprotectors were prescribed to all patients. Good result of complex treatment was achieved in 87.5% of cases.
Surgical Treatment of Scoliosis during the Period of Uncompleted Spine Growth
Authors: Kuleshov A A , Vetrile S T , Zhestkov K G , Guseinov V G , Vetrile M S
Published: October 2020

Outcomes of surgical treatment of 34 patients aged from 9 to 15 years (mean age
11.7 years) with basic curvature arch from 43 to 148° (99° average). In 9 patients dorsal correction and spine fixation by CD system without intervention on the vertebral bodies was performed (1st group). In 25 patients diskepiphysectomy (including thoracoscopic one in
7 patients) and interbody spondylodesis on the apex of the convex basic arch were performed prior to dorsal correction. Then halo-pelvic traction was performed for 7-10 days followed by dorsal fixation of the spine by CDI without posterior spondylodesis (2nd group). Subsequently depending on the degree of correction loss due to spine growth step-by-step corrections of the deformity were performed. After spine growth completion final instrumental correction and fixation of the spine with posterior spondylodesis were performed. In the 1st group step-by-step corrections were to be performed in 77% of cases, in 2nd group - in 28% only. It was shown that performance of diskepiphysectomy on the apex of the deformity with following correction and CD system fixation of the spine decreased the rate of postoperative spine deformity progression, eliminated asymmetric growth of vertebrae on the deformity and increased the achieved correction. In the process of patients' growth wedge shape of the vertebral bodies decreased in frontal and sagittal planes and no increase of their torsion-rotation changes occurred.
Weight-Bearing Feet Reactions at Walking in Patients with Pelvic Bone Fractures during Treatment by Transosseous Osteosynthesis
Authors: Dolganova T I , Martel I I , Shevedov V V , Dolganov D V
Published: October 2020

Quantitative assessment of weight-bearing feet reaction at walking (computer complex DiaSled-Scan, St.Petersberg) was performed in 6 patients with pelvic bone fractures treated by transosseous osteosynthesis using Ilizarov device. In stable fixation of pelvic bones by the device the forefoot was used as additional balance when walking without assistive devices. The decrease in anterior and posterior push range which is compensated by the increase in time during one cycle of gait and its' variability should be considered as a summarizing index of adaptive changes of gait. Compensatory increase up to 40% of stance phase variability on the less involved side is preserved by 1 year after surgery.
Diagnosis of Arthrosis by Morphologic Picture of Sy-novial Fluid
Authors: Shatokhina S N , Zar V V , Voloshin V P , Shabalin V N
Published: October 2020

Authors have studied the peculiarities of morphologic picture and distribution of chemical elements in dehydrated synovial fluid of normal individuals and patients with arthrosis. It has been determined that in the morphologic picture of synovial fluid the basic arthrosis marker is presented by spindle structures within the intermediate facies zone. It has been shown that in dehydrated synovial fluid P content was 4 times and Ca content - 7 times higher in patients with arthrosis as compared with healthy individuals. That was an evidence of the articular osteo-cartilagenous tissue destruction and accumulation of degradation products which were neutralized by calcites and phosphates.
Intra-articular Therapy of Osteoarthritis Using Drugs on the Base of Blood Serum
Authors: Chernyakova Yu M , Pinchuk L S
Published: October 2020

Comparison of biochemical composition and biophysical properties showed the pathogenetic expediency of blood serum use as a corrector of synovial environment in joints affected by osteoarthritis. For serum modification the patients were preliminary given a single dose of drug only. Then patient's blood was collected in the period of its maximum saturation by preparation. Serum obtained was applied in patients with knee joint osteoarthritis of 2-3 stages using three intra-articular injections. The evaluation of treatment results 5-6 months after treatment completion showed a significantly better and more stable therapeutic effect in test group as compared with patients from control group. Positive effect was stipulated by pain decrease, normalization of articular tissue trophicity, depression of local inflammation and cartilage lubrication improvement.
Total Knee Replacement Using Computer Navigation in Severe Extremity Deformities
Authors: Kavalerskiy G M , Murylev V Yu , Elizarov P M , Zhuchkov A G , Yakimov L A , Rukin Ya A , Terent'ev D I
Published: October 2020

Experience in cement total knee arthroplasty using computer navigation is presented. There were 42 patients with severe deformities of knee, condyles as well as tibia and femur diaphyses. Five patients out of them had prior implanted hip endoprostheses on ipsilateral side in whom use of routine arthroplasty technique with guide was impossible. In such cases computer navigation allowed to achieve high-precise insertion of implant with provision of correct ligament balance and maintenance of all axes and angles. The terms of rehabilitation and functional results were similar to common cases of primary knee joint replacement using computer navigation.
Biomechanical Analysis of Digital Movement in Injured Hand as Method for Functional Diagnosis
Authors: Biryukova E V , Frolov A A , Grinyagin I V , Korshunov V F , Romanov S Yu , Smirnitskaya I A
Published: October 2020

New method for functional diagnostics of motion activity of fingers based on registration of digital movements and their biomechanical analysis is suggested. Kinematical and dynamical parameters of digital movement accounted by biomechanical model adequately reflect the patterns of motion disorders and give the objective numerical evaluation. The method includes: a) registration of digital movement in both intact and injured hands using electromagnetic system of MiniBirds type; b) calculation of individual biomechanical parameters of fingers - length of phalanges, position and alignment; c) calculation of kinematic parameters of movement - time-base of joint angles, angular velocities and accelerations, range of motion of separate joints, degree of coordination of changes in various joints angles (kinematic synergy); d) evalua-tion of dynamic parameters of motion - time-base of total muscular forces moment in joints (dynamic synergy); e) evaluation of functional state based on analysis of kinematic and dynamic parameters of motion before, during and after treatment.
Refraction Introscopy at Synchronized Radiation: Expansion of Possibilities for Visualization of Bone Tissue Remodeling
Authors: Pogorelyi D K , Torgashin A N , Podurets K M , Rodionova S S
Published: October 2020

Method of refraction introscopy at synchronized radiation for visualization of bone structures and allografts in laboratory animals was described. The aim of study was adaptation of method for the study of alloigrafts in bones of laboratory anomals. Method was approved at 150 samples of rat tibia. It was shown that use of refraction introscopy at synchronized radiation enabled properly to visualize the borders of allografts and own bone tissue of rat. Method may be recommended for the study of bone remodeling dynamics in experimental animals during long term after operation.
Treatment of Patients with Bilateral Pelvic Fractures
Authors: Shlykov I L , Kuznetsova N L , Agalakov M V
Published: October 2020

Treatment results of 48 patients with bilateral pelvic injuries were analyzed. In all cases surgical treatment using combination of external and internal fixators was performed. That technique enabled to achieve excellent anatomic and functional results in 78-87% of cases with B2 and C3 injuries by OTA/AO classification. Authors consider that the main principle of operative treatment is the conversion of bilateral injuries to unilateral ones. Perspective method for the realization of this principle is application of module external fixation device with fixation of posterior pelvic segments. It enables to modify the location and construction of reposition angles during treatment. Elimination or diminution of the value of multidirectional pelvic deformity and additional fixation of the rotation component provides earlier functional restoration of patients with bilateral pelvic injuries. Taking into account the high risk of deformity recurrence in C3 injuries, after closed reposition by external fixation device transosseous osteosynthesis should be supplemented with internal fixation.
Low Back Pains in Athletes and Ballet Dancers: Apophysitis of Vertebral Bodies
Authors: Mironov S P , Burmakova Galina Maksimovna , Mironov S P , Burmakova G M
Published: October 2020

Experience in diagnosis and treatment of lumbar vertebrae apophysitis in 29 athletes and ballet dancers aged from 13 to 29 years is presented. In 25 patients pathology of thoracolumbar and upper lumbar spine was diagnosed. In 4 patients S1 apophysitis was detected including 3 patients with combination of S1 apophysitis and L4-L5 spondylolysis. Diagnosis consisted of clinical-neurologic, roentgenologic (standard including functional tests) and ultrasonographic examinations. In combination of apophysitis and spondylolysis radionuclide examination was performed. All patients were under conservative treatment which included individual complex of exercise therapy, massage, intramuscular, sympathetic trunk, ilipsoas muscle blockades, ozone-oxygen mixture injections into paravertebral muscles, use of vascular drugs, chondroprotectors and stimulating therapy. Analysis of the results confirmed high efficacy of the proposed methods for diagnosis and treatment of lumbar apophysitis in athletes and ballet dancers.
Treatment Tactics for Sequelae of Lower Extremity Bones Fractures
Authors: Eldzarov Petr Eliozovich , Zelyanin A S , Nikitin S E , Eldzarov P E , Zelyanin A S , Nikitin S E
Published: October 2020

Experience in treatment of 104 patients aged from 18 to 74 years with sequelae of femur and shin fractures (47 patients with ununited and improperly united fractures and 57 patients with noninfected pseudarthroses and bone defects) was presented. Analysis of the results showed that the main reasons for unfavorable consequences of fracture were osteosynthesis failure, inadequate appraisal of fracture pattern and localization, inadequate treatment-tactic measures (inobservance of optimum treatment terms, early abolition of external immobilization or groundless refusal of its application, discrepancy between osteosynthesis stability and early functional loads). Treatment outcome (assessment by N.A. Lyuboshits - E.R. Mattis and
I.L. Shvarzberg systems) was recognized as good in 49%, satisfactory - in 42.3% and poor - in 8.7% of cases.
Diagnosis of Mobility Disorders in Fingers Joints of Hand
Authors: Tsarev Valeriy Nikolaevich , Zubikov V S , Voloshin V P , Dorozhko I G , Martynenko D V , Tsaryov V N , Zubikov V S , Voloshin V P , Dorozhko I G , Martynenko D V
Published: October 2020

Algorithm to assess the limitation of functional mobility of hand fingers' joints using elaborated symbols is presented. That algorithm was applied to analyze the possibility of pinches and different types of power grips including ball, cylinder. A description of functional zero position is given. This position is used as starting point for the evaluation of motion restriction in joints and as a reference point for arthrodesis performance. Concept of remoteness of mobility sector in joint from functional zero position is introduced. Clinical cases demonstrate the possibility to apply algorithm for the evaluation of motion restriction and detection of indications for both conservative and surgical treatment.
Experimental Evaluation of Osteoinduction of Recombinant Bone Morphogenic Protein (rhBMP-2) of Native Production Fixative on Biocomposite or Bone Matrix
Authors: Mironov S P , Gintsburg A L , Es'kin N A , Lunin V G , Gavryushenko N S , Karyagina A S , Zaytsev Vladimir Valentinovich , Mironov S P , Gintsburg A L , Es'kin N A , Lunin V G , Gavryushenko N S , Karyagina A S , Zaytsev V V
Published: October 2020

Data on experimental evaluation of osteoinduction of recombinant bone morphogenic protein of native production fixative on xenogenic demineralizated bone matrix or collagen-calcium-phosphate biocomposite material. Evaluation was performed using experimental model of end-to-end osteosynthesis of diaphyseal femur fragments by external fixative device in Wistar rats. Roentgenologic examination, study of autopsy material and evaluation of bone consolidation strength using biomechanical twisting test showed high osteoinduction of rhBMP-2 containing biocomposites.
Diagnostic Value of Contrast Radiologic Examination for Rational Planning of Surgical Treatment of High Congenital Hip Dislocation in Children
Authors: Kozhevnikov O V , Morozov A K , Kralina Svetlana Eduardovna , Ogarev E V , Negmatov Zh M , Kozhevnikov O V , Morozov A K , Kralina S E , Ogaryov E V , Negmatov Zh M
Published: October 2020

Diagnostic value of contrast radiologic examination of hip joint was analyzed in 49 children aged from 1 to 12 years with high congenital hip dislocation. Informativeness of 38 standard hip joint arthrograms was studied for the choice of treatment technique and preoperative planning. It was stated that arthrography did not provide sufficient information on the changes in soft tissue and cartilaginous structures of the joint. Experience in joint pathologic changes diagnosis using contrast computed tomography (11 patients) was presented. Potentialities of that examination technique were determined. It was shown that in high dislocation of femoral head it provided real picture of interrelation of all articular structures. That enabled to take objectively substantiated decision on open or closed correction of dislocation and perform an adequate preoperative planning.
Development of Hip Joint in Early Aged Children after Open Hip Reduction
Authors: Pozdnikin Ivan Yur'evich , Pozdnikin I Yu
Published: October 2020

Peculiarities of hip joint development after its open reduction were studied in 45 early aged children. Depending on the pathology severity, terms of treatment initiation and its quality the types of postoperative hip joint development were determined. It was shown that open hip reduction was most effective in children under 12-15 months old on condition of early detection of hip irreducibility and refusal of repeated attempts of closed reduction.
Use of Cellular Technologу at Surgical Correction of Congenital Lower Limb Length Discrepancy in Children
Authors: Mironov S P , Omel'yanenko Nikolay Petrovich , Kozhevnikov O V , Il'ina V K , Ivanov A V , Karpov I N , Lazarev V A , Mironov S P , Omel'yanenko N P , Kozhevnikov O V , Il'ina V K , Ivanov A V , Karpov I N , Lazarev V A
Published: October 2020

First results of application of cultivated autologous stromal bone marrow cells for the stimulation of distraction bone regenerates' reparative regeneration in 8 patients aged from 3.7 to 16 years with congenital lower extremity length discrepancy (main group) are presented. In 24 children with similar pathology aged from 2.5 to 14 years (control group) no cellular technology was used. In the main group duration of treatment reduces to 4.5-6.5 months versus 7.5-
11 months in the control one. That enabled to avoid potential complications related to the long-term fixation of the extremity in the distraction apparatus.
Age-Related Dynamics of Roentgenologic Characteristics of Pelvis and Spine Osseous Growth Activity in Patients with Idiopathic Scoliosis
Authors: Tesakov Dmitriy Kimovich , Tesakov D K
Published: October 2020

Roentgenologic examination of pelvis and spine osseous growth activity was performed with the purpose to determine the peculiarities of its age-related dynamics in patients with idiopathic scoliosis. Total number of 2006 patients (1770 females and 236 males) was examined. Age if patients ranged from 4 to 20 years. Severity of spine deformity corresponded to I-IV stages. Activity of pelvis growth was assessed by Risser test (R), of spine growth - by Sadof'eva test (S).Results of those tests were divided into three groups of osseous growth activity state: group of active growth included indices R-0 - R-III and S-0 - S III, group of stabilized growth - R-IV and S-IV, group of completed growth - R-V and S-V. It was stated that in idiopathic scoliosis pelvis and spine came into periods of apophyseal ossification, synostosis and osseous growth completion at later age terms than at norm - the lag made up from 1 to 4 years. It was also detected that in given pathology the spine itself started and completed its physiologic growth with 1-3 years delay as compared with pelvic bones. The obtained results indicated that in idiopathic scoliosis Risser test results should be considered as an objective but indirect information on spine growth activity. Direct objective precise information on the spine growth activity could be obtained by Sadof'eva test that reflected directly the stage of leading affected organ development in that pathology.
Standardization of Traumatologic and Orthopaedic Care: Alternative Version
Authors: Mattis Edgar Robertovich , Es'kin N A , Mattis E R , Es'kin N A
Published: October 2020

The necessity in standardization of medical care directed to the improvement of diagnosis and treatment quality is obvious. However the methodic aspect of the current standardization and resulting standards not quite correspond to the hopes set on them. The authors adduce an alternative method of standardization. Method for standards elaboration based on the system of continuous monitoring of patients' condition has been created at CITO. At present the ideology and a number of practical elements of such system have been elaborated including the elements that have been tested in thousands of observations and which have proved their efficacy.
First Experience in one-step Surgical Treatment of Distal Forearm Bones Fractures Complicated by Regional Pain Syndrome
Authors: Golubev I O , Krupatkin A I , Kutepov Il'ya Aleksandrovich , Bushuev O M , Merkulov M V , Shiryaeva G N , Maksimov A A , Golubev I O , Krupatkin A I , Kutepov I A , Bushuev O M , Merkulov M V , Shiryaeva G N , Maksimov A A
Published: October 2020

Treatment results for 9 patients with distal forearm fractures complicated by sympathetically dependant type of complex regional pain syndrome were analyzed. After clinical, radiologic examination, laser Doppler flowmetry, computer thermography one-step open reposition of bone fragments with osteosynthesis and perivascular sympathectomy was performed in all patients. Follow-up period made up from 4 to 7 months. Excellent results was achieved in 1 (11%) patient, good - in 7 (78%), satisfactory - in 1 (11%) patient.
Treatment of Elbow Fractures in Children and Adolescents
Authors: Merkulov V N , Dorokhin A I , Stuzhina V T , El'tsin A G , Mininkov D S , Merkulov V N , Dorokhin A I , Stuzhina V T , El'tsin A G , Mininkov D S
Published: October 2020

Treatment results of 1353 children and adolescents with acute elbow injuries were performed. The main difficulties for diagnosis and treatment of those injuries were shown. Using stored experience the methods of diagnosis and treatment for all types of injuries were optimized. Potential complications and mistakes were described; the ways of their prevention were presented. Tactics of postoperative management of patients was elaborated. Differentiated approach to the treatment of every type of injuries enabled to obtain good and excellent results in 93.2% of patients.
Enoxaparin and Dabigatran Thromboprophylaxis after Total Hip Arthroplasty
Authors: Momot Andrey Pavlovich , Merkulov I V , Grigor'eva E V , Panov M Yu , Momot A P , Merkulov I V , Grigor'eva E V , Panov M Yu
Published: October 2020

Comparative assessment of the efficacy and safety of enoxaparin and dabigatran thromboprophylaxis after total hip arthroplasty was performed. Hemorrhagic and thrombotic complications as well as indices of laboratory tests after application of new oral thrombin inhibitor Dabigatran Etexilate were taken into account. Study included 161 patients who were randomized into two groups and operated on under spinal anesthesia. First group (81 patients) was on subcutaneous enoxaparin (40 mg/day), second group (80) was on dagibartan (200 mg/day). The day before surgery and on 5th and 10th days after arthroplasty duplex angioscanning of lower extremities and assessment of blood clotting parameters was performed. It was shown that in case of significant intraoperative blood loss thromboprophylaxis with both enoxaparin and dabigatran was similar to that with low-molecular-weight heparin. Postoperative thrombogenic risk by D-dimers level was higher with enoxaparin versus dabigatran application. Peroral use of anticoagulants is more acceptable due to its noninvasiveness, safety, low requirements in laboratory monitoring and convenience of application in out-patient conditions. In patients with low compliance testing of blood plasma thrombin can be used for the confirmation of dabigatran intake when necessary.
Low Back Pain Syndrome in Athletes and Ballet Dancers: Spinous Ligaments Pathology
Authors: Mironov S P , Burmakova Galina Maksimovna , Saltykova V G , Mironov S P , Burmakova G M , Saltykova V G
Published: October 2020

Experience in diagnosis and treatment of 32 athletes, ballet dancers and circus actors aged from 15 to 25 years with lumbosacral spine spinous ligaments pathology is presented. In 12 cases pathology of subspinous and in 24 cases of interspinous ligaments was diagnosed. Acute injury of spinous ligaments and ligamentopathy was diagnosed in 6 and 26 patients, respectively. Complex diagnosis included clinical-neurologic examination, ultrasonography and thermography. All patients were on conservative treatment: therapeutic physical training using special individual complex, massage, curative-analgesic blockades, injections of platelet-rich plasma, injections of sclerosing solutions in Baastrup syndrome, injections of nitrogen-oxygen mixtures into paravertebral muscles, use of vascular drugs and stimulating therapy. Analysis of the obtained results confirmed high efficacy of the proposed methods for the diagnosis and treatment of lumbosacral spine spinous ligaments pathology in athletes and ballet dancers.
Complications after Elastic Stable Intramedullar Osteosynthesis of Femur Diaphysis Fractures in Children
Authors: Yandiev Suleyman Israilovich , Yandiev S I
Published: October 2020

Results of surgical treatment for femur diaphysis fractures were analyzed for 115 children (119 operations of osteosynthesis). In all cases technique of elastic stable intramedullar osteosynthesis (ESIO) was used. Analysis of complications after ESIO was performed in 13 (11.3%) patients according to their types and time of development. It was detected that in femur diaphysis fractures a great number of ESIO complications could be either avoided or minimized with strict determinations of indications to ESIO, correct preoperative planning, observance of osteosynthesis technique and rational postoperative rehabilitation program.
Patellar Articular Surface Replacement in Total Hip Arthroplasty
Authors: Sagradyan Artur Stepanovich , Gritsyuk A A , Stoyko Yu M , Matushevskiy G A , Kuz'min P D , Sereda A P , Sagradyan A S , Gritsyuk A A , Stoiko YU M , Matushevskiy G A , Kuz'min P D , Sereda A P
Published: October 2020

Examination of 249 patients with unilateral coxarthrosis was performed after total knee arthroplasty with (group 1) and without (group 2) patellar resurfacing performed at orthopaedic department of National Medical Surgical Center named after N.I. Pirogov. Total arthroplasty outcomes were assessed using knee-specific Oxford Knee Score (OKS), general questionnaire Medical Outcome Study 36-item Short-Form Health Survey (MOS Sf-36) and patellofemoral-specific questionnaire (PFQ). The following indications to patellar resurfacing were determined: body weight over 95 kg, patellar lateral shift ratio over 9%, 3rd and 4th degree of patellar chondromalacia by Outerbridge. Outcomes of patellar resurfacing were independent of patellar tilt angle (б), Insall-Salvati index, patient's height, body mass index, 1st and 2nd degree of patellar chondromalacia by Outerbridge.
Experience in Use of Dabigatran at Knee Arthroplasty
Authors: Reyno Elena Viktorovna , Zhairova T A , Kuznetsova N L , Antropova I P , Reino E V , Zhirova T A , Antropova I P
Published: October 2020

Primary knee arthroplasty under combined spinal epidural anesthesia (CSEA) was performed to 30 patients with III stage of gonarthrosis. Anticoagulant prophylaxis of venous thromboembolism was started 12 hours prior to surgery - subcutaneous injections of 40 mg enoxaparine sodium (Clexane®). Postoperatively all patients were taken direct inhibitor of thrombin - dabigatran etexilate (Pradaxa®) by standard scheme: 110 mg in 3 hours after operation and than 220 mg once a day for 14 days. Deep vein thrombosis (DVT) was diagnosed in 2 cases (6.7% of patients). This rate was not higher than in case of prophylaxis with low molecular weight heparins. No hemorrhagic complications were noted. Maximum growth of total coagulation index was observed on 3 - 7 days after surgery that was manifested by raise of fibrinogen concentration, soluble fibrin-monomer complexes (SFMC) and increased activity of coagulation enzymic link. Indices returned to norm by 14th postoperative day. Use of dabigatran etexilate in knee arthroplasty provides an adequate prophylaxis of venous thromboembolism and does not increase the risk of hemorrhagic complications.
Endoprothesis of the Ankle Joint at Defeat by Tumours of Distal Part of Tibia
Authors: Sokolovskiy V A , Aliev M D , Sokolovskiy Anatoliy Vladimirovich , Sergeev P S , Sokolovsky V A , Aliev M D , Sergeev P S , Sokolovsky A V
Published: October 2020

In a current of two years with 2008 for 2010, to six patients with primary malignant and aggressively benign bone tumors of the distal tibia executed six operations, in value of tumor resection with the subsequent reconstruction of defect by an ankle joint endoprosthesis. In group of patients there were five males and one female, with a mean age of 30 years. Among the treated patients 2 were with an osteosarcoma, 2 with Ewing's sarcoma and 2 with giant cell tumor. The mean duration of follow-up after the operation was 14,7 months (7 to 28). Reconstruction of the distal tibia defect was carried out using oncological modular endoprosthesis of the ankle joint. Common free of recurrence surviving during 2,4 years was 83%. Progressing of the primary disease is revealed in 50 % in the form of occurrence of the remote metastasis in lungs. A mean functional result assessed with the using of the MSTS system and consisted 75%. During the whole period of supervision no patient of six had complications such as periprosthesis infection, instability of a design of endoprosthesis or its fracture. At one patient with the diagnosis an osteosarcoma, through a floor of year after endoprosthesis, revealed a local recurrence during the spent of conservative treatment, in communication, with what amputation has been executed. For achievement of good clinical and functional result observance of indications to carrying out of reconstructive operations of area of an ankle joint, careful selection of patients taking into account effect on the spent conservative treatment is necessary.
Relation of Efficacy of Combined Use of Ibandronic Acid and Alfacalcidol with Bone Tissue Remodeling in Women with Postmenopausal Form of Osteoporosis
Authors: Rodionova Svetlana Semenovna , Elovoy-Vronskiy A A , Rodionova S S , Elovoy-Vronskiy A A
Published: October 2020

Study of 51 female patients showed high efficacy of alfacalcidol (Alfa D3 - Teva) and ibandronic acid (Bonviva) combination for the treatment of postmenopausal form of systemic osteoporosis. Dependence of mineral bone density (MBD) on the primary intensity of bone tissue remodeling was observed. Assumption on the necessity of bone metabolism markers assessment at ibandronate use was confirmed. The fact that use of active form of vitamin D 3 eliminates such side effects of bisphosphonates as secondary hyperparathyroidism and hypocalcemia has been proved.
Comparison of Curative Effect of Cryosupernatant and Fresh Frozen Plasma at Complex Treatment of Disseminated Intravascular Coagulation Syndrome in Patients with Severe Concomitant Injury
Authors: Tseymakh Evgeniy Aleksandrovich , Men'shikov A A , Bondarenko A V , Kuznetsov S Yu , Gontarev I N , Komleva I B , Smirnova O I , Tseimakh E A , Men'shikov A A , Bondarenko A V , Kuznetsov S Yu , Gontarev I N , Komleva I B , Smirnova O I
Published: October 2020

Results of comparative study of cryoplasmic therapy applied at complex treatment of 168 patients with disseminated intravascular coagulation syndrome were presented. In 56 patients complex therapy included cryosupernatant plasma (CSNP) and 112 patients received fresh frozen plasma (FFP). Study of coagulation and fibrinolysis system showed that restoration of fibrinolysis activity, physiologic anticoagulants and normalization of plasma fibrinogen levels occurred sooner when CSNP was used. Application of CSNP promoted the relaxation of disease severity, prevention of thrombotic complications and decrease of lethality (by 14.2%) to a greater extent as compared to FFP use.
Peculiarities of Superficial Peroneal Nerve Surgical Anatomy at Malleolus Fracture Treatment
Authors: Zolotov Aleksandr Sergeevich , Dubovyy S A , Kudran' S P , Zolotov A S , Dubovyi S A , Kudran' S P
Published: October 2020

Peculiarities of superficial peroneal nerve surgical anatomy are presented. Data on 100 patients operated on for malleolus fractures have been analyzed. In external approach to the fibula and lateral malleolus superficial peroneal nerve was detected in 20% of cases. It crossed the anterior margin of the fibula 55-150 mm (mean 79.2±24.4 mm) above the apex of the lateral malleolus. In 17 cases the nerve was located subcutaneously, in 3 cases - subfascially. Awareness of the detected peculiarities of the superficial peroneal nerve anatomy may increase the efficacy of its' iatrogenic injury prevention.
Chronic Venous Insufficiency and Gonarthrosis
Authors: Shcheglov E. A
Published: October 2020

The rate of previously not diagnosed chronic insufficiency in patients with knee osteoarthrosis was determined. The effect of treatment measures directed to elimination of venous insufficiency was evaluated. It was shown that in 48.8% of patients chronic venous insufficiency was not diagnosed by orthopaedic surgeons. Observance of therapeutic regimen, use of elastic compression and phlebotropic drugs contributed to the elimination of gonarthrosis symptoms and improved the quality of life (by KOOS scale).
Tribochemical Component of Oxidative Stress Development at Artificial Joints Implantation. Part 3. Inhibition of Radical-Forming and Antiproliferative Ability of Wear Particles by Antioxidants and Bone Fat
Authors: Bulgakov V. G , Il'ina V. K , Gavryushenko N. S , Shal'nev A. N , Omel'yanenko N. P , Tsepalov V. F
Published: October 2020

Tsepalov Inhibition ability of certain antioxidants and bone fat upon the oxidative properties of wear particles was studied. It was shown that at presence of wear particles use of BHT and б -tocoferol resulted in an inhibition of cumene oxidation. Treatment of orthopaedic alloys particles with bone fat was also accompanied by complete inhibition of oxidation reaction and duration of effect depended on the content of bone fat antioxidants. Addition of bone fat into mixture of alloy and polyethylene particles prevented the development of free-radical reactions ana potential oxidative destruction ofpolymer. Treatment of alloy particles with bone fat considerably reduced their negative influence upon human bone marrow osteogenic cells.
Comparative Experimental Study of Hook and Pedicle Fixation Systems Used at Surgical Treatment of Spine Deformities
Authors: Kuleshov A. A , Lisyansky I. N , Vetrile M. S , Gavryushenko N. S , Fomin L. V
Published: October 2020

Using human cadaver spines we compared the stiffness of pedicle screws and laminar hooks under cyclic and static pull-out loads. Transpedicular and hook fixation (sub- and supralaminar) of cadaveric thoracic spine segments was performed. Axial pull-out strength was measured using w+b (walter + bai ag) servoelectric testing machine (LFV-10-T50, Switzerland). Static pull-out tests were performed on 7 spine blocks with transpedicular and 7 blocks with hook fixation. The same blocks were tested under cyclic loads. At cyclic pull-out loading 800 N strength with 5 Hz frequency was applied. It was shown that at increasing static load hook implants could bear 1417 N at average. At higher loads the vertebral arch was destroyed. Transpedicular implants could bear 2286 N at average and at higher loads the screw migrated from the arch root. Cyclic tests showed that hooks could bear 2935 cycles at average and at prolonged loading the arch was destroyed. The hooks could bear the full; program of cyclic loads without destruction (18 000 cycles).
Forty-Year Experience in Application of Correction Osteotomies for Blount Disease Treatment
Authors: Tenilin N. A , Bogos'ayn A. B , Karataeva D. S
Published: October 2020

Long-term results (up to 40 years) of surgical treatment using different types of correction osteotomy in 51 children with Blount disease showed that the operation was necessary but a delayed measure. The authors showed that when deformity achieved the degrees requiring surgical intervention with bone transaction the deforming gonarthrosis inevitably developed at terms up to 10 years after operation. The main causes of varus deformity recurrence were determined, i.e. presence of active but disturbed growth and ossification processes, distal osteotomy level, absence of intraoperative hypercorrection, inobservance of postoperative orthopedic regimen. The only way to achieve good results is early operative intervention directed to growth normalization and formation of proximal tibia with spontaneous deformity correction during the period of child's growth.
Influence of Sympatectomy upon Outcomes of Autoneuroplasty after Upper Extremity Nerve Injuries
Authors: Merkulov M. V , Golubev I. O , Krupatkin A. I , Kuz'michyov V. A , Bushuev O. M , Shiryaeva G. N , Kutepov I. A
Published: October 2020

Study on the assessment of influence of sympatectomy upon the regeneration of human upper extremity nerves is presented. During the period from 2008 to 2012 ninety patients (83 men, 7 women) aged 12 — 60 years were treated for the defects of median, radial, ulnar and musculocutaneous nerves. The length of defects was from 2.5 to 20.0 cm . In 46 patients from the main group autoneuroplasty was combined with sympatectomy (thoracoscopic clipping of sympathetic trunk at Th3 — Th4 level). In 44 patients from the control group sympatectomy was not performed. During the period from 1.5 to 2 years after operation increase in reinnervated muscles force up to M3 — M4 was registered in 47.7% of patients from the main group versus 10.9% of patients from the control one and restoration of sensation up to S3 — S3+ in 65.9 and 13.04% of patients respectively (p
Results of Cementless Femoral Components Use at Revision Hip Arthroplasty
Authors: Zagorodniy N. V , Nuzhdin V. I , Bukhtin K. M , Kagramanov S. V
Published: October 2020

Results of 98 revision total hip arthroplasties performed using cementless stems during the period from 2000 to 2012 are presented. In 1 st group of patients (36 operations) revision SLR stems were used. In group 2 (34 interventions) and group 3 (28 interventions) Solution stems and Wagner stems were implanted, respectively. Detailed characteristic of implants was given with account to the type of fixation. Follow up was from 3 to 6 years. Excellent and good results were achieved in 21 patients (58.33%)from the 1 st group, 14patients (41.18%) from the 2 nd group and 16 patients (57.14%) from the 3 rd group. Analysis of intraoperative, early (up to 6 months) and late (over 6 months) complications was performed. Recommendations for choice of revision femoral components depending on the degree of bone tissue defect are given.
Pathophysiologic Aspects of Soft Tissue Microcirculation in the Zone of Long Bones Pseudarthrosis
Authors: Mironov S. P , Es’kin N. A , Krupatkin A. I , Kesyan G. A , Urazgil’deev R. Z , Arsen’ev I. G
Published: October 2020

Thirty four patients with delayed consolidating fractures and long bones pseudarthrosis and 30 healthy individuals (control group) were examined using laser Doppler flowmetry and computed thermography. It was shown that during the osteogenesis process no isolated changes in bone circulation took place but the potentialities of blood flow in the extremity segment as a whole were mobilized. Important role of bone surrounding soft tissue circulation for provision of adequate osteogenesis was confirmed. In case of pseudarthrosis formation microcirculation system, especially its nutrient part, responded «keenly» to the changes in regional metabolism and bone regeneration. That stipulated diagnostic and prognostic importance of soft tissue microhemocirculation study in the zone of pseudarthrosis. Preoperative functional examination of soft tissue circulation enabled to determine risk group for nonconsolidation ordelayed consolidation of fractures. For better result special treatment tactics can be used (osteogenesis stimulators, free vascularized autografts, etc.).
Radiomorphologic Peculiarities and Density of Tibial Cortical Plate at Different Stages of Lengthening
Authors: D’yachkov K. A , D’yachkova G. V , Alexandrov Yu. M
Published: October 2020

State of maternal bone before and after lengthening was studied using computed tomography in 94 patients with shortening and deformities. It was shown that depending on shortening and deformity etiology the cortical plate possessed typical differences that consisted in different crosssectional shape and density. During distraction and fixation of the limb after its lengthening in the apparatus, cortical plate had a heterogeneous structure with resorption zones of different size and density in all groups of patients. Depending on the disease etiology and amount of lengthening organotypical bone remodeling after lengthening lasted for 1—3 years.