No 1 (2009)


Combined external osteosynthesis in treatment of forearm long bones fractures and its consequences

Solomin L.N., Kulesh P.N.


The authors observed the stages of developing of optimal combined (pin-wire) external fixation assemblies for forearm long bones fractures. Using 3-D paramethric modeling in software complex Solid Works the rigidity of bone fragments fixation in system «forearm skeleton + external fixation device» (105 series of experiments). Computer model adequacy is proved in experiments on cadaver material (15 series of experiment). The assemblies which provide good reduction capabilities while minimal number of transosseus elements, the smallest frame sizes and have the opportunity of module transformation are determined. They are approbated in treatment of 57 patients. Good and excellent results are achieved in 96 % of cases.
Traumatology and Orthopedics of Russia. 2009;(1):5-15
pages 5-15 views

Surgical treatment of patients with fractures of intraarticular fractures of distal humerus by combined osteosynthesis

Naumenko L.Y., Nosivets D.S.


Authors developed based on clinical study the combined method of the treatment of the intraarticular fractures of distal humerus. It was applied to 12 patients aged 18-64 (the mean age - 39,5). The average follow-up after the operation was 26,9 months (from 12 to 36 months). The indications for open reduction and internal fixation with the help of reconstruction or congruent plates were the intraarticular fractures of distal humerus (type C2-C3 by AO group classification). The uniplanar apparatus of external fixation with original ball hinge was used in all of these patients for early passive motion in elbow joint. All patients achieved the elbow stability and the recovery of its physiological range of motions. The average elbow joint range of motions was: extension/flexion - 0°/0°/130°±10°; pronation/supination - 70°±10°/0°/70°±10°. The average score according to the Mayo clinic scale was 95 points (from 85 to 100).
Traumatology and Orthopedics of Russia. 2009;(1):16-20
pages 16-20 views

Application of electromyographic feedback for forming new motor habit in reconstructed hands and fingers

Alexandrov N.М., Yakovlev N.М.


The authors developed the new methodological approach to restoration of motor skill of possession by the reconstructed hand with use of adaptive training with electromyography. New techniques of adaptive training after various reconstructive interventions and an estimation technique manipulating skills of a hand are presented. Application of the electromyographic biological feedback has allowed to achieve restoration manipulating skills with effectiveness ratio on the average 3,75. Bilateral hand grip has been restored at all patients.
Traumatology and Orthopedics of Russia. 2009;(1):21-26
pages 21-26 views

Surgical treatment of chronic dislocations and fracture-dislocations of the elbow joint

Dultsev I.A., Zhabin G.I., Neverov V.A.


Experience of treatment of 80 patients with old elbow dislocation and fracture-dislocation is presented. Reasons of medical errors at treatment of fresh dislocations of bones of forearm are analyzed. The authors describe basic methods of operations using at treatment of old elbow dislocation, indication (including elbow replacement), choice of operative access, difficulty and complications, long-term results.
Traumatology and Orthopedics of Russia. 2009;(1):27-31
pages 27-31 views

Prevention of cicatricial and adhesive epiduritis in surgical treatment of lumbar osteochondrosis

Nuraliev K.A.


Приведены результаты хирургического лечения 24 больных остеохондрозом позвоночника. Операции произведены на следующих уровнях: VL4 - 5 - 13, VL5-VS1 - 11. Удаление грыжи диска произведено традиционным интерламинарным доступом у 10 пациентов, по методике Каспара - у 14. Дискэктомия с максимальным удалением желтой связки и с сохранением эпидуральной клетчатки и вен, а также пластика послеоперационного дефекта с помощью дорсолюмбальной фасции является патогенетически обоснованным методом, позволяющим создать благоприятное условия для нервно-сосудистых образований позвоночного канала, что предупреждает развитие послеоперационного рубцово-спаечного эпидурита и улучшает результаты хирургического лечения больных с грыжами поясничных межпозвонковых дисков.
Traumatology and Orthopedics of Russia. 2009;(1):32-35
pages 32-35 views

Ultra-sound diagnostics and treatment of early stages of the hip osteoarthrosis

Volokitina E.A., Sazonova N.V., Maltseva L.V.


Ultrasonic research of hip joints is performed at 103 patients (185 joints), showing complaints to pain in this area. The control group consisted of 30 healthy people. Middle age in each group - 42,4±5,6 years. The condition of a contour and sphericity of a femoral head, a thickness of a joint capsule, and width of joint space were studied. Normal density of the articular lip (fibrous cartilaginous ring) on the anterior-lateral hip surface (20-23 c.u.) and the quantitative indices of the first (24-28 c.u.) and second (29-32 c.u.) grades of osteoarthrosis were using General Measurements program by H histogram method. The authors developed and approved the technique of the directed introduction of chondroprotectors into the area of the degenerative process under ultrasonography control.
Traumatology and Orthopedics of Russia. 2009;(1):36-41
pages 36-41 views

Osteogenous potencies of native autogenic marrow induced crystalline chymotrypsin in treatment of posttraumatic abnormalities of bone regeneration

Sklyanchuk E.D., Zorya V.I., Guriev V.V., Vasiliev A.P.


In treatment of 88 patients with different posttraumatic abnormalities of osseous regeneration autotransplantation of marrow in conjunction with crystalline chymotrypsin dissolved in was applied. Analysis of results showed effectiveness of proposed method in delayed union by 100% cases, in ununited fractures - by 91,7%, in hypertrophic pseudoartrosis - by 91.7%, in hypotrophic pseudoartrosis - by 76,6%, and in pseudoartrosis in combination with marginal bone defect - by 66,7%. Rigid fixation of fragments is indispensable condition of beneficial effects achievement.
Traumatology and Orthopedics of Russia. 2009;(1):42-49
pages 42-49 views

Biorhythmologic foundation of individual prevention of locomotor system traumas

Grechukhin I.V.


На большом статистическом материале с применением биоритмологического подхода установлено наличие цикличности травматизации городского населения на протяжении индивидуального года отсчитываемого от одной даты рождения до следующей. Выявлена связь частоты травм органов опоры и движения в течение индивидуальных годичных циклов с сезонами календарного года. Результаты проведенного исследования позволяют констатировать увеличение уровней травм в период, максимально приближенный к дате рождения, что более отчетливо прослеживается у взрослых летом, а у детей и подростков - весной, летом и осенью. Необходимо дальнейшее изучение биоритмологических особенностей индивидуумов в связи с возможностью получения ими различных повреждений опорно-двигательного аппарата.
Traumatology and Orthopedics of Russia. 2009;(1):50-54
pages 50-54 views

Neuro-orthopedic approach to treatment of contractures in patients with spastic paresis

Umnov V.V., Kenis V.M.


The objective of the study was the analysis of possibility of correction of contractures in children with spastic cerebral palsy after combined (neurosurgical and orthopedic) treatment. The total amount of patients was 29 (41 segments). Neurosurgical options included selective neurotomies of the branches of tibial nerve in spastic deformities of the feet in all of the patients were treated (41 procedures respectively). Orthopedic options included tenomyoplastic procedures (Achilles tendon lengthening, gastrocnemius aponeurotic lengthening) in 26 of the patients presenting with accompanying fixed contractures. Preoperative and postoperative investigation included clinical assessment (range of passive and active motion, Ashworth scale assessment) and electroneuromyography. The surgical procedure was performed by intraoperative electrostimulating control. The average postoperative follow-up was 11 months, 20 patients (28 segments) were surveyed. Decrease of the muscle tone was recognized in all of the cases, the average rate of diminishing was 57.5 %. The clonic reaction of foot was diminished or disappeared in 73 % of the cases. Achilles reflex was normalized in all of the patients. Electromyographic data did not reveal any trends. Particular deformation relapse was observed in 19 segments. The analysis of the presented material allows making a conclusion that combined single-event neurosurgical and orthopedic treatment is the method of choice in presence of the high tone and progressive or existing muscular contracture in evidence of inefficiency of conservative treatment in children with cerebral palsy.
Traumatology and Orthopedics of Russia. 2009;(1):55-60
pages 55-60 views

The conservative treatment of hips dysplasia in children with nervous pathology, following tonus disorder

Bahteeva N.H., Grigorieva A.V., Korshunova G.A., Ionova T.A.


The device for conservative treatment of hip dysplasia in infants with nervous pathology attended with tonus disorders. Comparative analysis of results of the treatment by Frake's pillow, Pavlik's stirrups and by our has shown that the greatest percent of excellent and good results is received at use of the developed device. The original device allows gradually and without traumas to achieve the optimum position of hips, to provide a centering of a femur head of in acetabulum. It also promotes further development of the hip components in children with dysplasia and tonus disorders.
Traumatology and Orthopedics of Russia. 2009;(1):61-64
pages 61-64 views

The surgical algorithm of child's acute torticollis treatment

Gubin A.V.


The acute torticollis is usual and frequent cause of child's hospitalization. 208 patients 2-17 years of old with this syndrome were analyzed. Epidemiology, clinics, diagnostic and treatment are presented. The surgical algorithm of child's acute torticollis is suggested.
Traumatology and Orthopedics of Russia. 2009;(1):65-69
pages 65-69 views

Functional status of locomotor system in school age children with bearing disorders

Salomova F.I.


The authors assert that the low functional state of prelum abdominale muscles is of great importance at the formation of carriage disorders in the children of primary school age, whereas the low indices of back muscles functions to a greater extent determine already formed carriage disorders. The strengthening of prelum abdominale muscles for the improvement of carriage should be started in primary school age.
Traumatology and Orthopedics of Russia. 2009;(1):70-73
pages 70-73 views

Loozer zones in patients with vitamin D-resistant rickets

Dyachkova G.V., Ryazanova E.A.


Research objective: on the basis of modern methods of radiodiagnostics to study the peculiarities of pathologic reconstruction at patients vitamin D-resistant rickets depending on age of patients and at various stages of treatment. Nine patients with vitamin D-resistant rickets were examined using CT and MRI before, after treatment and during the remote period. Methods of a computer tomography (КТ) and a magnetic resonance tomography (МРТ) survey. X-rays of 17 patients with of pathologic bone tissue reconstruction were studied. The age of patients varied from 12 till 42 years. Radiological changes in a zone of reconstruction of cortex in age aspect appeared as a wedge shape, planar, rectangular zones of resorption. CT and MRI are additional methods of diagnostics that reflect changes in bone architectonics, growth zones, periosteum, degree and character of reconstruction of internal bone structure after deformity correction, effectiveness of surgical treatment.
Traumatology and Orthopedics of Russia. 2009;(1):74-79
pages 74-79 views

Dynamics of bone mineral density in patients with gonarthrosis at conservative treatment

Sazonova N.V., Larionova T.A., Ovchinnikov E.N., Smotrova L.A.


Authors determined the mineral density of bone tissue and the evidence osteoporosis manifestation in area of knee joint before and after conservative treatment in 52 patients in age 31 - 65 years with gonarthrosis. After conservative treatment the positive dynamics in bone mineral density is marked in women in age 31 - 40 years both in area of knee joint and in the projection of lumbar spine (L2-L4). Absence of significant differences in age 51 - 65 years can testify about the age reduction of compensatory capabilities of organism.
Traumatology and Orthopedics of Russia. 2009;(1):80-85
pages 80-85 views

Internal osteosynthesis in treatment of trochanteric fractures

Gilfanov S.I., Klyuchevsky V.V., Danilyak V.V.


The authors studied the results of operative treatment of trochanteric fracture with the use of different devices for osteosynthesis at 817 patients. In 553 cases DHS (dynamic femoral screw) were applied, in 159 - DCS (dynamic condylar screw), in 105 - PFN (proximal femoral nail). Long-term results in terms from 1 are to 5 years are studied at 485 (61,4%) patients. The choice of device for osteosynthesis is determined by the type of injury. At stable fractures it is expedient to use the dynamic femoral screw, at unstable fractures the intraosseous fixators are more effective (proximal femoral nail, Gamma-nail). Application of dynamic condylar screw is justified at intertrochanteric fracture at young patients. At the patients of elderly and senile age it is necessary to execute osteosynthesis by the intraosseous fixators.
Traumatology and Orthopedics of Russia. 2009;(1):86-90
pages 86-90 views

Rеvision surgeries for dеgеnеrаtivе lumbar spine diseases

Gioev P.M., Davydov E.A.


Results of 86 repeated operations on the occasion of diseases of a lumbar sрinе are studied. Optimum tactics of surgical treatment of these patients is offered. The reasons of unsuccessful interventions are specified. The factors influencing these results are allocated. In all cases were carried out modified back surgical accesses. Authors consider that the positive result can be reached by means of the radical operations observed in the shortest terms after primary intervention.
Traumatology and Orthopedics of Russia. 2009;(1):91-95
pages 91-95 views

Assessment results surgically treatment of injuries of sciatic nerve

Khamzaev R.A., Bersnev V.P., Boroda Y.I.


The results of examination and operative treatment of 28 patients with sciatic nerve lesions are presented. Sciatic nerve injury and functional outcome were described, tactic and treatment recommendations were given in dependence to injury mechanisms, location, time to surgical repair, surgical techniques.
Traumatology and Orthopedics of Russia. 2009;(1):96-98
pages 96-98 views

Device for passive stage of restoration of movement in large joint of lower extremity at contractures

Magaramov M.A., Radjabov A.A., Ogurliev A.P., Dydymov Z.A.


For the purpose of increase in volume of movements in large joints of lower extremities authors offered the device allowing in the sparing mode to carry out the gradual stage increase in motion of joint. Efficiency of the device is shown by the example of treatment of the patient with posttraumatic extension contracture of left knee joint.
Traumatology and Orthopedics of Russia. 2009;(1):99-101
pages 99-101 views

Difficulties of prosthetics at incorrectly chosen tactics in children hand surgery

Koryukov A.A.


The authors examinated 565 children with defects of a hand, who were subjected to the rehabilitation, including prosthetics. The manufacturing of prothesis for 8 (1,4 %) patients appeared impossible or rather difficult. The description and illustrations of some cases of incorrectly chosen tactics of surgical treatment of children with defects of a hand in medical establishment of Russia are presented. After treatment they have been directed to clinic of our centre for prosthetics. At a choice of tactics of surgical treatment the considered and rational approach taking into account possibility of the subsequent prosthetics in the specialized centers is optimum.
Traumatology and Orthopedics of Russia. 2009;(1):102-106
pages 102-106 views

Structural characteristic of osteoarthrosis of lower extremities in Kurgan region inhabitants employed in different fields

Popova L.A., Sazonova N.V.


The article reports the results of the study of the structure and severity of the diseases of lower limbs big joints among the population of Zaural region of Russia. The methods of the general polling and questionnaire survey of the adults working in five main areas of public activity and non-working people were applied. It was stated that the females prevail in all study groups regardless of age and work position making up from 71.5 to 74% compared to 28.5 and 26% of the males. The main causes of the development of the chronic disease of the most frequently affected joints were revealed. The quality of specialized medical care provision was evaluated. It's insufficient in organization in the rural areas where 50% of all patients primarily applied to surgeons and therapists were the ones with the untreated osteoarthrosis of II and III degrees of the affection of big joints. Late visit of the rural inhabitants to a doctor was caused by financial difficulties due to heavy transport charges for a trip to regional specialized centers for examination and treatment.
Traumatology and Orthopedics of Russia. 2009;(1):107-111
pages 107-111 views

Gennady P. Kotelnikov

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Traumatology and Orthopedics of Russia. 2009;(1):112-114
pages 112-114 views

Nicolai P. Demichev

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Traumatology and Orthopedics of Russia. 2009;(1):115-117
pages 115-117 views

Anatoly D. Lee

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Traumatology and Orthopedics of Russia. 2009;(1):118-119
pages 118-119 views

Pravila dlya avtorov

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Traumatology and Orthopedics of Russia. 2009;(1):120-120
pages 120-120 views

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