Vol 17, No 1 (2011)

ORIGINAL ARTICLES

LONG-TERM RESULTS OF ARTHROSCOPIC TREATMENT FOR INSTABILITY AT RECURRENT SHOULDER JOINT, CAUSES OF FAILURE

Tikhilov R.M., Dokolin S.Y., Kuznetsov I.A., Trachuk A.P., Burulev A.L., Mikhailova A.M., Zakharov K.I.

Abstract

The authors analyse the results of the performance of arthroscopy stitch on the injured capsule with the use of anchor on 46 patients with anterior recurring instability of the shoulder joint within a period of time from 6 months to 4 years. When assessing the results of the given treatment, functional scales, clinical examination methods and radiological methods have been used. The article presents the results of arthroscopy diagnosis of the interior joint damage accompanying the recurring instability of the shoulder joint. The effectiveness of the conducted operations was 93,5%. The occurrence of postoperative relapses of joint instability (reoccurring dislocations) in 3 patients (6,5%) was caused by the presence of significant damage of bone formations in the shoulder joint – the shoulder-blade joint socket and the shoulder-bone head as well as the reduction of the strength and elasticity of the soft-tissue structures.

Traumatology and Orthopedics of Russia. 2011;17(1):5-13
pages 5-13 views

ALGORITHM FOR SURGICAL TREATMENT OF SPONDYLOSIS SPONDYLOLISTHESIS

Usikov V.D., Ptashnikov D.A., Kurnosenkov V.V., Rott A.N.

Abstract

Results of surgical treatment of 80 patients with ischemic spondilolistesis were analyzed. All patients were divided in two groups. All patients were treated surgically with reduction, TLIF and posterior transpedicular fixation. Differences in groups depended from volume of decompression and size of a reduction of a vertebra. The results have shown that effective treatment with good correction, decompression and stabilization can be archived from posterior approach. Using NEMG reduced neurological complication in correction of severe segmental deformation.

Traumatology and Orthopedics of Russia. 2011;17(1):14-22
pages 14-22 views

RESULTS OF TREATMENT OF LUMBAR PAIN SYNDROMES AT OSTEOCHONDROSIS WITH BLUE LIGHT

Vasilkin A.K., Zhirnov V.A., Kiryanov V.V., Zhulyov N.M.

Abstract

The authors studied results of treatment of lumbar pain syndromes with blue light (a wavelength of 470 nanometers). The clinico-neurologic observation, neuropsychological testing, an electromyography, rheovasography in terms till 12 months after treatment were carried out. The blue light allows to stop a pain syndrome at 93,3% of patients with a lumbar ischialgia, to enlarge terms of remission and to reduce quantity of exacerbations that leads to improvement of quality of life of patients. Complex treatment of patients with lumbar ischialgia with application of blue light has allowed to receive excellent and good results in 94,4 % of cases, while the same treatment, but without blue light – in 82,9%.

Traumatology and Orthopedics of Russia. 2011;17(1):23-28
pages 23-28 views

MECHANOGENESIS AND CLINICAL-ANATOMICAL CHARACTERISTICS OF HAND CONTACT BLAST INJURY IN PEACE AND WAR TIME

Fomin N.F., Tikhilov R.M., Nisht A.Y.

Abstract

Thorough research has been done on the characteristics of surgical anatomy and mechanogenesis of the explosion-related hand injuries received during military campaigns and in non-military explosion-related accidents. This research consisted of clinical, statistical and experimental-anatomical parts. 241 patient data files of the wounded during the military campaign in Afghanistan have been analysed as well as 70 patient data files of the injured in non-military explosion-related accidents. The most common, according to the patient data analysis, morphological variations of the explosion-related hand injuries were simulated during 24 in-field experiments by exploding hands of cadavers. The characteristics of the explosion-related hand injuries were analysed using radiography and precision preparation of the extremities after the in-field experiments. The correlations between the hand damage levels, the types of explosive materials, their orientation and position in hand during explosion have been identified.

Traumatology and Orthopedics of Russia. 2011;17(1):29-34
pages 29-34 views

OPTIMIZATION OF THE ORTHO-SUV FRAME ASSEMBLY FOR CORRECTION OF THE DISTAL FEMUR DEFORMITIES

Solomin L.N., Skomoroshko P.V., Vilensky V.A., Utekhin A.I.

Abstract

The aim of the study was to investigate optimal assembly of the computer assisted Ortho-SUV Frame for correction of the distal femur deformities which will provide the maximal bone fragments mutual movements and have the minimal assembly sizes. For it 360 bench tests on 12 model was performed. The dependence of the Ortho-SUV Frame reduction capabilities (translation, angulation, torsion) and distance between supports, places of struts fixation and use of Z-shaped plates for struts fixation was investigated. It is found that in Ortho-SUV assembling to provide the necessary requirements 3/4 ring supports is reasonable. Distal support should be placed at the level VII, proximal at the distance 150–200 mm higher. For fixation of the strut 1 to the proximal support position 2 should be used, for the strut 3 – the place between position 5 and 6, for strut 5 – position 10; for fixation of the strut 2 to the distal support position 4 should be used, for fixation of the strut 4 – position 8, for strut 6 – position 12. Use of the Z-shaped plates in fixation of strut 1 and 5 increases the reduction capabilities on 11.4–25.5% in average. Use of modular transformation of the frame allows decreasing the bulkiness of the frame after deformity correction. Investigated assembly was applied in treatment of 14 patients. In all the cases the aim of Ortho-SUV frame use (deformity correction) was reached.

Traumatology and Orthopedics of Russia. 2011;17(1):35-41
pages 35-41 views

REPLACEMENT OF THE RADIAL HEAD BY BIPOLAR ENDOPROSTHESIS

Zhabin G.I., Fedyunina S.Y., Ambrosenkov A.V., Boyarov A.A.

Abstract

For last 2 years it is executed replacement heads of a radial bone concerning splintered fractures of III type on Mason and inveterate fractures with deformation of a head of a radial bone of 16 patients. At all patients were applied a bipolar endoprosthesis. The remote results are known at 9 patients. From them at 6 results have appeared excellent and good, at one satisfactory and at two bad.

Traumatology and Orthopedics of Russia. 2011;17(1):42-46
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CEMENTLESS COMPONENT APPLICATION IN KNEE ARTHROPLASTY

Tikhilov R.M., Kazemirsky A.V., Preobrazhensky P.M., Klyubanov V.A.

Abstract

During the period from 2007 to 2010 38 operations of the hybrid knee arthroplasty and 24 cementless knee arthroplasty (LCS De Puy) were performed. In the control group of patients 100 operations in cement knee replacement (LCS De Puy) ware carried out. In the studied groups of patients women dominated – 125 (77,1%). The patients’ age ranged from 38 to 88 years (average – 62 years). Treatment results were evaluated in accordance with the scales of Joseph & Kaufman and WOMAC, based on postoperative radiographs, the measurement of femoral-tibial angle. In the study and control groups in the early postoperative period, as well as future annual observation period of 3 years, the authors obtained the same results. Thus, hybrid and cementless arthroplasty are indicated in patients with good bone quality metaepiphysis femur and tibia bones, those young adults with high levels of physical activity, as well as in cases where it is desirable to eliminate or minimize the use of polymethylmethacrylate bone cement for fixation of femoral components.

Traumatology and Orthopedics of Russia. 2011;17(1):47-52
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SURGICAL TREATMENT OF THE TIBIAL PLATEAU FRACTURES

Shapovalov V.M., Khominets V.V., Rikun O.V., Gladkov R.V.

Abstract

The analysis of the frequency, structure, causes and circumstances of fractures of condyles of the tibia in 122 victims, as well as evaluated the results of treatment 57 patients using conventional techniques. Have been identified and systematized the main reasons for poor treatment outcomes, to develop modern diagnostic and treatment depending on the type of fractures of the condyles on the classification of J. Schatzker. The differentiated approach to the selection methodology reposition and fixation of fractures of condyles of the tibia from the limited or minimally invasive approaches with different variants bone grafting and stable functional osteosynthesis. Endovideohirurgicheskih determine the significance of technology in the diagnosis of injury and recovery of intraarticular soft tissue structures of the knee. Studied the immediate and long-term anatomical and functional results of the implementation developed tactics when choosing the method of reduction and fixation of the condyles of the tibia in 76 patients with fractures of various types.

Traumatology and Orthopedics of Russia. 2011;17(1):53-60
pages 53-60 views

THEORETICAL AND EXPERIMENTAL STUDIES

THE INFLUENCE OF COLD PLASMA ABLATION ON HUMAN AND ANIMAL KNEE JOINT CARTILAGE

Bogatov V.B., Matveeva O.V., Petrov A.B.

Abstract

Cold plasma ablation is widely used in knee arthroscopy during past decade. We studied its influence on knee joint cartilage in a human in vitro and in dogs in vivo. Histomorphological study was performed in a human cartilage right after the exposition of CPA. In animals MRI and morphological study were performed after three months of exposition of CPA. It was shown that CPA was able to cause immediate changes of collagen in the human cartilage in vitro and also death of chondrocytes in animal in vivo after three months. The depth of necrosis of the cartilage in animal was significantly deeper the subhondral bone.

Traumatology and Orthopedics of Russia. 2011;17(1):61-66
pages 61-66 views

THE INTRAARTICULATE IMPLANTATION OF BIODEGRADED POLYHYDROXYALKANOATES IN EXPERIMENT

Maiborodin I.V., Shevela A.I., Beregovoy E.A., Matveeva V.A., Angelsky A.A., Drovosekov M.N.

Abstract

The processes of regeneration damaged rat cartilage of knee joint after implantation of biodegraded polyhydroxyalkanoates (PHA) were studied by method of light microscopy. After application PHA the destructive changes in the damaged joints have been expressed much more strongly, than after natural course of healing. In all cases for all terms of supervision the PHA has not been found out between articulate surfaces. However, sometimes PHA lay freely in lateral plicae of articulate capsule. Much more often small fragments of PHA settled in tissues round a joint, were incapsulated by actively proliferated fibrous tissue and were deformed. In all cases there were no reactions of macrophages and leucocytes to a foreign body and signs of granulomatous inflammatory process. There were no also certificates of PHA degradation. The materials, prepared from PHA, are not biodegraded, but are expressed bioinertness.

Traumatology and Orthopedics of Russia. 2011;17(1):67-75
pages 67-75 views

CASE REPORTS

EXPERIENCE OF REVISION HIP ARTHROPLASTY AT THE PROLAPSE OF THE ACETABULAR COMPONENT INTO THE SMALL PELVIC CAVITY

Mashkov V.M., Dolgopolov V.V.

Abstract

The successful experience of revision arthroplasty at acetabular component instability complicated by its prolapse into the small pelvic cavity. The authors underline the need for a comprehensive preoperative examination of patients in preparation for revision surgery, careful planning of the operation and dynamic observation of patients in the postoperative period.

Traumatology and Orthopedics of Russia. 2011;17(1):128-131
pages 128-131 views

EXPERIENCE EXCHANGE

USING TRABECULAR METAL AUGMENTS FOR TOTAL HIP REPLACEMENT IN PATIENTS AFTER ACETABULAR FRACTURES

Tikhilov R.M., Shubnyakov I.I., Chiladze I.T., Karpukhin A.S., Pliev D.G., Ambrosenkov A.V., Bliznyukov V.V., Myasoedov A.A.

Abstract

The authors presented the experience of treatment of two patients with hip arthritis after acetabular fracture. Both patients were treated with total hip replacement. During the operation, to manage posterior-superior bone defects of the acetabulum, augments of trabecular metal were used. Pain and limitation of motions in hip were indications for operative treatment. After a year of follow up there was no pain in hip; also recovery of motion and improved quality of life were observed.

Traumatology and Orthopedics of Russia. 2011;17(1):76-81
pages 76-81 views

ANAESTHESIA, POSTOPERATIVE ANALGESIA AND EARLY REHABILITATION FOR UPPER EXTREMITY BONE AND MAJOR JOINTS SURGERY

Kurnosov A.V., Mamaeva E.G., Zhabin G.I., Mohanna M.I.

Abstract

A new method was developed to perform prolonged brachial plexus block with almost 100% effectiveness. It was also shown in 44 patients to be 33 % safer for local complications and 11,3 % safer for general complications than common used supraclavicular Winnie block (42 patients in control group, received opiates and NSAID for post-operative analgesia). This new method of analgesia allows effective rehabilitation after elbow arthroplasty to be started on the first day after the surgery.

Traumatology and Orthopedics of Russia. 2011;17(1):82-86
pages 82-86 views

URGENT OSTEOSYNTHESIS OF TIBIAL CONDYLAR FRACTURES USING PLATES OF DOMESTIC PRODUCTION

Voronkevich I.A.

Abstract

The technique of tibial condylar fracture osteosynthesis designed in our institute happened to be effective for urgent surgery in 30 consecutive patients with using relatively cheap plates of domestic production. We met no residual deformities, nonunions, marked joint stiffness, deep infection or blood transfusions. Two patients had migrations of pins used for additional fixation of comminuted impression. Pins were removed in outpatient department. Urgent osteosynthesis of tibial condylar fractures made favorable background for surgery and wound healing which allowed to discharge patients from hospital at 5–9-th day. Shortening of hospital stay was quite safe for patient and positively appreciated by insurance companies.

Traumatology and Orthopedics of Russia. 2011;17(1):87-91
pages 87-91 views

TREATMENT OF LOCAL DEEP DEFECT OF A KNEE JOINT CARTILAGE COMBINED WITH I STAGE MEDIAL GONARTHROSIS AND VARUS DEFORMATION OF THE LOWER EXTREMITY

Kulyaba T.A., Bryanskaya A.I., Kornilov N.N., Selin A.V.

Abstract

The authors presented one case of combination high tibia osteotomy with mosaic osteochondral autoplasty for the treatmentof the patients suffering from local full thickness cartilage defects of femur condyle and early degenerative changes in the same knee compartment. The positive intermediate results were achieved in this case. The correction of mechanical overload of the damaged knee compartment creates favorable conditions for cartilage restoration and slows down osteoarthrosis progression.

Traumatology and Orthopedics of Russia. 2011;17(1):92-95
pages 92-95 views

THE ANALYSIS OF RESULTS OF TREATMENT A SHOULDER PRIMARY TRAUMATIC DISLOCATION

Matveev R.P., Aslanov V.A.

Abstract

The analysis of results of treatment a primary traumatic dislocation of a shoulder in 36 patients is carried out. The significant amount of adverse results was revealed that testifies to necessity of change of a technique of treatment this pathology, especially in patients of elderly age.

Traumatology and Orthopedics of Russia. 2011;17(1):96-100
pages 96-100 views

THE ENDO-EXO-FEMORAL PROSTHESIS

Aschoff H.

Abstract

Patients with above knee amputation (AKA) face many challenges to mobility including difficulty with socket fit and fatigue due to high energy consumption. The aim of the Endo-Exo-Femur Prosthesis (EEFP) is to avoid problems at the interface between the sleeve of the socket-prosthesis and the soft tissue coat of the femur stump which often impedes an inconspicuous and harmonic gait. In 1999 we began using a transcutaneous, press-fit distal femoral intramedullary device whose most distal external aspect serves as a hard point for AKA prosthesis attachment. The bone guided prosthesis enables an advanced gait via osseoperception and leads to a decreased oxygen consumption of the patient. Thirty two patients underwent the procedure between 1999 and 2008. Their indication for surgery was persistent AKA prosthesis difficulties with a history of AKA for trauma. The paper presents the patient data regarding the design of the implant, the operative procedure, patient satisfaction, gait analysis and oxygen consumption.

Traumatology and Orthopedics of Russia. 2011;17(1):101-105
pages 101-105 views

METHODS OF EXAMINATIONS

A COMPLEX MONITORING OF OSTEOGENESIS OF THE DISTRACTION REGENERATE IN CHILDREN WITH THE SEQUELAE OF HEMATOGENOUS OSTEOMYELITIS IN LOWER LIMB LENGTHENING

Garkavenko Y.E., Yanakova O.M., Bergaliev A.N.

Abstract

With the help of X-ray, radionuclide and ultrasonographic examinations in children with sequelae of hematogenous osteomyelitis, the formation of the distraction regenerate was studied. Preservation of potency to the normal osteogenesis was observed. Formation of the osseous regenerate was accompanied by an active total blood flow and accumulation of radionuclides. Some retardation of bone formation after 2,5–3,0 months due to loss of compensatory capacity of the vascular bed during distraction and as a consequence of slowing the processes of tissue metabolism in the regenerate were observed.

Traumatology and Orthopedics of Russia. 2011;17(1):106-111
pages 106-111 views

HIP JOINT PATHOLOGY IN THE NEONATAL PERIOD

Baindurashvili A.G., Chukhraeva I.Y.

Abstract

The frequency of developmental hip dysplasia among newborns and its change with ultrasound application are presented. The ultrasound estimation of coxofemoral joints in children of the first days of life is resulted and the analysis of conformity of the clinical and ultrasonic data is carried out. The tactical algorithm of screening and monitoring of coxofemoral joints is offered.

Traumatology and Orthopedics of Russia. 2011;17(1):112-116
pages 112-116 views

MODERN TECHNOLOGIES IN TRAUMATOLOGY AND ORTHOPEDICS

PLATE OSTEOSYNTHESIS OF DISTAL HUMERAL SHAFT FRACTURES

Litvinov I.I., Klyuchevsky V.V., Ryzhkin A.A.

Abstract

On the basis of three-dimensional analysis of the humerus bones was shown that the plate, placed on posterior-and-medial surface of the lower section of these bones, should be twisted in terminal portions and bended on both ends in the contact surface direction and should have an intermediate untwist sector. The results among 31 operatively treated patients with 32 distal third diaphyseal fractures of the humerus were analyzed. Was stated that the modified osteosynthesis of distal third diaphyseal fractures of the humerus associates with lower risk of iatrogenic damage it, provides fixation stability and significantly better outcomes (Students criterion – 2,7), which allows to use that method of internal fixation in cases where the performance of intramedullary nailig is not possible.

Traumatology and Orthopedics of Russia. 2011;17(1):117-120
pages 117-120 views

RATIO OF SURGICAL CORRECTION SPINAL CANAL WITH INJURIES AND DEGENERATIVE SPINE DISEASES

Shchedrenok V.V., Orlov S.V., Sebelev K.I., Anikeev N.V., Moguchaya O.V., Sovakov I.A., Tyulkin O.N., Chizhova M.V.

Abstract

Ratio of surgical correction spinal canal during injury and illness was suggested. At SCT and MRI in the sagittal projection of the measured diameter of the cross-section of the spinal canal at the site of maximum narrowing (d2), in the overlying (d1) and underlying (d3) levels, we calculated the coefficient of stenosis (Kst): Kst = 1 – 2d22: (d12 + d32). After surgery, surgical correction factor was determined (KK): KK = 1 – Kst2: Kst1, where Kst1 – coefficient of stenosis before surgery, Kst2 – after the operation. Surgical correction was considered unsatisfactory by KK < 0,4.

Traumatology and Orthopedics of Russia. 2011;17(1):121-124
pages 121-124 views

THE METHOD OF KNEE JOINT ARTHRODESIS

Fedorov V.G.

Abstract

The usage of bone plastics by cylindrical autotransplant in cases of posttraumatic changes of knee joint is described. Knee joint arthrodesis is supposed to be used as alternate in term of replacement impossibility (for example, high-grade deformity, the age (osteoporosis), concomitant diseases that can lead to complicate operation).

Traumatology and Orthopedics of Russia. 2011;17(1):125-127
pages 125-127 views

TRAUMA AND ORTHOPEDIC CARE

FREQUENCY AND TRENDS IN THE MUSCULOSKELETAL SYSTEM MORBIDITY AMONG RESIDENTS OF THE CHUVASH REPUBLIC

Nikolaev N.S., Shapiro K.I., Barieva V.E.

Abstract

The comparative assessment of indexes of musculoskeletal system and connective tissue diseases incidence in the Chuvash Republic in the period from 1999 to 2009 based on the data of state statistical observation and selective targeted clinical examination of the population is presented. The needs of the population in trauma and orthopedic care and priorities for the development of specialized service are defined.

Traumatology and Orthopedics of Russia. 2011;17(1):132-137
pages 132-137 views

ДЛЯ ПРАКТИЧЕСКИХ ВРАЧЕЙ

SPECIFICITY OF ANTICOAGULANT CHOICE FOR VTE PROPHYLAXES AFTER MAJOR ORTHOPEDIC SURGERY- THE VIEW OF CLINICAL PHARMACOLOGISTS

Bozhkova S.A.

Abstract

The issue of development of venous thrombosis and embolism still remains a serious problem in the traumatology and orthopedics. To maintain a balance between efficacy of thromboprophylaxis and the risk of serious bleeding in special patient groups the authors encourage to undertake the choice of anticoagulant on an individual basis taking into account the patient's weight, as his liver and kidneys, the duration of prophylaxis course, the possibility of laboratory monitoring of coagulation parameters after discharge from hospital. The authors analyze the possibility of the use of new oral anticoagulants in patients after hip or knee arthroplasty.

Traumatology and Orthopedics of Russia. 2011;17(1):138-143
pages 138-143 views

REVIEWS

ANKLE JOINT REPLACEMENT (REVIEW)

Stoyanov A.V., Emelyanov V.G., Pliev D.G., Mikhaylov K.S.

Abstract

Ankle joint replacement remains the most promising but at the same time one of the most challenging fields of orthopedics. In this article the authors analyzed the history of ankle joint replacement development with meticulous details of the prosthesis structure as well as complications occurring with different generations of the prosthesis. Major tendencies of development and improvements of the prosthesis are described while taking into account the complicated biomechanics of the ankle joint. Based on the completed analysis the conclusion was made that using new materials in combination with improved structure allows for major improvements in the ankle joint replacement.

Traumatology and Orthopedics of Russia. 2011;17(1):144-152
pages 144-152 views

REVISION TOTAL HIP ARTHROPLASTY IN PATIENTS WITH ASEPTIC LOOSENING OF FEMORAL STEM (REVIEW)

Sementkovsky A.V.

Abstract

The paper presents literature data with regard to the classification of femoral bone loss defects. It also describes the contemporary techniques of revision total hip arthroplasty in patients with aseptic loosening of the femoral component and provides the evaluation of the treatment outcomes of the described approaches.

Traumatology and Orthopedics of Russia. 2011;17(1):153-159
pages 153-159 views

HISTORY OF MEDICINE

LORENZ BÖHLER (1885–1973)

Bashurov Z.K.

Abstract

The detailed biography of the famous Austrian scientist and surgeon Lorenz B hler ia presented, his contribution to the development of modern traumatology is opened.

Traumatology and Orthopedics of Russia. 2011;17(1):160-162
pages 160-162 views

MEMORIAL DATES

Georgy D. Nikitin

Abstract

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Traumatology and Orthopedics of Russia. 2011;17(1):163-164
pages 163-164 views

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