Vol 16, No 3 (2010)
- Year: 2010
- Published: 19.11.2010
- Articles: 28
- URL: https://journal.rniito.org/jour/issue/view/30
- DOI: https://doi.org/10.21823/2311-2905-2017-0-4
Full Issue
Clinical studies
LONG-TERM RESULTS OF ENHANCED TAPERED STEM VerSys ET USE IN PRIMARY TOTAL HIP ARTHROPLASTY
Abstract
The authors reported the outcome at a minimum of five years of 130 consecutive arthroplasties of VerSys ET (Zimmer) in 111 patients. The procedures were performed between 2001 and 2004. In 129 cases (99.2%) Trilogy cup (Zimmer) was used in one case - Muller's acetabular cage (Mathys). The mean age of patients was 49.5 (SD 11.5) (23 to 73), male 76 (58.5%), female - 54 (41.5%), overweight patients 109 (83.8%). Majority of patients had activity in Charnley class A. The most frequent was femur Dorr type A (27,0%) and Dorr type В (66,1%). The mean follow-up was 76 months (60 to 96). The outcomes assessed in 103 patients (120 hips) (92.3%). Outcomes of ten cases were not determined. The mean Harris Hip score improves from 35.1 (SD 8.3) preoperatively to 94.3 (SD 8.5) post-operatively. Kaplan-Meier analysis with revision of the stem as the end-point demonstrated 97,7% survival in term 60 to 96 months, for aseptic loosening - 99,2%. Subsidence of the implants in 61 (50.8%) patients was fixed at a mean follow-up 18.3 (SD3.7) months after surgery and did not progress further. After surgery stem position was neutral 91(75.8%) patients, varus - 14 (12.1%) and valgus - 14 (12.1%). Complications were observed in 8 (6.7%) cases: among them - periprosthetic fractures 6 (5.0%), stem aseptic loosening - 1 (0.8%), recurrent dislocation - 1 (0.8%). Four patients undergone revision surgery We consider the high efficiency of VerSys ET stem use for primary total hip arthroplasty.
Traumatology and Orthopedics of Russia. 2010;16(3):7-15
7-15
EVALUATION OF THE POSSIBILITYOF RESTORATION OF LEG LENGTH IN PATIENTS WITH SEVERE HIP DYSPLASIA IN DIFFERENT VARIANTS OF SURGICAL TECHNIQUE OF HIP REPLACEMENT
Abstract
The authors performed the comparative analysis of radiographs of two groups of patients with severe dysplastic coxarthrosis who underwent total hip replacement with osteotomy of T. Paavilainen and without it. The study revealed significant differences in the results: the degree of leg lengthening and the degree of displacement of the greater trochanter with the restoration of the anatomical center of rotation using osteotomy on T Paavilainen significantly greater than with a standard prosthesis. The average limb lengthening without osteotomy was 29.1 mm, 95% confidence interval (from 24.5 to 33.6), and using osteotomy - 45.7 mm (from 41.8 to 49.6) (p <0.0001). The average displacement of the greater trochanter without osteotomy was 27.2 mm, 95% confidence interval (from 22.8 to 31.6), and with osteotomy - 61.4 mm (from 54.4 to 68.4) (p <0, 0001).
Traumatology and Orthopedics of Russia. 2010;16(3):16-20
16-20
LONG-TERM RESULTS AFTER BONE PLASTY AT KNEE REPLACEMENT
Abstract
From 1999 to the present time in the Russian RITO n.a. R.R. Vreden 28 knee joint replacements were performed using bone autoplasty in patients with stage V aseptic necrosis of the tibial condyles. The control group included 150 patients who underwent knee arthroplasty using a standard technique. All the patients were monitored in the preoperative and postoperative periods in time from 3 to 7 years. Results of treatment were assessed using a 100-point Josef and Kaufman scale, as well as the scale of WOMAC. Among the patients were 128 (71,9%) women and 50 (28,1%) males, mean age was 67 years old. If comparing experimental and control groups in the preoperative period showed a significant difference, the postoperative results were identical. Bone autotransplantation during arthroplasty of the knee is a simple and effective method used in large defects condyles of the femur and tibia (more than 1/3 of the condyle, the depth of the defect over 10 mm).
Traumatology and Orthopedics of Russia. 2010;16(3):21-27
21-27
VARIANTS OF SPINE OSTEOSYNTESIS AT LOW MINERAL DENSITY OF BONE
Abstract
The analysis of the results of transpedicular screw fixation in the treatment of patients with osteoporotic vertebral compression fractures was done. In the first group (N=27) the polysegmental transpedicular screw fixation was applied. In the second group (N=20) we used short-level stabilization with additional augmentation of transpedicular screws by bone cement. The spinal stability, restoration of function, correction of spine's deformation and pain relief was same in both groups. But in the second group the results was achieved with less traumatization and time of rehabilitation of the patients.
Traumatology and Orthopedics of Russia. 2010;16(3):28-34
28-34
RESULTS OF THE TREATMENT OF DEGENERATIVE DYSTROPHIC SPINE LUMBAR DESEASE USING MECHANICAL DECOMPRESSOR
Abstract
The current problems of treatment of degenerative dystrophic spine disease are discussed. The authors have fulfilled a research in microinvasive surgery by mechanical decompressor. 55 persons, 25 of which are men and 30 are women with degenerative dystrophic spine diseases complicated by intervertebral disk hernia were observed. The results were estimated in 5 days and 3, 6, 12 months after the operation. Good results of the treatment in all the patients were received, pain syndrome was disappeared. The microdiscectomy using mechanical decompressor appeared to be useful in treatment of osteochondrosis of spine.
Traumatology and Orthopedics of Russia. 2010;16(3):35-40
35-40
PREVENTIVE MAINTENANCE OF ISCHEMIC CONTRACTURES AT PATIENTS WITH SEVERE HAND INJURIES
Abstract
Results of surgical treatment of 35 victims who had received serious blunt open and closed injuries of hand were analyzed. All injuries of hand were divided into three types, depending on mechanism and circumstances of trauma. On the basis of the data received at direct measurement of compartment pressure, indirect signs of a menacing ischemia of intrinsic muscles have been defined, and the technique of preventive maintenance of an ischemic lesion of own hand muscles were developed. High efficiency of the offered medical approaches at the expense of the maximum restoration of function of the injured extremity was proved.
Traumatology and Orthopedics of Russia. 2010;16(3):41-46
41-46
THE ANTIMICROBIAL BIODEGRADABLE COMPOSITION BASED ON HIGH-MOLECULAR WEIGHT POLYVINYLPYRROLIDONE FOR THE PROPHYLAXIS OF EXPERIMENTAL OSTHEOMYELITIS
Abstract
The aim of study was to evaluate the efficacy of antimicrobial composition of amikacin with dioxydin and polyvinylpyrrolidone as a biodegradable prolonging agent for the post-surgery infections prophylaxis. The data obtained show the efficacy of the amikacin combination with dioxydin based on high-molecular weight polyvinylpyrrolidone and an opportunity to it's application for the post-surgery infections prophylaxis in traumatology, orthopedics and other surgery areas.
Traumatology and Orthopedics of Russia. 2010;16(3):47-54
47-54
THE LATE RESULTS OF ARTHROSCOPIC SURGERIES WITH KNEE INJURIES IN CHILDREN
Abstract
The purpose of the work is the follow-up of the late results of management of children and adolescents with knee injuries. Arthroscopy was performed to 68 patients. Resection and suturing of the torn meniscus and ACL reconstruction were performed. The results were followed up to eight years after operations. It was shown, that meniscal tears in children should be treated conservatively in most cases. The suturing of the torn menisci is preferable method. Indications for suturing are wider in children that in adults. ACL reconstruction in young patients is unpredictable in its results.
Traumatology and Orthopedics of Russia. 2010;16(3):55-60
55-60
COMBINATION OF DISTRACTION OSTEOSYNTHESIS AND BONE PLASTIC AT TREATMENT OF CHILDREN WITH CONGENITAL LOW LIMB-LENGTH DISCREPANCY
Abstract
Research objective was the estimation of combination distraction osteosynthesis with bone plastic in treatment of children with congenital lower limb discrepancy. Results of surgical treatment of 26 children (17 girl and 9 boys) with congenital lower limb-length discrepancy are analyzed. The method consists in creation of superfluous osteogenesis in the field of prospective lengthening. The control group included 10 patients with whom lengthening was carried out by typical way. Results: at the analysis of roentgenograms faster formation of a new bone has been revealed in basic group (on the average for 7,8 days faster on each centimetre of lengthening). Combination of distraction osteosynthesis and combined bone plastics shortened the treatment period by accelerating new bone regeneration during distraction osteogenesis of the children with congenital low limb-length discrepancy.
Traumatology and Orthopedics of Russia. 2010;16(3):61-67
61-67
ESTIMATION OF EFFICIENCY OF PHYSIOTHERAPEUTICAL TREATMENT FOR SCHOLIOSIS IN CHILDREN WITH BIOTESTING
Abstract
Blood serum biotesting in children of 9-14 years old with idiopathic scoliosis of I-II level (according to V.D. Chaklin) revealed neurohumoral background change in comparison with age-related standard. Treatment regiment of this disease included magneto impulse therapy with field induction up to 1,5 Tl or/and electrophoresis. Repeated testing displayed that isolated magneto impulse influence evokes neuro-peptide regulation normalization under the most positive clinical effect.
Traumatology and Orthopedics of Russia. 2010;16(3):68-73
68-73
CRIO-INFLUENCE IN SURGICAL TREATMENT OF BENIGN TUMOURS OF FOOT BONES
Abstract
The material of investigation was the results of treatment of 131 patients with foot bones tumours. The largest number of patients referred, to age interval from 11 to 30 years (69,6%). More than half of cases were osteochondromas (54%), then solitary bone cyst (14,5%) and chondromas (13%). Other nosologic forms were met significantly seldom. Two groups of patients were examined: the main group (with crio-influence) - 44 patients and group of comparison (without crio-influence) - 87 patients. The plot of operation was in flat, border-line, intrafocusal or segmental resection of damaged section, crio-instillation or contact curio-processing of bone and auto- or allopathic of respected defect. The results of treatment were estimated in a year after operation. After usage of curio-surgical method there were observed positive results in 41 patients, satisfactory - in 2 and unsatisfactory - in 1. The results of treatment with traditional method were positive in 79 cases, satisfactory - in 2, unsatisfactory - in 6. The worked-out method of curio-surgical treatment of foot bone tumours includes resection of pathological focus, itraoperative crio-influence on bone tissue and bone plastic transplantation of resected, defect. The analysis of criosurgical operations of foot gave the foundation to consider such interventions significant and perspective in treatment of patients with tumours and tumour similar damages of foot bone.
Traumatology and Orthopedics of Russia. 2010;16(3):74-78
74-78
Case Reports
ARTHROSCOPIC TREATMENT OF ELBOW CONTRACTURE IN SPORTSMAN
Abstract
This is an example of treatment of a professional sportsman with osteochondritis dissecans and flexion-extension contracture of an elbow. As a result of treatment it was proven, that the arthroscopic method of treatment undoubtedly had an obvious positive effect compared to the traditional non-operative treatment. The course of treatment for such patients with similar pathologies should be an active one - the use of arthroscopy followed by a rehabilitation in order to achieve the best result possible.
Traumatology and Orthopedics of Russia. 2010;16(3):131-134
131-134
Reviews
MERITS AND DEMERITS OF MODERN BEARING SURFACES OF HIP IMPLANTS (REVIEW OF FOREIGN LITERATURE)
Abstract
Promising results of total hip allowed to perform a hip replacement in younger and active patients. However, the results of arthroplasty in young populations are still not comparable with outcomes in patients of older age groups. The advent of new materials and further improvement of production technology is increasing interest in the use of alternative bearing surfaces, but to assess the effectiveness of each new implants needed long-term clinical studies. Use of any bearing surface has its own potential advantages and disadvantages that must be assessed in each case.
Traumatology and Orthopedics of Russia. 2010;16(3):147-156
147-156
TARSAL COALITIONS IN CHILDREN (REVIEW)
Abstract
Tarsal coalition is uncommon condition in childhood foot disorders. Historically tarsal coalitions are well described in literature, but only since wide usage of computed and magnetic resonance tomography it became possible to diagnose these conditions in early stages. Etiological theories of disorder are discussed. Clinical, x-ray and tomographical signs are summarized. Differentiated approaches to nonsurgical and surgical treatment are described and discussed.
Traumatology and Orthopedics of Russia. 2010;16(3):159-165
159-165
CONGENITAL METACARPAL SYNOSTOSIS (REVIEW)
Abstract
The article is devoted to actual problem of children orthopedics - congenital metacarpal synostosis. The analysis of literature was performed, the different variant this rare congenital abnormality and method of treatment were diagnosed.
Traumatology and Orthopedics of Russia. 2010;16(3):166-168
166-168
171-178
Experience exchange
THE EXPERIENCE OF DIAGNOSTOCS AND TREATMENT OF LONG BONE ADAMANTINOMAS
Abstract
The experience of diagnostics and treatment of long bone adamantinomas in 3 patients in age 23-52 are presented. The signs of tumor pathomorphism in recurrence in case of nonradical resection were revealed. In one of clinical cases there was a atypical expression immunohistochemical markers by tumors in recurrence.
Traumatology and Orthopedics of Russia. 2010;16(3):79-86
79-86
INTRAJOINT OSTEOTOMIES FOR POSTTRAUMATIC DEFORMITIES OF TIBIAL CONDYLAR SURFACES
Abstract
Twenty two patients were operated on account of joint surface deformities developed due to malunion of healed tibial condylar impressions. The peculiarity of operation was the osteotomy line, which contoured the perimeter of impression to mobilize it, and after that the fragments were plated with bone grafting. Early function is essential. We met one deep infection. The late follow-up was generally positive. The intrajoint osteotomies can effectively restore posttraumatic deformities of tibial condylar surface and normalize the anatomy with good function and low pain. This operation optimizes anatomic and functional conditions for probable joint replacement and is able to delay the need in it at least for decade and for thus decrease the problems of revisions.
Traumatology and Orthopedics of Russia. 2010;16(3):87-91
87-91
THE RESULT OF INTRAMEDULLARY NAILING WITH BONE GRAFTING OF TIBIA'S PATHOLOGIC FRACTURE
Abstract
The authors give the clinical case of successful surgical treatment of patient with tibia's pathologic fracture by intramedullary nailing with bone grafting. The disadvantages of such patients' treatment by plaster immobilization and by some invasive methods like vascular autografting by Ilizarov's method and bone plating were also discussed. The obvious benefits of proposed surgical treatment technique of observed patient category are shown.
Traumatology and Orthopedics of Russia. 2010;16(3):92-95
92-95
THE TREATMENT OF EXTRA- AND INTRA-ARTICULAR FRACTURES THE DISTAL HUMERUS
Abstract
From 2005 to 2009 we treated 112 patients with fractures of distal segment of the humerus, 83 (74,10%) of them were injured when falling from the height of its own growth, 8 (7,14%) - in an accident, 6 (5,35%) - a fall from a height, 13 (11,6%) - in sports, and two - as a result of violent acts. In 97 (87%) cases the fractures were closed, in 15 (13%) - open. 19 patients were treated conservatively and 93 - operatively. Functional results were evaluated using the Mayo elbow performance score (MEPS) in 78,37% of patients. Results of the conservative method: excellent and good - 46,66%, and in all patients with type A without displacement - in 100%. The fair results - in 33% and the poor in 20% - with type В and C. The results of operative treatment: excellent and good - 90,41%, the fair results - in 9,58%, no poor results. Initial prevent the oedema and bleeding into joints and soft tissues, adequate rigid fixation of fractures with the maximal restoration of the elbow joint congruent without additional immobilization and early active mobilization is essential to prevent the elbow stiffness and achieve a good outcomes.
Traumatology and Orthopedics of Russia. 2010;16(3):96-102
96-102
METHODIC PRINCIPLES OF FILLING-IN FOREARM BONE DEFECTS USING TECHNOLOGIES OF TRANSOSSEOUS OSTEOSYNTHESIS
Abstract
The article is based on treatment experience of 93 patients with defects and pseudoarthroses of forearm bones using transosseous osteosynthesis. The work presents main methodic principles and approaches to rehabilitation of patients using closed transosseous osteosynthesis and surgical lengthening of bone fragments.
Traumatology and Orthopedics of Russia. 2010;16(3):103-110
103-110
SURGICAL RECONSTRUCTION OF THE FINGERS WITH THE USE OF CONVENTIONAL AND MICROSURGICAL TECHNIQUES
Abstract
The authors presents a new method of hand and finger reconstruction, which makes it possible to restore finger surface and bony frame by transfer of vascularized osteo-cutaneous grafts on microvessel anastomoses and transposition of the radial flap on peripheral pedicle. Lipocutaneous flaps on temporary pedicles provide coverage for the most part of the reconstructed digit as well as for the present hand defects. Complete acceptance of segments was achieved in 92,8% of cases. In all the cases of successful segment acceptance bony frame stability in the reconstructed digits and restoration of the bilateral hand grip were achieved.
Traumatology and Orthopedics of Russia. 2010;16(3):111-117
111-117
ERRORS AT RESTORATIVE TREATMENT OF CHILDREN WITH ELBOW INJURIES
Abstract
Presented analysis based on a large clinical material of reconstructive management of children with posttraumatic contractures of the elbow joint. In reconstructive management of children a plenty of errors are committed, and most of them are through undervaluation of displacements that have not been eliminated after bone fractures at the elbow joint.
Traumatology and Orthopedics of Russia. 2010;16(3):118-125
118-125
Modern technologies in traumatology and orthopedics
METHOD OF SURGICAL TREATMENT OF PATIENTS WITH RECURRENT ACHILLES TENDON RUPTURES
Abstract
In order to justify a new method of surgical treatment of patients with recurrent and chronic Achilles tendon ruptures conducted applied topographic-anatomic study of 12 fixed and 8 fixed preparations of the lower extremities was performed. In the developed technique were carried out operations in 18 patients aged from 30 to 72 years with repeated ruptures Achilles tendon. The results of treatment were followed-up in all 18 patients in the period from 6 months to 3 years. Repeated tears of Achilles tendon were not observed. The range of motions in ankle joint reconstructed almost in its entirety. Performed topographic and anatomical studies and accumulated clinical experience allow us to recommend the proposed method for a wider clinical use.
Traumatology and Orthopedics of Russia. 2010;16(3):126-130
126-130
Trauma and orthopedic care
COMPARATIVE ANALYSIS OF QUALITATIVE CHARACTERISTICS OF TRAUMATOLOGIC SERVICE'S BED POOL WORKING AS ONE OF DIRECTIONS IN SURGICAL ACTIVITY OF SAINT-PETERSBURG MUNICIPAL HOSPITALS IN 2000 AND 2008 YEARS
Abstract
Qq the basis of longstanding monitoring of state and work of St.-Petersburg adult traumatologic service and state statistic observation data the comparative assessment of structure, dynamics and work index of bed pool at the profile departments of municipal hospitals in 2000 and 2008 and its part in the work of the whole surgical service are presented. For better informativity all main rates are presented separately for children and adult traumatologic services.
Traumatology and Orthopedics of Russia. 2010;16(3):135-142
135-142
FOR PRACTICIONERS
MAGNETIC RESONANCE TOMOGRAPHY OF SPINE AFTER DISKECTOMY
Abstract
The author lists then possible immediate and remote complications after diskectomy and describes clinical presentations and methods of diagnostics at this pathology. Detailed MR-imaging of spine in 6 months after operation is presented.
Traumatology and Orthopedics of Russia. 2010;16(3):143-146
143-146
Discussions
ON ROLE OF CHONDROPROTECTIVE AGENTS IN OSTEOARTHRITIS: ON THE WAY TO THE EVIDENCE-BASED MEDICINE
Abstract
Chondroitin sulfate, glucosamine and hyaluronic acid (HA) applied for the treatment of arthrosis (osteoarthritis) are designated as chondroprotective agents. There is evidence in favor of their effectiveness. However, some recent reviews questioned it, while it was noticed that later publications tended to be less positive than older industry-sponsored trials. For intraarticular injections predominantly HA is used. Clinical efficacy of intraarcticular injections and significance of the difference from placebo has been questioned as well. Moreover, no plausible explanation has been found for the discrepancy between the short intraarticular half-life of injected HA and reported long duaration of the positive effect (6-9 months) after a course of intraarticular injections. Chondroprotective agents are administered to osteoarthritis patients, including pensioners and citizens with low incomes, who purchase them for a prolonged use. It must be largely equivalent to recommend them, instead of peroral drugs or dietary supplements, a diet modification with consumption of more food containing natural glycosaminoglycans. More comprehensive analysis of literature is required in the process of registration of drugs and dietary supplements.
Traumatology and Orthopedics of Russia. 2010;16(3):179-182
179-182
Anniversaries
183-184
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 82474 от 10.12.2021.
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 82474 от 10.12.2021.