Vol 22, No 1 (2016)

CLINICAL STUDIES

COHORT STRUCTURE OF PATIENTS WITH PROXIMAL FEMUR FRACTURES AND ESTIMATION OF AVERAGE ANNUAL DEMAND FOR EMERGENCY SURGICAL TREATMENT

Vorontsova T.N., Bogopol’skaya A.S., Cherny A.Z., Shevchenko S.B.

Abstract

The aim of this study is to examine cohort structure of patients with proximal femoral fractures (PFF) and estimate an average annual demand in emergency surgical treatment for St. Petersburg adult population with mentioned diagnosis.
Material and methods. The authors examined case histories and radiographs of 1412 adult patients with proximal femur fractures admitted to three St. Petersburg large general hospitals during one year. Analysis was done using statistical and expert evaluation methods.

Results. Cohort structure of patients with PFF demonstrated the following distribution: female – 71,7%, male – 28,3%; Patients of elderly group prevailed: 70 years and older – 70,6%, 60–69 years old – 12%, 50–59 years old – 10,8%; Retirees with various disability status – 80%. Injury structure showed prevalence of femoral neck fractures –
52%, pertrochanteric fractures represented 42%, subtrochanteric fractures – 5%. 11,3 days was the average time span from injury till surgery. The authors separately estimated urgent surgical treatment demand for patients with femoral neck fractures and patients with trochanteric fractures. Consequently, both groups results were summed up to generate the total average annual demand for emergency operative treatment for PFF which for adult population of St. Petersburg amounted to 4098 interventions, meaning one surgery per one thousand of adults.

Conclusions. Absence of a common consistent approach to treatment of patients with proximal femur fractures as well as significant variance among St. Petersburg hospitals in respect of material, technical and staff resources result in a situation when not every patient with PFF undergoes surgical treatment. There is a strong need to develop and regulate implementation of a standardized treatment algorithm for such injuries, to improve infrastructure and resources of St. Petersburg general hospitals as well as to continuously monitor quality of medical treatment for patients with PFF.

Traumatology and Orthopedics of Russia. 2016;22(1):7-20
pages 7-20 views

SURGICAL DECISION MAKING IN PATIENTS WITH END-STAGE OF ANKLE OSTEOATHRITIS

Mikhaylov K.S., Emelyanov V.G., Tikhilov R.M., Kochish A.Y., Sorokin E.P.

Abstract

Purpose of the study - to validate the selection algorithm of surgical treatment for patients with advance stage of ankle joint deforming arthrosis based on comparative analysis of risk factors for failed cases of fusion and joint replacements. Material and methods. The authors analyzed poor treatment outcomes and reasons therefore after ankle joints fusion and replacement surgeries performed at Vreden Russian Research Institute of Traumatology and Orthopaedics starting 2003 till 2014. First study group included 63 patients who underwent biarticular fusion of ankle and subtalar joint by intramedullary locked nail; second study group included 71 patients after ankle joint replacement using the following implants: Mobility (DePuy) - 27 patients, Hintegra (NewDeal) - 37 and STAR (Waldemar Link) - 7 patients accordingly. Clinical and radiological examination of patients as well as their surveying on pain rating scale and AOFAS scale was carried out in the period starting 6 months to 10 years from surgery. Results. Study results proved that severe deformities of ankle joint bones particularly varus or valgus deformities with angle above 100 preclude the possibility to correctly position the implant components and do not promise long term and successful functional recovery. Thus, fusion of affected joint should be recommended as treatment option to patients with abovementioned heavy deformities of angle joint. Reasonable fusion angles for ankle joint around 90950 in sagittal plane could diminish potential rapid arthrosis progression in midfoot joints. Conclusion. In view of identified risk factors for development of morbid conditions that account for poor surgical outcomes of ankle joint fusion and replacement, basing on own research results and specialized literature data the authors have validated and presented the selection algorithm of surgical treatment options for patients with end stage of deforming arthrosis
Traumatology and Orthopedics of Russia. 2016;22(1):21-32
pages 21-32 views

CLASSIFICATION AND ALGORITHM FOR DIAGNOSIS AND TREATMENT OF HIP PROSTHETIC JOINT INFECTION

Winkler T., Trampuz A., Renz N., Perka C., Bozhkova S.A.

Abstract

Prosthetic joint infection (PJI) is the second common reason for revision surgery of the hip joint prosthesis. The rate of hip PJI is about 1% after primary surgery and it goes up to 4% or higher after revision surgery. In most cases, the main cause of this complication is an intraoperative bacterial contamination, rarer is a haematogenic one. An up-to-date diagnostic approach and clearly defined treatment strategy are required for the successful therapy of PJI. Based on the analysis of the scientific literature and own experience, an algorithm for diagnosis and treatment of this complication is proposed. A thoroughly obtained case history plays a predominant role in the diagnosis of PJI. Lack of the increased serum C-reactive protein cannot be considered as an exclusion criterion because in some cases, especially chronic infection, it can be within the normal range. Bacteriology lab tests of periprosthetic tissue biopsies and synovial fluid is the gold standard for the diagnosis. Novel methods such as ultrasound debridement of the removed prosthetic components have allowed to substantially increase the diagnostic sensitivity of bacteriology tests. This led to the discovery of PJI in some cases which before that were regarded as aseptic loosening. Visualization methods including MRI and scintigraphy play only a secondary role. The authors propose the classification of PJI for further determination of the treatment strategy which takes into account parameters such as biofilm maturity, prosthesis stability, the type of pathogen and soft tissue state for the decision on the treatment strategy. While desire to retain the implant is only justified in case of the immature biofilm, in most cases the infection can be cured only after the replacement of endoprosthesis. According to the proposed algorithm, patients undergo one- or two-stage procedure with a short or long interval. Antibiotics that are active against biofilm pathogens play an important role in the efficacy of the therapy. Selection of these antibiotics should be based on the results of bacteriology tests, preferably in collaboration with specialists in infectious diseases and microbiology.
Traumatology and Orthopedics of Russia. 2016;22(1):33-45
pages 33-45 views

POSSIBILITIES OF THE MINIMALLY INVASIVE SURGERY IN THE TREATMENT OF SEVERE FOREFOOT DEFORMITIES IN THE RHEUMATOID ARTHRITIS PATIENTS

Berezhnoy S.Y.

Abstract

Introduction. Approximately 90% of the rheumatoid arthritis patients present with foot symptoms. Rheumatoid foot is characterized by toe dislocations and chronic wounds due to the corticosteroid treatment. In case of surgical intervention metatarsophalangeal joints excision arthroplasty remains the standard. To perform second through fifth metatarsal head resection extensive transverse plantar or longitudinal dorsal incisions are routinely used. The rate of the wound-healing problems after rheumatoid foot surgeries is 23-45%. The purpose of this study was to demonstrate the possibilities and advantages of the rheumatoid arthritis patients with severe forefoot deformities minimally invasive surgical treatment and to develop mini-invasive approach for central metatarsal heads resection. Material and methods. By the example of 23 rheumatoid arthritis female patients (30 feet) surgical treatment possibilities of percutaneous techniques in severe forefoot deformities correction were demonstrated. The average age of the group was 54.5 years (range, 39 to 72). There were 24 primary surgeries and 6 repeated. Four feet had chronic wounds. Percutaneous techniques were used to correct all the forefoot deformities components but central metatarsal head resections (7 cases). To make them minimally invasive plantar approach has been developed. Surgical technique of the central metatarsal heads resection using proposed approach was presented. Decision-making algorithm for choosing appropriate surgical technique (to perform first metatarsophalangeal arthrodesis with central metatarsal heads resection or joint-preserving surgery) was proposed, including functional test, performed under fluoroscopic control and tricks for the dislocated fifth toe reduction. Results. The mean follow-up was 12 months (range, 3 to 52). The average hospital stay was 1.23 days. No infectious or wound-healing problems were noted. Chronic wounds have healed in four weeks after surgery. Overall, patients were satisfied with the result of the 12 surgical interventions and satisfied with reservations with the result of 18 surgeries. Unsatisfactory results were not noted. Average preoperative AOFAS score was 23.7 points (range, 0 to 34); postoperative 79.2 points (range, 52 to 100), the average AOFAS score increase was 55.5 points. Conclusions. Percutaneous techniques allow correction of nearly all severe forefoot deformities components in rheumatoid arthritis patients, eliminating the need for first and fifth metatarsal head resection and significantly reducing the need for central metatarsal head resection. If central metatarsal head excision is necessary, they can be removed using minimally invasive 2-3 сm plantar approach, proposed by the author, thus reducing the risk of wound-healing complications.
Traumatology and Orthopedics of Russia. 2016;22(1):46-54
pages 46-54 views

AN ATTITUDE OF TRAUMATOLOGISTS-ORTHOPAEDICS TO THE OSTEOPOROSIS PROBLEM IN RUSSIAN FEDERATION AND THEIR PARTICIPATION IN ITS SOLVING

Ivanov S.N., Kochish A.Y., Sannikova E.V., Sudyakova M.Y., Biybolatova K.B.

Abstract

The results of an osteoporosis survey held around 153 traumatologists-orthopaedics are analyzed in this article. The survey aim: the assessment of an awareness level and opinion record among traumatologists-orthopaedics about diagnostics and treatment of osteoporosis and their participation in solving these problems. An executed survey revealed low level of the osteoporosis registration as an independent nosologic unit with individual ICS code. The registration was held barely by 23% of interviewed doctors. Despite the fact that there is a sufficient provision of X-ray densitometers (91% respondents showed) and osteoporosis prophylaxis centers in the regions (75% respondents showed) only 34% patients with diagnosis «osteoporosis» are guided to the X-ray densitometry. According to doctors’ opinions the X-ray radiography appears to be the leading research for osteoporosis diagnostics. The FRAX method is used in a real clinical practice rarely. Due to the doctors’ opinions the following results confirm the necessity of creation of fracture liaison service in our country that would deal with secondary prevention of osteoporotic fractures. This service should mobilize traumatologists-orthopaedics in order to increase the knowledge level of osteoporosis diagnostics and treatment.
Traumatology and Orthopedics of Russia. 2016;22(1):55-64
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TOTAL KNEE ARTHROPLASTY AFTER PROXIMAL TIBIA FRACTURE

Malyshev E.E., Pavlov D.V., Gorbatov R.O.

Abstract

We have analyzed the results of 32 TKA of 32 patients after fractures of the proximal tibia, which were operated in the period from 2011 to 2014. We have used intramedullary stems for tibial component in 28% of cases, CCK implants in 15.6% of cases, metal augments for bone defects in 25%, in 59.4% of cases autologous bone, cementation for minor defects was performed in 68.8% of patients. 12 of 32 (37.5%) operations were performed under the control of computer navigation (Orthopilot). Average KOOS score one year after the operation in subscales was as follows: "pain" - 86.1 (69,4-97,2), "daily physical activity" - 80,8 (57,4-92,6), "symptoms and stiffness "- 67,8 (57,1-85,7)," physical activity in sports"- 30,0 (5,0-70,0)," quality of life "- 50.0 (37,5- 81.3). The average ROM after the operation was as follows: flexion 100 degrees (90-120), extension 0 degrees (0-5), which corresponds to good and excellent results. There was only one case (3.1%) of septic instability, requiring a two-stage revisional surgery by articulating spacer. All the patients after surgery had a significant improvement of joint function and reduction of pain. However, these patients are at risk for postoperative complications and require a special approach when performing arthroplasty. Treatment outcomes are due to the restoration of axial and rotational alignment, normalization of the joint line by the use of augments, elimination of instability in the joint by application of CCK implants.
Traumatology and Orthopedics of Russia. 2016;22(1):65-73
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FUNCTIONAL RECOVERY AFTER MINIMALLY INVASIVE OSTEOSYNTHESIS IN FRACTURES OF THE SHAFT OF THE RADIUS AND ULNA

Chelnokov A.N., Lazarev A.Y., Solomin L.N., Kulesh P.N.

Abstract

Introduction. Closed intramedullary nailing and external fixation are minimally invasive treatment options in radial and ulnar shaft fractures. We found no comparative studies of these methods in the current literature. Objective. A comparative analysis of both methods in radial and ulnar shaft fractures treated by closed intramedullary nailing and external fixation. Material and methods. 63 patients with forearm shaft fractures treated by closed intramedullary nailing (group I); 24 patients treated by external fixation (group II). All patients were operated within 30 days after injury. Postoperatively, all patients were evaluated clinically (range of motion of elbow and wrist, rotation of the forearm) and radiologically. Disability of the Arm, Shoulder and Hand (DASH) score was used to assess the functional status and quality of life. Results. The average time of radiological bone union in the group I and group II was 12,6 ± 1,4 weeks. and 12,7 ± 0,6 weeks, accordingly. Statistically significant differences in range of motion in the elbow and wrist occurred in 1 month after the surgery with the advantage in Group I. Restoration of rotation was faster in Group I up to 1 year after surgery. DASH scores in 2 month after the surgery were 11,2±1,96 in the nailing group (as in healthy population) and 45,2±6,7 in the external fixation group. In 6 months after surgery the subjective assessment of the quality of life did not differ in both groups. Conclusion. Both minimally invasive methods of surgical stabilization provide restoration of anatomy of the forearm and complete functional recovery in final outcome, but closed intramedullary nailing results with significantly more rapid restoration of range of motions and quality of life measures.
Traumatology and Orthopedics of Russia. 2016;22(1):74-84
pages 74-84 views

CORRELATION BETWEEN TUNNEL POSITION ACCORDING TO RADIOLOGICAL DATA AFTER ACL RECONSTRUCTION, SURGEON’S TUNNEL ESTIMATION DURING SURGERY AND ANTROPOMETRIC CHARACTERISTICS OF THE PATIENT

Korolev A.V., Magnitskaya N.E., Ryazantsev M.S., Pilipson Z.Y., Khashanshin M.M., Il’yin D.O.

Abstract

Purpose - to assess the correlation between tunnel position according to radiological data after ACL reconstruction and surgeon’s estimation during surgery. Material and methods. The study included 86 patients who underwent primary ACL reconstruction with the same surgeon and surgical technique in European Clinic of Sports Traumatology and Orthopedics between 2013 and 2015. In all cases hamstring autograft was used and patients received coronal and sagittal radiographs on the first day after surgery. Surgical data on tunnel position were obtained directly from the OR as dictated by the performing surgeon and fixed in the special registry. Radiological data were exported to eFilm, Merge Healthcare software for graphical analysis. Results. The study group included 54 male and 32 female patients, mean age 35.2 ±1,13, range from 17 to 56 years. Analysis of surgical data showed the median femoral tunnel angle on coronal plane to be 45° (IQR 45° - 60°), angle which occurred most often was 45°, median tibial tunnel angle on coronal plane appeared to be 30° (IQR 30° -35°), angle which occurred most often was 30°. According to radiological coronal plane data median femoral tunnel angle accounted 32° (IQR 28° -36°), angle which occurred most often was 35°, while median tibial tunnel angle accounted 20° (IQR 17-25°,) angle which occurred most often was 19°. Coronal plane mean tibial plateau width was 90,2±,1,1mm with tibial tunnel center located on the 48.55% from the medial side. Sagittal plane mean tibial plateau depth was 53,8 ± 0,6 mm with tibial tunnel center located on the 43.95% from the ventral side. Median tibial plateau posterior slope on the sagittal plane accounted 8° (IQR 6°-9°). Conclusion. Tunnel placement during arthroscopic ACL reconstruction could hardly be standardized. Anthropometric differences between patients can lead to different bone tunnel positions even if the procedure is performed by the same surgeon and surgical technique.
Traumatology and Orthopedics of Russia. 2016;22(1):85-95
pages 85-95 views

THE CLINICAL EFFICACY OF SCIATIC NERVE BLOCK BY LATERAL APPROACH FOR THE OSTEOSYNTHESIS OF FRACTURES LEG AND FOOT

Shapovalov A.A.

Abstract

BACKGROUND. For sciatic nerve blockade using the rear, front and lithotomy accesses. Wide application of these approaches in the clinic hinder the necessity of a certain body position, technical difficulty, high failure rates and complications. The aim of the study was to evaluate the clinical efficacy of blockade sciatic nerve lateral approach at osteosynthesis of bone fractures leg and foot. METHODS: 110 patients with fractures of the lower legs or feet were enrolled in our study. Patients were randomly allocated into two groups. Blockade of sciatic nerve in the first group (n = 68) was performed from a lateral approach, the second group (n = 42) - from the anterior approach. In both groups, the manipulation using ultrasound guided and neurostimulation was performed. A fixed the execution of blockade, its success, intensity of pain, hemodynamic monitoring, acute stress markers, and drug load on the system analgesia. RESULTS: The duration of performance of the blockade in the first group was 2,36 ± 0,1 min, the second group - 4,67 ± 0,2 min (P <0.05). It was unsuccessful blockade in the first group in 2 (2.9%) patients in the second group - in 6 (14.3%) patients (P <0.05). The blockade of the sciatic nerve structures protects the central nervous system from of operative stress. The intensity of pain during the operation and two days of the postoperative period in patients in the first group was significantly (P <0.001) lower than a second group. In postoperative period dose of ketoprofen was in the first group - 23,5 ± 0 5 mg, in the second group - 114,3 ± 12,8 mg (P <0.001), the administration of promedol was shown in 3 (4.4%) and in 9 (21.4%) patients (P <0.001), respectively. Complications were found in the first group in 3 (4.4%) patients in the second group - in 9 (21.4%) patients (P <0.001). CONCLUSIONS: The blockade of the sciatic nerve lateral approach at osteosynthesis of fractures of the lower leg and foot is a simple process, eliminates the special placement of the patient, safe and efficient.
Traumatology and Orthopedics of Russia. 2016;22(1):96-99
pages 96-99 views

THEORETICAL AND EXPERIMENTAL STUDIES

EXPERIMENTAL ANALYSIS OF THE HEALING PROCESS IN THE AREA OF TIBIAL BONE FRACTURE

Аkhtyamov I.F., Shakirova F.V., Klushkina Y.A., Baklanova D.A., Gatina E.B., Aliev E.I.

Abstract

Purpose. To quantify the density of the cortical bone of the tibia in the area of reparative regeneration and the state of the vascular bed (hemodynamics) of the operated limb under intramedullary osteosynthesis using pins coated with titanium and hafnium nitrides. Materials and methods. In the experiment, changes in the bone density and the characteristics of the local blood supply were studied on 40 outbred rabbits which underwent intramedullary osteosynthesis by the use of pins with a nanocoating based on superhard compounds which consist of titanium and hafnium nitrides and pins without a coating. Using color Doppler mode helped to evaluate the condition of the vascular bed proximally to the fracture site. Results. It is noted that the use of pins with the described coating above did not violate the osteoregeneration staging. The density of the cortical bone in the test group exceeded that of the comparison group by an average of 30%. Bone remodeling processes in the test group completed at an earlier date, as determined by the higher rates of its density. In the study of the vascular bed of the operated limb, it was found that on the 10th day of the experiment, an increase in the maximal velocity of the blood flow was recorded (TAMAX). In animals of the test group this index approached preoperative values on the 30th day, while in animals of the comparison group this index approached the initial values only by the 60th day. Conclusion. The use of implants coated with titanium and hafnium nitrides which are characterized by high strength, thermal and chemical stability is accompanied by the formation of a cortical bone in the area of osteotomy with higher density characteristics. The changes which are typical of the vasodilatation in the area of injury in the early postoperative period can be regarded as a positive factor in the formation of primary bone union. In the group where implants coated with titanium and hafnium nitrides were used, the return of the parameters to the values of intact bone occurred at an earlier date than in the group with uncoated implants.
Traumatology and Orthopedics of Russia. 2016;22(1):100-107
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CASE REPORTS

USING CUSTOM TRIFLANGE IMPLANT IN REVISION HIP ARTHROPLASTY IN PATIENT WITH PELVIC DISCONTINUITY (CASE REPORT)

Tikhilov R.M., Shubnyakov I.I., Kovalenko A.N., Bilyk C.C., Tsybin A.N., Denisov A.O., Dmitrevich G.D., Vopilovsky P.N.

Abstract

Revision hip arthroplasty rate is growing, and pelvic discontinuity rate ranges from 1% to 5% of acetabular component revision reasons. According to AAOS acetabular defects classification, pelvic discontinuity is fourth type defect in which cranial part of hip bone is separated from caudal part at acetabular level. Usually it occurs from bone loss secondary to osteolysis, infection, fracture or aseptic loosening. There are a lot of techniques for pelvis discontinuity treatment. Published results of bulk allografts and antiprotrusion cages have generally been poor. More preferable methods with acceptable rate of good results are cup-cage systems and custom triflange acetabular components(CTAC). CTACs are designed based on preoperative CT scans to build a custom titanium 3D-printed implant to address the patient's specific bone defect and provide secure fixation in the ilium, pubis, and ischium. We faced pelvic discontinuity, in which extensive iliac bone loss was added to caudal hip bone part medial displacement and pelvic ring deformity, in patient with multiple hip surgeries. Preoperative investigation called into question the possibility of using off-the-shelf hip implants, which could restore the biomechanics of the hip and provide reliable primary fixation at the same time. We present case report of the patient with pelvic discontinuity and massive bone loss treatment using a custom triflange component.
Traumatology and Orthopedics of Russia. 2016;22(1):108-116
pages 108-116 views

TRAUMATIC DISLOCATION OF THE POSTERIOR TIBIAL TENDON (CASE REPORT AND REVIEW)

Shchepkina E.A., Sorokin E.P., Lasunsky S.A., Stafeev D.V.

Abstract

The tibialis posterior tendon is the most superficial structure, passing behind the medial malleolus in the groove, which continue to strong fibro-osseus tunnel. Dislocation of the tibialis posterior tendon - a rare pathology, caused often by trauma. Analysis of foreign literature revealed that at present, since 1968, there is a description of only 34 cases of such injury. In russian literature such cases have not been described. The first case of this pathology is described by C. Martius in 1874. The authors analyzed the recent literature on this issue, and present a case of surgical treatment of the posterior tibial tendon dislocation. Patient had an injury during playing football and it was a direct trauma. During the MRI, radiologist had suspected dislocation of posterior tibial tendon, and the patient was sent to Vreden Institution of Traumatology and Orthopedics. Patients underwent surgery: recess medial malleolus groove was deeped, a flexor retinaculum flap was made, then it was fixed by transosseous sutures to the tibia. At one year follow-up patient showed a complete range of motion in the joint, the absence of any pain and returned to the previous sports activity. This article shows the difficulty for the diagnosis of traumatic dislocation of the posterior tibial tendon and shows the possibilities of surgical treatment in such cases.
Traumatology and Orthopedics of Russia. 2016;22(1):117-123
pages 117-123 views

MULTIPLE DAMAGE OF THE TIBIAL POLYETHYLENE INSERT IN KNEE JOINT PROSTHESIS (CAN EXCELLENT POSTOPERATIVE OUTCOME BE THE CAUSE OF FRACTURE OF THE TIBIAL INSERT?) CASE REPORT AND LITERATURE REVIEW

Song E., Eshnazarov K., Asilova S., Seon J.

Abstract

Despite improvements in prosthesis technology and use of high-quality materials in recent years, the number of revisions related to implant failures (4.7%) remains high. Several phenomena were reported in literature as reasons for dislocation and fracture of tibial insert in mobile bearing prosthesis: incorrect positioning of components, discrepancy of extension and flexion balancing or ligament weakness. However, in our cases neither of these causes were observed. The authors consider that bio-physiological and biomechanical aspects of total knee arthroplasty and knee joint prosthesis should be thoroughly studied and implemented into the clinical practice. In the described cases, multiple damage of the insert due to flexion instability and “twist-hyperflexion” in overweight patients is perceived as the reason for failures.

Traumatology and Orthopedics of Russia. 2016;22(1):124-128
pages 124-128 views

ARTHROSCOPIC METHOD OF THE RADIAL HEAD FRACTURE OSTEOSYNTHESIS (СASE REPORT)

Kuznetsov I.A., Salikhov M.R., Shulepov D.A.

Abstract

Radial head fractures constitute about 3% of all fractures and 30% within the group of elbow joint injuries. Conventional open surgical treatment is accompanied by an extensive soft tissue incision and sometimes by capsule release for adequate visualization. Arthroscopic methods feature relatively insignificant soft tissue trauma, allow to reduce pain syndrome in postoperative period and to accelerate rehabilitation. Besides, arthroscopy improves surgical view in cases of intraarticular fractures and facilitates a better anatomical reduction of articular surface. The authors demonstrate a clinical case of a patient with closed fractures of radial head and ulna coronoid process with displacement of left elbow joint fragments where arthroscopic surgery provided for good anatomical and functional results.
Traumatology and Orthopedics of Russia. 2016;22(1):129-135
pages 129-135 views

REVIEW

SCLEROTIC OSTEODYSPLASIAS

Petrushin A.L., Tyusova N.N., Nekhoroshkova T.V.

Abstract

Sclerotic osteodysplasias represent a group of relatively rare diseases; a common feature of them is the diffuse or local bone sclerosis. The reasons for their development are congenital abnormalities of endochondral and intramembranous bone formation either the hereditary nature or arising from spontaneous mutations. The main diagnostic problems arise when the differential diagnostic sclerotic dysplasias from various symptomatic osteopathies entailing bone sclerosis is needed. The aim of this research is the information about the group of rare congenital disorders characterized by diffuse and local osteosclerosis, and analysis of the literature on the diagnosis and differential diagnosis from other diseases and states, accompanied by compaction of bone tissue. A search of publications in English and Russian in electronic databases PUBMED, PUBMED CENTRAL, GOOGLE SHOLAR and eLIBRARY is performed. Keyword: sclerotic osteodisplasias, hyperostosis, osteopetrosis, osteopoikilosis, pyknodisostosis, melorheostosis, osteopathia striata, progressive diaphiseal dysplasia, diaphiseal sclerosis, enostosis and their Russian analogs for the period from 1953 to 2015. This clinical and radiological signs of osteopetrosis, osteopathia striata. osteopoikilosis, enostosis, piknodisostosis, progressive diaphyseal dysplasia, generalized hyperostosis cortical generalisata, melorheostosis and other forms of sclerotic osteodysplasias are presented. The main attention is paid to clinical and radiological diagnosis and differential diagnosis from osteoblastic metastases, primary benign and malignant bone tumors, chronic osteomyelitis and other diseases accompanied by local or diffuse osteosclerosis.
Traumatology and Orthopedics of Russia. 2016;22(1):136-150
pages 136-150 views

JUBILEE

Svyatoslav B. Korolev

Abstract

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Traumatology and Orthopedics of Russia. 2016;22(1):151-152
pages 151-152 views

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