Vol 16, No 1 (2010)
- Year: 2010
- Published: 12.05.2010
- Articles: 36
- URL: https://journal.rniito.org/jour/issue/view/28
- DOI: https://doi.org/10.21823/2311-2905-2010-0-1
Full Issue
Clinical studies
FEATURES OF USING EXTERNAL AND SEQUENTIAL OSTEOSYNTHESIS IN CASUALITIES WITH GUNSHOT FRACTURES OF LONG BONES
Abstract
In article the special features and the stage-treatment results of two groups of casualties with long bone gunshot fractures analysis have shown. In first group the casualties were treated by external ostheosynthesis (145 cases) and in second group the last ones were treated by the sequential two-step ostheosynthesis (29 cases) on medical evacuation stages. The two-step ostheosynthesis method supposed the external fixating device dismounting after the wound healing and further executing of subsequent internal ostheosynthesis by plates. The investigations have shown that proposed sequential ostheosynthesis technique allows to reliably reduce the average consolidation terms of wounded patients for about 19-26% accordingly to injured segment. The sequential ostheosynthesis technique indications were specified and its suitability was also proved for the second and third echelons of specialized orthopedic medical stages.
Traumatology and Orthopedics of Russia. 2010;16(1):7-13
7-13
OSTEOSYNTHESIS OF THE SPINE AT PATHOLOGICAL FRACTURES AGAINST THE BACKGROUND OF EXTENSIVE METASTATIC SPREAD IN COMBINATION WITH RADIO- AND CHEMOTHERAPY
Abstract
The results of the stabilizing spine osteosynthesis in 82 patients with extensive metastatic spread are presented. Patients have been distributed to 3 groups: in I group the extended osteosynthesis of a spine without application cement vertebroplasty was carried out, in II group the extended spine osteosynthesis was performed, but with performance vertebroplasty through cannulated screws, in III group the limited osteosynthesis with cement vertebroplasty through cannulas screws was applied. Results of treatment were estimated considering spine support ability, elimination of a painful syndrome (scale of pain McAfee, 1989) and neurologic dysfunctions (scale ASIA/IMSOP, 1992), improvement of quality of a life (scale SF-36). The received positive results of treatment allow to conclude that tactics of treatment has been chosen correctly.
Traumatology and Orthopedics of Russia. 2010;16(1):14-20
14-20
THE CORRECTION OF HALLUX VARUS DEFORMITY IN CONSEQUENCE OF SURGICAL TREATMENT FOR HALLUX VALGUS
Abstract
The analysis of treatment of 21 patients (24 feet) with postoperative hallux varus deformity which have arisen after operations apropos hallux valgus is carried out. For correction of vicious position of the first finger we successfully carried out the Brandes procedure, sometimes in a combination to operations on sinews of muscles of the first finger - an adductor hallucis tendotomy and/or lengthening of the extensor hallucis longus tendon.
Traumatology and Orthopedics of Russia. 2010;16(1):21-27
21-27
BIOGLASSERAMICS IN THE SURGERY OF TUBERCULOSIS OF BONES AND JOINTS
Abstract
The experiment had proved compatibility of biosytall and bone tissue in the conditions of tuberculous inflammation. Clinical researches show the positive effect of usage of biosytall in combination with native bone in the radical surgery in case of tuberculosis of bones and joints, which consisted in surgery time saving, reduction of operational and postoperational bleeding, with the same amount of positive results in the screening group.
Traumatology and Orthopedics of Russia. 2010;16(1):28-32
28-32
OPEN FRACTURE WOUND MICROFLORA RESISTANCE TO ANTIBIOTICS (II REPORT)
Abstract
The study demonstrates the analysis of resistance to antibiotics of clinically common strains of microorganisms that were isolated from open fracture wounds in the patients admitted to our clinic within the period of 2006-2008. It was found that gram-positive bacteria feature a significantly restrained growth of resistance to universally used antibiotics. The increase in numbers of MRSA and MRSE stains was revealed. Enterococci feature a linear growth of resistant stains to most studied antibiotics. Gram-negative bacteria showed an increase in resistance to cephalosporins of generation III-IV. Most strains of non-fermenting bacteria (Pseudomonas, Acinetobacter) were sensitive to amikacin and imipenem.
Traumatology and Orthopedics of Russia. 2010;16(1):33-37
33-37
EXAMINATION RESULTS OF CHILDREN WITH CERVICAL SYNDROME
Abstract
By the example of examination of 80 children aged from 4 to 18 with cervical syndrome it is indicated, that the diagnosed abnormalities of hemodynamics in vertebrobasilar basin in patients of all age groups are connected both with bone and vascular pathology of the cervical part of the spine. The pathology has functional or congenital character. Early detection of discicirculatory vascular injuries in the cervical part of the spine in children with cervical syndrome will allow to define the therapeutic management of patients and to prolong juvenile osteochondrosis clinical behaviour.
Traumatology and Orthopedics of Russia. 2010;16(1):38-42
38-42
ANESTHESIA FOR MICROSURGICAL AUTOTRANSPLANTATION OF TOES ON THE WRIST IN CHILDREN WITH CONGENITAL AND POSTTRAUMATIC PATHOLOGY
Abstract
Intraoperative combination of monolateral spinal anesthesia and prolonged brachial plexus block is evaluated in 65 children with autotransplantation of fingers from foot to hand. Variability of heart rhythm demonstrated autonomous stability in the main group. Dynamical study of skin temperature and dopplerographic evaluation demonstrated local sympatholysis in the blocked extremity. Significant improvement of circulation and quality of analgesia is revealed in case of prolonged perineural use of local anesthetics in the postoperative period. Described combination of intra- and postoperative treatment of such patients makes complex treatment more effective.
Traumatology and Orthopedics of Russia. 2010;16(1):43-47
43-47
Theoretical and experimental studies
HIERARCHIC SKELETAL ORGANIZATION - A FACTOR REGULATING THE STRUCTURE OF FATIGUE INJURIES. PART II. HYPOTHETICAL MODEL OF FORMATION AND DISTRUPTION OF BONDS BETWEEN CRYSTALLITE ASSOCIATIONS
Abstract
The authors discuss the questions concerning local structural-temporal changes in skeletal mineralization degree, local hyper-mineralization, the role of the spatial gradient of skeletal mineralization in forces distribution during locomotion, microstructural distribution of crystallite associations, ultrastructural mineral matrix transformation in the process of its formation. Hypothetical mechanisms of joining crystallite associations into a unified mineral complex are suggested; a hypothetical spatial structure of junction formation between the nearest crystallite associations is described, as well as a supposed schema of mineral massif destruction and restoration of disrupted connections.
Traumatology and Orthopedics of Russia. 2010;16(1):48-57
48-57
Reviews
CONTEMPORARY VIEW ON COMPUTER NAVIGATION USING AT PRIMARY KNEE TOTAL REPLACEMENT (REVIEW)
Abstract
The topical questions of optical computer navigation at knee total arthroplasty are widely covered. The indications, contraindication to use, using features and possible complications of this technique are listed. The analysis of literature data makes it clear that computer navigation assists in the accuracy of endoprosthesis implantation that may to decrease the rate of revision surgeries in future.
Traumatology and Orthopedics of Russia. 2010;16(1):115-123
115-123
DIAGNOSTICS AND TREATMENT OF SPASTIC HAND IN CHILDREN WITH INFANTILE CEREBRAL PARALYSIS: THE REVIEW. PART 1. THE ASSESSMENT OF UPPER EXTREMITY STATE
Abstract
World literature disembodied data about methods of observation of upper extremity in children with infantile cerebral paralysis are elucidated and systematized in this article. The most essential research and clinical technique are described and analyzed, namely: clinical examination, the assessment of spasticity, functionality and sensibility of spastic hand, electromyography, radiography and intelligence assessment. The most often used classifications are presented.
Traumatology and Orthopedics of Russia. 2010;16(1):124-130
124-130
Experience exchange
SOME TECHNICAL DIFFICULTIES AND WAYS OF THEIR OVERCOMING DURING VERTEBROPLASTY DEVELOPMENT
Abstract
Vertebroplasty was performed in 8 women in the age of from 43 till 80 years. The indication to intervention in one case was metastatic involvement, in four cases - osteoporotic vertebral fractures; to three patients vertebroplasty was performed in occasion of vertebral body gemangioma. The results of this study revealed, that for increase of safety the authors recommend to carry out the vertebroplasty under local anesthesia at presence of an anesthesiologist for possible additional intravenous anesthesia. The safest from the point of view of extravertebral distributions of cement is transpedicular access; flebospondylography does not allow predicting reliably distribution of cement in view of significant distinction of physical and chemical properties of entered substances however can be used for a tentative estimation of venous outflow at tumor process in vertebral bodies.
Traumatology and Orthopedics of Russia. 2010;16(1):68-70
68-70
TREATMENT OF INTRA-ATICULAR FRACTURES OF THE PROXIMAL SEGMENT OF THE TIBIA
Abstract
The experience of treatment of patients with intra-articular fractures of proximal segment of the tibia is presented. For improvement of diagnostics the body section radiography was used. Conservative methods were applied in 146 patients, surgical - in 202. The best results were achieved on application of dampening skeletal traction - 88,2%.
Traumatology and Orthopedics of Russia. 2010;16(1):71-74
71-74
MANAGEMENT OF ATYPICAL CLUBFOOT BY PONSETI METHOD
Abstract
From May 2006 to August 2009 analyzed 28 clinical observations (34 feet) for children aged from 7 days to 1.5 years with severe atypical congenital clubfoot (Pirani 5,6 points), treated by the method of I. Ponseti. The average number of gypsum one foot to the full correction was - 6.3. It was written 38 achillotomy. Dates from the beginning of gypsum to achillotomy averaged - 34 days. All of the children undergoing treatment with us after the removal of plaster, dressed brace, fixing the foot fixed in position 45° abduction and 15° of flexion of the back and encouraged them to carry up to 3-4 years. All the children in this group achieved a complete correction of foot deformities without performing tenoligamentocapsulotomy. Results of treatment were evaluated according to the classification C. Pirani. Average score was 1.1 points. Follow-up was an average of 1 year 35 days.
Traumatology and Orthopedics of Russia. 2010;16(1):75-79
75-79
REHABILITATION OF CHILDREN WITH CICATRICIAL CONSEQUENCES OF BURNS: FEATURES, ERRORS, POSSIBLE SOLUTIONS
Abstract
Late results of treatment of thermal injury and its sequelae are presented. According the data obtained, the most severe deformities developing after a thermal injury are the flexion contractures of fingers. The results of the study are evidence of a cardinal importance of an appropriate immobilization of the affected segments and of early functional rehabilitation for prevention of contractures development. Without dynamic keeping the children under observation, secondary skeletal deformities develop which are changes in form of bones and their hypoplasia. This enhances the number and volume of reconstructive procedures needed as well as deteriorates the final outcome of the treatment.
Traumatology and Orthopedics of Russia. 2010;16(1):80-84
80-84
POSTTRAUMATIC MYOCARDIAL SYNDROME IN CHILDREN WITH VERTEBRAL COMPRESSION FRACTURES
Abstract
Complex clinical and instrumental observation of the children with vertebral compression fractures (VCF) revealed pathological changes in the heart. Clinical symptomatology, confirmed by electrocardiogram and appropriate anamnesis gives opportunity to consider this fact as a posttraumatic myocardial syndrome. Special drug therapy resulted in the positive dynamics.
Traumatology and Orthopedics of Russia. 2010;16(1):85-88
85-88
Modern technologies in traumatology and orthopedics
A NEW METHOD OF SINGLE-STAGE ISLAND PLASTY BY TWO BONE AUTOGRAFTS WITH BLOOD SUPPLY IN PATIENTS WITH PSEUDOARTHROSIS OF BOTH FOREARM BONES
Abstract
The applied topographic-anatomic studies prepared in 14 fixed and 16 unfixed preparations of upper extremity allowed to precise the details of radius blood supply with reference to possibilities of formation of bone autografts with blood supply. Due to this fact the novel method of single-stage bone plasty for pseudoarthrosis of both forearm bones was developed and successfully approved in clinic. This method proposes the formation of two periosteal-cortical grafts with blood supply and small muscle cuff in distal and middle one-thirds of radius simultaneously.
Traumatology and Orthopedics of Russia. 2010;16(1):89-93
89-93
THE METHOD OF TREATMENT OF PATIENTS WITH NONUNIONS AND GUNSHOT PSEUDOARTHROSIS OF LONG BONE OF EXTREMITIES
Abstract
Developed by the authors the method of treatment for nonunions and pseudoarthrosis of extremities long bones is described. It consist in mini-invasive preparation of interfragmentary space and bone grafting with cancellous graft from the wing of ilium. Successful use this method in 23 patients with gunshot wounds of humeral, forearm, femur and shin bones allows to recommend it for wide application. Suggested method of surgical treatment can be used not only after gunshot wounds, but after long bones fractures of another genesis.
Traumatology and Orthopedics of Russia. 2010;16(1):94-98
94-98
BONE-CUTTING METHOD OF ANKLE ARTHRODESIS
Abstract
The experience of bone plasty by cylindrical auto-transplants in patients with posttraumatic ankle diseases are describes. Effectiveness of developed method was demonstrated by successful use in patients with deforming arthritis and fibrous alkalosis of ankle.
Traumatology and Orthopedics of Russia. 2010;16(1):99-101
99-101
Trauma and orthopedic care
THE RESULTS OF EXAMINATION OF MEDICAL CARE QUALITY FOR ASSOCIATED VERTEBRO-SPINAL-CORD INJURY
Abstract
Medical care quality assessment for patients with vertebro-spinal-cord injury at different stages in St.-Petersburg during year was performed. The first aid in the most cases (74,8%) was rendered by emergency service. A vertebro-spinal-cord injuries were not diagnosed by a staff of line and special medical aid brigades in 31,6-51,9%. The causes of incorrect diagnostics at hospital stage: insufficient and delayed patient examination, underestimation of injury severity in consequence of delayed use of neuro-imaging methods. Surgical operations for vertebro-spinal-cord injuries were performed in 59 (8%) cases. 43 (73%) patients needed in vertebral fixation.
Traumatology and Orthopedics of Russia. 2010;16(1):102-105
102-105
THE DYNAMICS OF THE MAIN MORTALITY RATES BY REASON OF TRAUMAS AND EXTERNAL CAUSES OF DEATH IN SAINT-PETERSBURG (TOTALS OF MONITORING FROM 1976 TILL 2008)
Abstract
On the basis of statistical findings, received by monitoring of levels of mortality happened as the result of injuries, poisonings and other external causes in adult population of Leningrad-St-Petersburg, the analysis of dynamics of main death level indices was done. The article introduces with basic findings gained in long term investigation. The level of mortality happened as the result of injuries, poisonings and other external causes for better obviousness was calculated separately for each age and for each causal group.
Traumatology and Orthopedics of Russia. 2010;16(1):106-114
106-114
METHODS OF EXAMINATIONS
MAGNETIC RESONANCE IMAGING FOR TRIQUETROUS FIBROCARTILAGE COMPLEX DAMAGES AT WRIST JOINT INJURIES
Abstract
A brief review of the literature on normal anatomy and pathological changes of trihedral fibro-cartilage complex of wrist. The authors described in detail a method of wrist MRI, MR-image of normal and damaged articular disk, considered possible variants for his injuries. The results of MRI of wrist in 110 people including 40 patients with suspected damage were analyzed. At present MRI is the only available non-invasive method for diagnosing injuries of intraarticular structures, in particular trihedral fibro-cartilage complex.
Traumatology and Orthopedics of Russia. 2010;16(1):58-61
58-61
CAPABILITIES OF COMPLEX SONOGRAPHIC IMAGING FOR BENIGN SOFT TISSUE TUMORS OF FOOT AND ANKLE
Abstract
The article presents the results of the complex ultrasound examination for 49 patients with benign soft tissue tumors of the foot and ankle. Ultrasound findings of benign tumors have been compared and systematized taking into account their morphological patterns at the additional use of dopplerography. High diagnostic efficiency of this complex ultrasound examination has been shown.
Traumatology and Orthopedics of Russia. 2010;16(1):62-67
62-67
Anniversaries
131-132
133-134
Obituaries
135-136
MATERIALS OF THE SCIENTIFIC AND PRACTICAL CONFERENCE
138
137
THE MORPHOLOGICAL FEATURES OF VARIANTS OF GIANT CELL TUMOR STRUCTURE
Abstract
The morphological criteria of giant cell tumor and the different ways of the run of the disease were designated as the result of collation between the histopathologic feature with the clinicoradiographic dates and the long-term results of treatment of 101 of patients. These findings promote a better collaboration of pathologist and surgeons. In future these results could be used for creating an algorithm of determination of the surgery extent and treatment approach.
Traumatology and Orthopedics of Russia. 2010;16(1):139-145
139-145
EXPERIMENTAL ESTIMATION OF THE DEMINERALIZED BONE ALLOGRAFTS MADE BY TECHNOLOGY OF CITO
Abstract
Research is devoted an experimental estimation of osteoinductive properties of demineralized bone implants (DBA) made on technology CITO with use of lyophilization and radiating sterilization by stream of fast electrons. As experimental animals, white rats on ectopic osteogenesis model for a period of 40 days and rabbits to which DBA implanted into defect of the jaw with terms of experiment 10, 20, 30, 60 and 90 days have been chosen. Results of morphological researches testified to absence of toxicity, presence of high indicators of biointegration and osteoinductance studied DBA. The offered technology of processing of a bone tissue allows to keep biological activity of tissues and to receive biological materials with the expressed plastic properties. Obtained among other data were the bases for the decision of use of these materials in clinic of different bone pathologies.
Traumatology and Orthopedics of Russia. 2010;16(1):146-149
146-149
THE NEW PLASTIC METHOD OF ARTICULAR HYALINE CARTILAGE DEFECTS WITH COMBINED CELLULAR-TISSUE GRAFT
Abstract
The new method of restoration of injured articular cartilage using plasty of intraoperative bone-cartilage defects with combined allograft based on biologic porous carrier and cell culture from stroma of costal cartilage. The transplantation of allogenic culture of chondroblast cells on demineralized spongy substance «Lioplast» ensure еру the formation of hyaline cartilage tissue on the site of defect and amplified development of microcirculatory network in subchondral bone. The heterotopic principle obtaining cellular material allows to perform low-traumatic operations.
Traumatology and Orthopedics of Russia. 2010;16(1):150-155
150-155
THE MORPHOMETRIC ASSESSMENT OF CHEMOTHERAPY EFFICACY IN PATIENTS WITH OSTEOGENIC SARCOMA
Abstract
Postoperative materials of 31 patients with osteosarcoma after radical resection of bone segment were studied. The low efficacy of preoperative chemotherapy of osteogenous sarcoma was revealed in 58,1% that testifies to the need of retrieval of new combined and complex methods of treatment this pathology. The histomorphometric results of tumor regress gave occasion to delivery of tactics of further postoperative treatment with or without chematherapeutic agents.
Traumatology and Orthopedics of Russia. 2010;16(1):156-159
156-159
THE PART OF PATHOMORPHOLOGIC STUDY IN SURGICAL TREATMENT PLANNING AT METASTATIC BONE TUMORS
Abstract
The pathomorphologic study is the key examination in the therapy planning of patients with metastatic bone tumors. Since 1994 till 2009 424 patients with this pathology were treated in RRITO n.a. R. Vreden. The authors give clinical example showing the influence of pathomorphologic study results on the sequence of stages of complex treatment of patients with malignant tumors.
Traumatology and Orthopedics of Russia. 2010;16(1):160-164
160-164
EXPERIMENTAL STUDY OF OSTEOINTERGRATION OF SYNTHETIC MATERIAL POLYTETRAFLUOROETHYLENE IMPLANTED IN BONE
Abstract
The authors presented the results of experimental study devoted the examination of features of synthetic polymer polytetrafluoroethylene (ePTFE) implanted in the bone. It was determined that ePTFE with 70% porosity has the more marked osteointegration and can be recommended for clinical use.
Traumatology and Orthopedics of Russia. 2010;16(1):165-168
165-168
THE EXPERIMENTAL MODEL OF OSTEONECROSIS
Abstract
The experimental investigation for the purpose of modeling of knee osteonecrosis were performed in 36 rats. The chronic renal insufficiency by means of left nephrectomy and electrocoagulation in 25% cortical substance of right kidney was induced before 6 months till experiment with subsequent introduction of 0,1% adrenalin solution and methylprednisolone in paraarticular structures. The results of experiment showed the polyetiologic feature of disease.
Traumatology and Orthopedics of Russia. 2010;16(1):169-171
169-171
COMPARATIVE ASSESSMENT OF MORPHOLOGIC EVOLUTION OF TENDINOUS AND BONE ALLOGRAFTS STERILIZED USING DIFFERENT METHODS
Abstract
The results of longstanding investigations devoted to study of morphologic evolution of tendinous and bone allografts sterilized using methods developed at tissue bank of RRITO n.a. R. Vreden. The experiments were performed in 370 rats and showed high information value of morphological study of biografts and its sufficiency for transplant assessment from the clinical standpoint.
Traumatology and Orthopedics of Russia. 2010;16(1):172-174
172-174
SOME LEGAL AND ORGANIZATION ISSUES OF SAMPLING AND APPLICATION POSTMORTEM TISSUES IN CLINICAL TRANSPLANTOLOGY
Abstract
The legal issues of tissue donation organization in Russian Federation and the part of tissue banks in providing of patient care institution with biological grafts are considered. The differences in activity of services of tissue and organ donation are expounded. The authors discussed the problems of tissue banks financing and possibility of its commercial activity.
Traumatology and Orthopedics of Russia. 2010;16(1):175-178
175-178
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