Vol 19, No 1 (2013)

ORIGINAL ARTICLES

TECHNOLOGIES OF PLASTIC AND RECONSTRUCTIVE MICROSURGERY IN TREATMENT OF PATIENTS WITH PATHOLOGY OF HIP REGION

Tikhilov R.M., Kutyanov D.I., Rodomanova L.A., Kochish A.Y.

Abstract

Objective: This study aimed to determine the capabilities of plastic and reconstructive microsurgery in treatment of patients with traumas and diseases of hip. Material and methods: We have studied the results of surgical treatment of 10 patients with pathology of hip. All the patients were treated in Vreden Russian Research Institute of Traumatology and Orthopedics (Saint-Petersburg, Russia) within the period from 2000 to 2011. All the patients had pedicled flap transfer (10 cases) or free tissue transfer (1 case). 6 patients had additionally primary or revision total hip replacement. Results and conclusions: Microsurgical operations mainly aimed to correct various pathological changes of soft tissues and to cure infectious process in hip area. It was stated that microsurgical operations themselves is an effective method of treatment of wide neurotrophic sores located in the area of hip joint as well as hematogenic osteomyelitis of hip joint. Only microsurgical technologies provide opportunities for successful total hip replacement in patients with combined pathology of para-articular soft tissues and bones.
Traumatology and Orthopedics of Russia. 2013;19(1):5-11
pages 5-11 views

CAUSES OF REVISION SURGERY AFTER UNICOMPARTMENTAL KNEE ARTHROPLASTY

Kornilov N.N., Kulyaba T.A., Fedorov R.E.

Abstract

Objective - to study the structure of complications developing after unicompartmental knee arthroplasty and to analyze its causes. Material and methods. The causes of 18 revision interventions after 142 consecutive UKA that have been performed in 137 patients since 2001 till 2012 were evaluated. The main reason for revision surgeries in these series was traumatic damage of different knee structures (7 cases): 3 - medial femur or tibia condyle fractures due to fall from height or collision, 1 - ACL rupture and one bearing dislocation both during mountain skiing injury, 1 - lateral menisci tear after rotational trauma, 1 - loose body formation caused by direct blow. All traumatic events took place during first five years after surgery. Other indications for revision were aseptic loosening of tibial component in 6 patients (after 4,8 years in average), disease progression in 2 (after 3 years in average), early infection in 1 and late hematogenous infection in 2 cases. In 16 patients revision TKA were performed with 10 cruciate-retaining, 5 posterior stabilized and 1 varus-valgus constrained implants. In 2 patients with lateral menisci tear and loose body arthroscopical intervention resolved the problem. Surprisingly in this cohort of patients acute trauma especially during sport activities shared the first place with aseptic loosening among the reasons for revision after UKA. This indirectly evidences that patients after UKA retained high level of physical activities and less restricted in sport that after TKA.
Traumatology and Orthopedics of Russia. 2013;19(1):12-18
pages 12-18 views

ARTHROSCOPIC CORRECTION OF THE INJURIES OF THE COMPLEX «TENDON OF THE BICEPS LONG HEAD - THE ARTICULAR LIP» IN TREATMENT OF PATIENTS WITH FULL-LAYER RUPTURES OF THE ROTATOR CUFF

Dokolin S.Y., Kuz'mina V.I., Bazarov I.S., Kislitsyn M.A.

Abstract

Damage of the long head of the biceps at the place of attachment to the articular tubercle supraglenoidal lip of shoulder, to the entrance and throughout intertubercle furrows are common causes of pain and dysfunction of the shoulder joint. At the same clinical manifestations of the morphology of such lesions may be different. The current literature discusses various options of surgical correction of the biceps injury. Variety of methods of surgical treatment and the lack of consensus in support of their application in different patients in different types of injuries were the basis for the present study. A prospective analysis of the functional results of surgical treatment of the 34 - year’s patients with associated rotator cuff (SSP+ISP+SSC+) and the tendon of the biceps muscle in age from 34 to 75 years. Options for surgical correction of the damaged part of the biceps were: biceps tenotomy, biceps tenotomy with intraarticular tenodez of the shoulder to the head before entering intertubercle furrow, biceps tenotomy and extraarticular subpectorialtenodez to the proximal humerus is intertubercle interferrent screw groove, as well as its attachment to the tendon suture large pectoral muscle. Choice of surgical approach depended on the patient's age, level of daily physical activity, morphology and localization of lesions. The best results were obtained when the extra-articular subpectorialtenodez of long head of the biceps to the proximal humerus interferrent screw and suture fixation to the pectoralis major muscle, the average follow-up was 16,6 ± 4,7 months.
Traumatology and Orthopedics of Russia. 2013;19(1):19-27
pages 19-27 views

THE RESULTS OF THE CLINICAL USE OF A NEW METHOD OF OSTEOSYNTHESIS WITH NON-FREE BONE AUTOPLASTY AT THE MEDIAL FEMORAL NECK FRACTURES

Tikhilov R.M., Karelkin V.V., Kochish A.Y., Kornilov B.M.

Abstract

Objective - to improve treatment outcomes in patients with medial fractures of the femoral neck through the development and introduction into clinical practice a new method of fixation with non-free plastic by the autograft from the iliac crest on a permanent muscular-vascular pedicle. Materials and methods. A comparative analysis of short- and long-term results of surgical treatment of 57 patients with medial fractures of the femoral neck, which were divided into primary and control groups. The study group included 24 patients who have undergone an osteosynthesis with cannulated screws with additional autoplasty with vascularized graft from the iliac crest. The control group consisted of 33 patients who underwent fixation with cannulated screws for the traditional method. Results. The use of non-free bone autoplasty in the main group of patients provided the best short- and long-term outcomes: fracture healing occurred in all cases in a period of 6 to 8 months. The long-term results of treatment of 22 patients after 2-6 years after the operation showed comparatively better anatomical functional outcomes. Conclusions. The indications for the clinical use of the fixation with the non-free bone autotransplantation are prognostically unfavorable for the union medial fractures of the femoral neck (II-III types by Pauwels or III-IV types by Garden) in patients aged under 60 years with no signs of deforming arthrosis II-III stages.
Traumatology and Orthopedics of Russia. 2013;19(1):28-36
pages 28-36 views

COMPARATIVE ANALYSIS OF BIOCHEMICAL PARAMETERS OF MUSCLE TISSUE ALTERATION DEPENDING ON APPROACHES FOR TOTAL HIP ARTHROPLASTY

Tikhilov R.M., Andreev D.V., Goncharov M.Y., Shneyder O.V.

Abstract

The results of the comparative analysis of biochemical alterations of muscle tissue in the blood serum of patients who underwent primary total hip replacement. In this study, we consider the data of 75 patients who underwent total hip arthroplasty (75 operations) from November 2010 to April 2012 to analyze the data was divided into 3 groups of patients: the first - using a minimally invasive technique MIS AL (22 operations), the second - with the use of the modified approach Muller (pending on the invention) - (29 operations), and the third - with approach by Hardinge (26 operations). The levels of glutamic oxaloacetic transaminase, creatinine phosphokinase, lactate dehydrogenase, myoglobin, creatinine, and C-reactive proteine in serum were determined preoperatively and at 3, 5, 7, 9 days after surgery. CRP included in the study as an indicator of non-specific inflammation of the tissues. When comparing the biochemical indicators in three types of approaches to the hip joint, the highest increase in GOAT, LDH, CPK, CRP, and myoglobin was detected at surgery approach by Hardinge. The results of this study may indicate a decrease in the degree of tissue trauma during surgery using a minimally-invasive approaches, which is characterized by the retention of attachment to the middle gluteal muscle of the femur.
Traumatology and Orthopedics of Russia. 2013;19(1):37-43
pages 37-43 views

FUNCTIONAL RESULTS OF SURGICAL TREATMENT FOR ISTHMIC SPONDYLOLISTHESIS USING ANTERIOR AND POSTERIOR EXPOSURES

Rudenko V.V., Gulyaev D.A., Godanyuk D.S., Tatarintsev A.P.

Abstract

Objective - to compare results of spondylolisthesis treatment using different surgical technologies. Material and methods: 84 patients (aged from 19 till 67) with spondylolisthesis of 1-3 degree (H.W Meyerding) were operated. Two methods of surgical exposures were used for decompression and stabilization. Anterior decompression and stabilization exposures from retroperitoneal access were used for the first group of patients. The second group was operated using posteriolateral interbody fusion with transpedicular screw fixation. The following results were estimated after operation: the level of patients’ postoperative adaptation period and the rate of neurological and orthopedic rehabilitation during the postoperative period. Conclusions. The obtained functional results show no difference for both groups where posterior and anterior exposures were used for spondylolisthesis surgical treatment of 1-3 degree.
Traumatology and Orthopedics of Russia. 2013;19(1):44-50
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TRACTION-EXTENDED THERAPY OF PATIENTS WITH LUMBAR DEGENERATIVE DISEASE

Zhirnov V.A., Krest'yanov D.P., Vasil'kin A.K.

Abstract

Based on the survey of 148 patients with an lumbar degenerative disease, there have been studied immediate and medium-term results of the comprehensive conservative treatment of the patients with and without application of traction exposure on the spine. It was found out that the traction of the spine leads to a quicker and more durable relief of symptoms in comparison with the control groups where traction therapy wasn't carried out. Application of the traction-extended therapy in three planes with a usage of robotized set for dry skeletal traction of a new generation KinetracKNX-7000 is proved to increase the effectiveness of treatment for the patients with stated pathology, fasten regress of the pain syndrome and clinical symptomatology, lead to more durable and lasting remission of the desease, in comparison with the patients that had traction of the spine in one plane only during the treatment.
Traumatology and Orthopedics of Russia. 2013;19(1):51-60
pages 51-60 views

INFLUENCE OF DURATION OF TUBERCULOSIS SPONDILITIS ON THE DEVELOPMENT OF POSTOPERATIVE COMPLICATIONS

Burlakov S.V., Oleynik V.V., Vishnevskiy A.A.

Abstract

Objective - to find out dependence of long inspection, and late operations from the sick tuberculosis spondylitis (TS) with presence of complications arising after surgical treatment. Material and methods. The retrospective estimation of complications of surgical treatment of 364 sick TS which was in the Spine Center St.-Petersburg Institute Phthisiopulmonolgy during the period with 2008 on 2010г is spent. To patients it is executed 451 operations. Concerning complications of the previous operative interventions it has been executed 53 (11,8 %) operations. Results. In research the dispersive analysis of influence of various factors (the TS form, duration of disease, prevalence of the process, the amazed department of a backbone, age) on development of postoperative complications is carried out. High statistical reliability (р≤0,001) dependences of occurrence of postoperative complications on the TS form is revealed. At patients with the complicated form of the TS (neurologic infringements, paravertebral abscesses, neurotrophic complications and fistulas) postoperative complications arose more often, than in group with not complicated form. Smaller, but considerable influence on development of postoperative complications was rendered by duration of disease (p <0,05): the more time passed to operations, the complications were more often observed. Prevalence of process statistically authentically influenced development of postoperative complications (p≤0,05). At defeat more than one vertebral segments complications arose more often. Conclusion. Among for the first time revealed sick tuberculosis spondylitis is marked increase in the complicated and widespread forms. Late diagnostics of a tuberculosis leads to an inefficiency of surgical treatment and an exit of the majority of patients on physical inability.
Traumatology and Orthopedics of Russia. 2013;19(1):61-66
pages 61-66 views

RESULTS OF SURGICAL TREATMENT OF HAGLUND’S DESEASE

Kardanov A.A., Bualy N.M., Rusanova V.V., Nepomyashchiy I.S.

Abstract

Objectives. The article presents the results assessment of open calcaneal excision compared to percutaneous excision of patients with Haglund’s disease. Materials and methods. Twenty-one patients (26 feet) underwent the surgical treatment during the period from 2010 to 2012. The clinical diagnosis was confirmed by axial load radiography estimated with “Fowler-Philip” and “posterior pitch lines” methods. Eight feet were treated with open calcaneal excision and 18 feet - with percutaneous procedure. The mean duration of follow-up was 21,8 months. Clinical evaluation criteria were deformity and/or bursitis recurrence, tenderness, pain by wearing shoes, return to the sport training, patient satisfaction, presence/absence of major complications. Results. Good results were reported for 21 patients; fair results - for 4 patients; and poor results - for one patient. No significant differences in results depending on the method of intervention have been identified.
Traumatology and Orthopedics of Russia. 2013;19(1):67-71
pages 67-71 views

SURGICAL CORRECTION OF HALLUX VALGUS IN PATIENTS WITH TRANSVERSE FLATFOOT AND DEFORMING ARTHROSIS OF THE FIRST METATARSOPHALANGEAL JOINT

Mashkov V.M., Nesenyuk E.L., Sorokin E.P., Bezrodnaya N.V., Shakhmatenko I.E.

Abstract

Objective: to determine the opportunity of usage of Schede-Brandes procedure in the treatment of patients with hallux valgus. Material and methods. The results of Shede-Brandeis operation were studied in 119 patients (198 feet). The study included patients who were followed up long-term results of treatment for up to 10 years. The results of the surgical treatment were assessed by the AOFAS scale and total criteria proposed I.A. Pakhomov. According to these scales the following results were obtained: the good - in 59,59% of patients, satisfactory - in 22,73%, poor - in 17,68%. Conclusion. These results allow to recommend Schede-Brandes procedure for use in elderly patients with osteoporosis, concomitant vascular diseases of lower extremities and with rheumatoid arthritis.
Traumatology and Orthopedics of Russia. 2013;19(1):72-78
pages 72-78 views

THEORETICAL AND EXPERIMENTAL STUDIES

HISTOMORPHOMETRIC ANALYSIS OF THE KNEE ARTICULAR CARTILAGE AND SYNOVIUM FOR METADIAPHYSEAL LEG LENGTHENING (EXPERIMENTAL-AND-MORPHOLOGICAL STUDY)

Stupina T.A., Schoudlo N.A., Petrovskaya N.V., Stepanov M.A.

Abstract

The knee articular cartilage and synovial membrane have been studied for metadiaphyseal leg lengthening using the methods of light miscroscopy, computer morpho- and stereometry. The manner of bone integrity breaking, the rate and rhythm of distraction conformed to the lengthening technique most often used in the clinic. The results of the histomorphometric analysis have demonstrated that when osteotomy at the level of metadiaphysis and manual distraction by 1 mm a day for 4 times is performed, synovitis of mild and moderate degree develops through subsynovial layer hypervascularization, as well as reactive-destructive changes in nerve fibers with the tendency to regeneration. The structural-functional changes of reactive and/or destructive-reparative character have been revealed in the articular cartilage, and the manifestation degree of these changes correlates with synovial membrane changes. The intensity of the destructive-reparative processes in the articular cartilage and synovial membrane depends on fixation stability.
Traumatology and Orthopedics of Russia. 2013;19(1):80-86
pages 80-86 views

METHODS OF EXAMINATIONS

DYNAMICS OF THE FUNCTIONAL STATUS OF PATIENTS IN THE TREATMENT OF CLAVICLE FRACTURES BY TRANSOSSEOUS OSTEOSYNTHESIS

Shchurov V.A., Darvin E.O.

Abstract

Purpose - assessment of the dynamics of the state, blood supply regenerate bone, muscle contractility of the arm and forearm in patients with clavicle fractures during the treatment with external fixation device. Material and methods. Authors studied 38 patients during the treatment by Ilizarov method. The muscle dynamometry, Doppler ultrasound, psychophysiological study using SF-36 test were performed. Results. The strength of the humeral and forearm muscles on the side of damage was reduced and increased by 50-80% of the conditional baseline during transosseous fixation. The high rate of blood flow in the area of injury was characteristic during the first week in the fixation period. In the process of the treatment and recovery of muscle contractility its value normalized. The treatment of clavicle fractures by Ilizarov method allows in the early period of fixation to restore the ability of patients to self-service, to reduce the influence of pain limiting factor, improves mood and health of patients.
Traumatology and Orthopedics of Russia. 2013;19(1):87-92
pages 87-92 views

EXPERIENCE EXCHANGE

FEATURES OF PATHOGENESIS, CLINICS AND DIAGNOSTICS OF EQUINOPLANOVALGUS IN PATIENTS WITH CEREBRAL PALSY

Umnov V.V., Umnov D.V.

Abstract

By data of the literature and own supervision, authors describe features pathogenesis of equinoplanovalgus foot deformations (EPVFD) in cerebral palsy patients and also the clinical displays of disease revealed by them at inspection of 52 patients (79 foot). In article you can find the earlier not described clinical supervision - presence by a considerable part of patients of the expressed feeling of tiredness feet at walking. This complaint was at 87,0 % patients. Main principles and methods of diagnostics of disease are described, and also a new way is computed tomography scan, allowing to visualize all characteristic for deformation of infringement of anatomy of joints and bones of foot in the conditions of influence modeling on it orthostatic load. Authors come to the conclusion that EPVFD by cerebral palsy children’s possesses a number of prominent features which probably to reveal special receptions and diagnostics methods, and also it is necessary to consider for increase of efficiency of the complex surgical approach to treatment EPVFD at patients with cerebral palsy.
Traumatology and Orthopedics of Russia. 2013;19(1):93-98
pages 93-98 views

CASE REPORTS

ARTHROSCOPIC TREATMENT OF PATIENT WITH ELBOW IMPINGEMENT SYNDROME

Kuznetsov I.A., Ryabinin M.V., Salikhov M.R., Rybin A.V.

Abstract

On the example of treating a patient with osteoarthritis, chondromatosis and the flexion-extension contracture of elbow the authors show the effectiveness of arthroscopic treatment. In the treatment of this disease the authors recommend the minimally invasive arthroscopic surgery for elimination of intra-articular pathology, combined with early postoperative rehabilitation, which provides a good functional outcome in the short term.
Traumatology and Orthopedics of Russia. 2013;19(1):104-108
pages 104-108 views

CLUBFOOT RECCURENCES AFTER THE TREATMENT BY PONSETI

Blandinskiy V.F., Vavilov M.A., Gromov I.V.

Abstract

Congenital clubfoot is one of the most frequent pathologies of the musculoskeletal system. The treating of clubfoot by Ponseti gives promising results and complete correction of the deformity in 90-95% of patients sparing them from extensive surgery. In the Yaroslavl Regional Children's Hospital from May 2006 to December 2007 54 children (83 feet) with severe congenital clubfoot were treated. Treatment for all patients was initiated at the age of 1 year. With remote monitoring for 5 years recurrences were noted in 19.3% of cases. Despite its high efficacy in patients under the age of three years, non-compliance of brace wearing results in the number of recurrences and require re-gypsum. In older children (3 to 5 years) the treatment by Ponseti is supplemented by transfer of tibialis anterior muscle tendon. In cases of postoperative recurrence of the treatment program is complemented by local releases and arthrodesis.
Traumatology and Orthopedics of Russia. 2013;19(1):99-103
pages 99-103 views

MODERN TECHNOLOGIES IN TRAUMATOLOGY AND ORTHOPEDICS

DEVICE FOR REMOVAL OF INADVERTENTLY LEFT DRAINAGE TUBE IN THE FIELD OF SURGERY

Mamedov A.A., Turkov P.S.

Abstract

The paper presents a description of the device for removal of surgical drains, developed at Novosibirsk RITO, and the experience of its application at the Department of Joint Replacement and Endoscopic Surgery. The device enables to remove a drainage tube or its fragments from a surgical site completely and with minimal damage to surrounding soft tissues in case of its breakage or a threat of breakage. This prevents revision surgery to remove the drain or its fragment, and eliminates the possibility of secondary infection of the wound and complication development.
Traumatology and Orthopedics of Russia. 2013;19(1):109-112
pages 109-112 views

DISCUSSIONS

ATYPICAL FRACTURES DUE TO LONG TREATMENT WITH BISPHOSPHONATES (CRITICAL REVIEW)

Golubev G.S.

Abstract

This paper reviews the evidence for an association between atypical subtrochanteric fractures and long-term bisphosphonate use. A PubMed search of literature was performed. Estimation of scientific level of evidences, extraction of quantitative data about atypical fractures from publication were performed. Common clinical and X-ray features of ‘atypical’ fractures are described. Level IV publications contain assumptions of relationship between long term (more than 5 years) bisphosphonates’ (alendronate, ibandronate) treatment and atypical fractures. No data found about connection between zoledronic acid and atypical fractures. Data about relative risk of atypical fractures which is retrieved from meta-analysis’s and post-hock analysis’s of randomized clinical investigations is discrepant. No meta-analysis’s and randomized clinical investigations with statistically valid evidence of correlation between atypical fractures and long term bisphosphonates treatment have been found. Despite the relative rarity of atypical femoral fractures and doubtful evidences of their connection to bisphosphonates therapy, physicians and patients should be made aware of the possibility of such phenomenon. Principles of rational bisphosphonates therapy are being discussing. Because bisphosphonates accumulate in bone, they create a reservoir leading to continued release from bone for months or years after treatment is stopped. The feature described above is the base to recommendation for a drug holiday after 5-10 yr of bisphosphonate treatment. Clinical recommendations to reduce risks, rational diagnostic and surgical algorithm to treat atypical fractures are proposed for physicians dealing with osteoporosis, osteoporotic fractures and their consequences. Researches should be undertaken to get additional epidemiologic and clinical data to establish the true relationship between atypical fractures and long term bisphosphonates using. Bisphosphonates are effective and relatively safe remedies which reduce risk of osteoporotic fractures of any part of skeleton. Clinical advantages of bisphosphonates using exceed the doubtful and unproved risk of atypical fractures.
Traumatology and Orthopedics of Russia. 2013;19(1):113-123
pages 113-123 views

On the risk of atypical fractures of the femur with prolonged use of bisphosphonates

Kochish A.Y., Golovach I.Y.

Abstract

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Traumatology and Orthopedics of Russia. 2013;19(1):123-126
pages 123-126 views

REVIEWS

CRITICAL ANALYSIS OF MECHANOSTAT THEORY PART II. STABILITY OF MECHANO-METABOLIC SKELETON ENVIRONMENT AND HOMEOSTATIC PARAMETERS OF CALCIUM IN ORGANISM

Avrunin A.S., Parshin L.K., Melnikov B.E.

Abstract

Aim: Basing on own and literature date to characterize biological necessity of modification the ability of bone structures to be deformed and carrying capacity of lacunar-channel system to provide the basis for interaction between this pathways and parameters of calcium homeostasis. Results: There are two ways of bone matrix remodeling. The first group of pathways is responsible for slow adaptation of bone structures ability to be deformed within physiological range during weeks, months, years. The second group ensures rapid response of carrying capacity of lacunar-channel system (minutes and ours). This two mechanisms function in conjunction with hierarchically organized calcium metabolism. The first level of the latter is direct two-phase exchange of ionized calcium between extracellular liquid of bone tissue and blood: a) paracellular arrival of ionized calcium from blood into the bone; b) transcellular arrival of ionized calcium from extracellular liquid of bone into blood. The second hierarchical level is remodeling of perilacunar matrix by osteocytes. The third hierarchical level is bone remodeling with collaboration both osteoclasts and osteoblasts.
Traumatology and Orthopedics of Russia. 2013;19(1):127-137
pages 127-137 views

SURGICAL CORRECTION OF SPINAL DEFORMITY IN IDIOPATHIC SCOLIOSIS: THE HISTORY AND CURRENT STATE (REVIEW)

Vissarionov S.V., Sobolev A.V., Efremov A.M.

Abstract

The article presents the historical and contemporary aspects of the state of the question correct scoliosis spine with dorsal and ventral spinal systems. The variants of spinal deformity correction method from Harrington to modern surgical techniques using both hook and metal screw. Detailed technological aspects of surgical interventions for the correction of spinal deformity using a variety of spinal structures. A comparative estimate of the correction of spinal deformity, the impact on the result of the initial mobility of the spine, level metallofiksatsii vertebral-motor segment, as well as the degree of true derotation vertebrae at the top of the curvature in a variety of surgical procedures. Describes the advantages and disadvantages of options for surgery.
Traumatology and Orthopedics of Russia. 2013;19(1):138-145
pages 138-145 views

TREATMENT OF TRANSCONDYLAR EXTENSOR FRACTURES OF THE HUMERUS IN CHILDREN: ON THE ISSUE OF HISTORY OF THE METHOD “COLLAR AND CUFF”

Zolotov A.S., Dubovyy S.A.

Abstract

The article is devoted to the history of one of the methods of conservative treatment humeral transcondylar extensor fractures in children - a method «collar and cuff». The second and very common name of this method is connected with the name of the american orthopaedist Walter Blount. «The method of Blount» is mentioned in many domestic and foreign sources. Nevertheless the analysis of publications on the history of the discussed method of treatment indicates the priority in this matter other famous doctor - British podiatrist Robert Jones.
Traumatology and Orthopedics of Russia. 2013;19(1):146-148
pages 146-148 views

OBITUARIES

Viktor M. Kustov

Abstract

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Traumatology and Orthopedics of Russia. 2013;19(1):149-149
pages 149-149 views


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