No 2 (2009)

ARTICLES

The plasty of humeral proximal part using lateral edge of scapula

Tikhilov R.M., Lushnikov S.P., Kochish A.Y.

Abstract

Applied anatomical research prepared in 18 specimens allowed to refine important details of blood supply of lateral edge and inferior angle of scapula with reference to possibility vascularized bone graft formation. Due to this fact the original method of pedicle bone plasty for humeral proximal part pseudoarthrosis was suggested and successfully approved in four patients. Applied anatomical research and successfully clinical testing of original method allow to recommend it for wide application.
Traumatology and Orthopedics of Russia. 2009;(2):7-14
pages 7-14 views

New methods of pathologically changed hand segments transfer

Alexandrov N.М., Petrov S.V.

Abstract

The article presents new methods of hand and finger reconstruction by transfer of various hand segments, i.e. digits, digital and metacarpal stumps. Described methods are based on preparatory distraction of segments transferred, which is effected in order to elongate their pedicles. Pedicle distraction enables reconstruction of the thumb and, moreover, of any finger by transposing a digital or metacarpal stump with the proximal amputation level to a recipient with a more distal amputation level. The segment is transferred either on one or two pedicles depending on blood supply sufficiency. 100% of cases saw successful acceptance of transferred segments. Positive functional results were achieved in 92,5% of cases.
Traumatology and Orthopedics of Russia. 2009;(2):15-19
pages 15-19 views

Sravnitel'nyy analiz zhestkosti osteosinteza, obespechivaemoy chreskostnymi apparatami, rabotayushchimi na osnove komp'yuternoy navigatsii i kombinirovannym spitse-sterzhnevym apparatom

Solomin L.N., Vilenskiy V.A., Utekhin A.I., Terrel V.

Abstract

The aim of the study was to compare osteosynthesis rigidity provided by computer-assisted external fixation devices (Ortho-SUV Frame, Taylor Spatial Frame, Ilizarov Hexapod Apparatus) and combined pin-wire device. In 180 series of experiment the rigidity of osteosynthesis while applying forces in three standard planes and in 6 degrees of freedom was analyzed. It's revealed that computer-assisted devices have essential detail - backlash. The maximal backlashes are observed in Taylor Spatial Frame, the minimal - in Ilizarov Hexapod Apparatus. After backlash's elimination indexes of osteosynthesis rigidity in computer-assisted devices are practically the same as in combined pin-wire device.
Traumatology and Orthopedics of Russia. 2009;(2):20-25
pages 20-25 views

Influence of the osteoscintigraphyc data on a choise of medical tactics at patients with chronic posttraumatic osteomyelitis

Kotelnikov G.P., Stolyarov E.A., Sonis A.G., Kapishnikov A.V.

Abstract

The article discusses the questions of chronic posttraumatic osteomyelitis combined with bone nonunion. The treatment results of such patients depend on the correctly chosen therapeutic management. When choosing the therapeutic approach surgeons are also guided by the revealed tendency of reparative osteogenesis in the nonunion zone. Diagnostic opportunities of osteoscintigraphy for such cases are not adequately explored. The monitoring results of bone tissue reparative regeneration in the nonunion zone of 42 patients are compared in this research, with using osteoscintigraphy. Scintigram data handling and interpreting are carried out by author's strategy. The results obtained show great diagnostic value of osteoscintigraphy. Carried out investigation demonstrate that using scintigraphy promotes making a sound tactical decision at an earlier stage.
Traumatology and Orthopedics of Russia. 2009;(2):26-32
pages 26-32 views

Features of anterograde blood flow and venous thrombotic complications in patients with fractures of bone diaphysis of lower extremity

Pisarev V.V., Lvov S.E., Kutyreva O.I., Molchanov O.S.

Abstract

The study based on ultrasound angioscanning examination of the venous bed in early postoperative period in 74 patients with fractures of bone diaphysis of lower extremity after internal osteosynthesis. Pathology of deep venous bed of the lower extremity was found in 51.4%, thrombosis - 24.3% of cases. Half of the revealed proximal thrombi of the deep venous bed were floating, thus, creating highest risks of embolism. It was found out that in cases of femur and tibia diaphysis fractures changes of anterograde blood flow are most persistent and relevant in muscular-venous sinuses of the lower leg. Thrombosis of the femoral-popliteal segment of the venous bed leads to anatomo-hemodynamic changes in the system of deep veins of the injured leg and to increase of blood volume in superficial veins. Fractures of the bones of the lower extremity lead to changes in the system of deep veins of noninjured extremity.
Traumatology and Orthopedics of Russia. 2009;(2):33-38
pages 33-38 views

Ventral operations in patients with rigid scoliotic deformities

Usikov V.D., Ptashnikov D.A., Mikhaylov S.A., Smekalenkov O.A.

Abstract

We analyzed the results of treatment of 76 patients with rigid scoliotic deformity. All the patients taking into account the expressiveness of scoliosis arc, its degree of stiffness was used differing of tretment. In rigid scoliosis with residual deformation of the main arc of 60% or more of the baseline values shown in the first phase of implementation of ventral mobilize intervention. Ventral intervention allowed to increase the correction of scoliotic main arc in the final stage of surgical treatment.
Traumatology and Orthopedics of Russia. 2009;(2):39-45
pages 39-45 views

Anatomical and clinical substantiation of treatment technique of pelvic injuries with its disrupted ring

Bagnenko S.F., Kashanskiy Y.B., Rzaev R.S., Kucheev I.O.

Abstract

By analyzing of the anatomy of the cadaveric material without pelvic trauma, topographical determination of the optimal zones for screws insertion into iliac wings and sacro-iliac joints was made. Using features of the step-by-step method of combined osteosynthesis were defined, by modeling of the way of treatment of unstable damages of the pelvic ring with infringement integrity on the 15 anatomic preparations of injured people, which died during different periods of traumatic disease. The obtained data has been successfully applied in clinical practice to treatment of victims with heavy damages of pelvic. By the analysis of the early and long term (till two years) results of treatment it has been established that in the basic group (32 patients) on comparison with control (85 patients) the number of complications was reduced from 80% to 56%, and the exiting on primary physical inability lowered from 33% to 22%.
Traumatology and Orthopedics of Russia. 2009;(2):46-52
pages 46-52 views

Fixation of posterior pelvic ring in unstable pelvic fractures

SI Gilfanov S.I., VV Danilyak V.V., YM Vedeneeev Y.M., MA Emelin M.A., VV Vrzhesinsky V.V.

Abstract

41 patients, aged 14-60 years with posterior pelvic ring fractures were treated between 2006-2009. Fractures occurred after motor vehicle accident (33) , fall from height (7), gas explosion (1). 30 patients (73,1%) had sacral fractures, 10 (24,4%) - SI joint rupture, 1 (2,5%) had fracture of iliac bone. According to Denis classification 6 patients had transalar fractures (zone I), 20 patients - transforaminal fractures (zone II), and 4 - a central sacral fracture (zone III). 2 - complete sacroiliac joint dislocations. For stabilization sacroiliac screw fixation were used in 2 cases, sacral bars - in 2, posterior sacroiliac plate fixation had 9 patients, local osteosynthesis of a sacrum with a spinopelvic fixation - 24. The technique of ileolumbar fixation in a combination with local osteosynthesis of sacrum or with any other way of SI joint fixation is optimal for bringing down of half of pelvis at vertical displacement on zone SI joint or on sacral fracture.
Traumatology and Orthopedics of Russia. 2009;(2):53-58
pages 53-58 views

Immunologic criteria of prediction of bone delayed union

Berdyugina O.V., Berdyugin K.A.

Abstract

The authors studied cellular and humoral immunity, phagocytosis, proteins of acute phase, cytokine status in patients with facial skeleton injuries before and after a stable external osteosynthesis of the lower jaw (66 patients - with normal consolidation, 17 - with delayed union). Results of research have allowed to establish that rotatory stages of bone regeneration (an inflammation, osteoblast proliferation, collagen synthesis and ossification) are accompanied by changes of immunologic status. Comparative study of dynamics of immunologic indexes at normal and abnormal osteogenesis has revealed criteria of the delayed bone consolidation.
Traumatology and Orthopedics of Russia. 2009;(2):59-66
pages 59-66 views

Features of curative physical factors use for correction of synovial homeostasis disorders at rehabilitation of patients with posttraumatic osteoarthritis of large joints

Udartsev E.Y., Chantsev A.V., Raspopova E.A.

Abstract

The purpose of the work is to study the influence of therapeutic physical factors on synovial homeostasis at patients with posttraumatic osteoarthritis large joints. The rehabilitation of 194 patients with posttraumatic osteoarthritis of hip, knee and ankle joints which was accompanied by increased intra-articular friction as a result of disorders of synovial homeostasis was carried out. The most evident positive changes in synovial homeostasis were achieved by means of complex of therapeutic physical factors including mechanotherapy in the swimming-pool with nitric-siliceous radon containing mineral water, peloidotherapy, interferencetherapy and electromyostimulation of the para-articular muscles. The achieved medical effect is comparable with intraarticular introduction of elastoviscous synovial fluid implant «Synocrom».
Traumatology and Orthopedics of Russia. 2009;(2):67-72
pages 67-72 views

Complex treatment of coxarthrosis using magnetotherapy and phonophoresis with gel Nurophen

Egorova E.V., Shiman A.G., Shabrov A.V., Linnik S.A., Romashov P.P.

Abstract

Investigation of 80 patients with coxarthrosis in I and II stages is carried out. Clinical, functional and tool methods of research are applied for the purpose of study of a functional status of the affected joints. The estimation of efficiency of appointment of complex therapy with application of medicamentous treatment, magnetotherapy and phonophoresis with nurophen at patients with coxarthrosis is carried out. The expressed anaesthetising and myorelaxing action of the developed technique leading to substantial increase of efficiency of complex treatment of patients is revealed.
Traumatology and Orthopedics of Russia. 2009;(2):73-75
pages 73-75 views

The effect of features of surgical treatment of children with the extensive thermal injuries on the frequency of invasive candidosis

Baindurashvili A.G., Kolbin A.S., Brazol M.A., Aristov A.M.

Abstract

The authors analyzed the results of treatment of 78 children with the extensive thermal injury in age from 4 months to 16 years. The frequency of invasive candidosis was 32%. Following peculiarities of surgical treatment exert statistically reliable influence on the development of this mycological complication: the burn more than 50% body surface, necrectomy on the 1-2 day after injury, escharotomy more than 15% body surface, disuse the xenografts, size of the donor wound more than 10% in the primary skin grafting, the number of skin graftings less than 3.
Traumatology and Orthopedics of Russia. 2009;(2):76-80
pages 76-80 views

Types of locomotor dysfynction in children with paralytic foot deformities with sequerlae of meningo myelocele of lumbosacral localization

Degtyareva E.I., Baindurashvili A.G., Konyukhov M.P.

Abstract

64 patients with sequelae of meningomyelocele in lumbosacral region /age: 0-17 years/ were examined for with clinical and neurological status and electromyografy. These examination have allowed to reveal three types of locomotor dysfunction depending on a level of spinal cord affection.
Traumatology and Orthopedics of Russia. 2009;(2):81-88
pages 81-88 views

Reproducibility error of dera method in pbmd measurements around a non-cemented «Spotorno» stem (experimental research)

Avrunin A.S., Tikhilov R.M., Shubnyakov I.I., Ganeva M.P., Pliev D.G., Popov V.V., Tovpich I.D.

Abstract

Aim of study - to estimate a reproducibility error (RE) of DERA measurements of periprosthetic bone around a non-cemented «Spotorno» stem on an in vitro model, and basing on these data to suggest an examination algorhythm allowing its minimization to clinically negligible values. The main factors influencing method RE are: patients' incorrect positioning and RE of the apparatus-programming unit. In cases of femoral bone rotation within the limits of +50 the greatest PBMD deviations amount to 5.1-8.8%. The maximal reproducibility error of the apparatus-programming DERA unit is found in Gruen area 7, amounting to 6.5%. With the help of computer modeling an algorhythm has been found, which allows to minimize the apparatus-programming unit RE to clinically negligible values.
Traumatology and Orthopedics of Russia. 2009;(2):89-95
pages 89-95 views

The modeling of elbow posterior instability after injuries of forearm anterior structures (experimental study)

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

Abstract

Authors made experiment to study conditions at which recurrent posterior dislocation of forearm bones occurs. Bone and soft tissue structures providing stability of elbow joint, necessary and sufficient conditions of its stabilization were studied. It is found out that the most important structure stabilizing an elbow joint is the forward portion of medial collateral ligament. Its damage against the background of bone fracture results in posterior dislocation. The biomechanical substantiation of efficiency of various techniques of operative treatment of old recurrent posterior dislocation of forearm bones is received.
Traumatology and Orthopedics of Russia. 2009;(2):96-101
pages 96-101 views

Possibility assessment bone quality by radiogrammetry in femoral neck fractures

Pliev D.G., Tikhilov R.M., Shubnyakov I.I., Deev R.V., Popov V.V., Ganeva M.P.

Abstract

The authors conducted a comparative analysis of dual energy X-ray absorptiometry, histomorphometry and radiogrammetry to assess the quality of bone and to identify possible correlations between them. Selected group of 40 patients with femoral neck fractures. Femoral head removed during the operation sent to histomorphometry, then do densitometry of proximal femur and the evaluation of the quality of bone radiogrammetry method to conventional X-ray proximal femur in the front-rear projection. The high degree of correlation method radiogrammetry with methods histomorphometry and dual energy X-ray absorptiometry, which allows you to use this method to evaluate the quality of bone in patients with neck fractures in the acute period of trauma.
Traumatology and Orthopedics of Russia. 2009;(2):102-105
pages 102-105 views

Locked intramedullary osteosynthesis in nonunion and pseudarthrosis of the tibia

Pavlov D.V., Novikov A.E.

Abstract

The results of locked intramedullary osteosynthesis in 48 patients with pseudarthrosis and nonunion of the tibia, from 6 months to 4 years, have been observed. In 27 cases the patients had been previously operated by means of external fixation with Ilizarov apparatus (13), with plates (11), with screws (2), with plate and Ilizarov apparatus (1). We achieved union in 44 patients (91,6%) at 10±1,3 months, including 4 from 6 patients with bone defects and osteomyelitis of the tibia with remission. The results of treatment allow the application of locked intramedullary osteosynthesis in complicated pseudarthrosis.
Traumatology and Orthopedics of Russia. 2009;(2):106-111
pages 106-111 views

Two cases of surgeral correction of scoliosis complicated with syringomieliya

Umarkhodjaev F.P., Matyushin A.F., Tadjiev M.M., Salamatov G.M.

Abstract

The authors describe two cases of radical correction scoliosis complicated with syringomyelia. Stages of spinal operative treatment without using neurosurgical methods of central nervous system decompression are expounded.
Traumatology and Orthopedics of Russia. 2009;(2):112-116
pages 112-116 views

Version of the subastragalar arthrodesis

Tikhilov R.M., Voronkevich I.A., Malygin R.V., Lasunsky S.A.

Abstract

A new internal fixator The Plate for osteosynthesis of periprithetic femoral fractures is described and illustrated in compare with conventional straight AO-ASIF femoral LCP. This new plate is simple, reliable and AO-ASIF compatible metal implant designed for fractures around or below the stable endoprothetic stem i.e. for В1 and C types according the Vancouver classification by C.P. Duncan and B.A. Marsi. The periprothetic plate allows to fix these types of fracture more rigidly than other internal fixators and thus improve final functional results
Traumatology and Orthopedics of Russia. 2009;(2):117-122
pages 117-122 views

New methods for elimination of hand post-replantation neurogenetic deformity

Valetova S.V., Rodomanova L.A.

Abstract

A new internal fixator for osteosynthesis of periprithetic femoral fractures after hip replacement is described. This new plate is simple, reliable and AO-ASIF compatible metal implant designed for fractures around or below the stable endoprothetic stem i.e. for В1 and C types according the Vancouver classification by C.P. Duncan and B.A. Marsi. The periprothetic plate allows to fix these types of fracture more rigidly than other internal fixators and thus improve final functional results.
Traumatology and Orthopedics of Russia. 2009;(2):123-126
pages 123-126 views

Version of the subastragalar arthrodesis

Tikhilov R.M., Koryshkov N.A., Privalov A.M., Bezgodkov Y.A.

Abstract

Post-traumatic disoders and deformities of the hindfoot are important problems of modern traumatology. Original technique for stabilization of talocalcaneal joint and correction of hindfoot deformity by special bioresorbable transplant is described. Diagram illustrating the method of fixation is presented.
Traumatology and Orthopedics of Russia. 2009;(2):127-129
pages 127-129 views

The method of tenioperoneal canal decompression

Toshev B.R., Khamraev S.S.

Abstract

Разработан и внедрен в клинику оригинальный способ хирургической декомпрессии тениоперониального канала при посттравматических туннельных синдромах, вызванных неправильно сросшимися переломами пяточной кости. Характерной особенностью предложенного способа является поднадкостничая резекция латеральной стенки пяточной кости, которая позволяет увеличить объем канала и оптимизировать скольжение сухожилий малоберцовых мышц.
Traumatology and Orthopedics of Russia. 2009;(2):130-132
pages 130-132 views

The case of calcaneal osteochondroma

Zasulsky P.Y., Zaytseva M.Y., Privalov A.M.

Abstract

The case of successful surgical treatment of a patient with calcaneal osteochondroma is described. Diagnostic pitfalls during outpatient examination and treatment are discussed. The obvious histological and morphological illustrations as well as roentgenographic picture are cited. The authors describe low-traumatic approach for surgical operation.
Traumatology and Orthopedics of Russia. 2009;(2):133-135
pages 133-135 views

Pedicle plasty with axial muscle flaps at foot osteomyelitis (review)

Tikhilov R.M., Kochish A.Y., Philimonova M.N., Kozlov I.V.

Abstract

The authors present the literature review, devoted to a problem of reconstruction of osteomyelitic foot defects. In spite of the revealed tendencies, the necessity of some questions adjustment, connected with use of local plastic resources still remains.
Traumatology and Orthopedics of Russia. 2009;(2):136-143
pages 136-143 views

Current aspects of treatment of hindfoot fracture complications

Tikhilov R.M., Fomin N.F., Koryshkov N.A., Emelyanov V.G., Privalov A.M.

Abstract

Actuality of the problem of treatment in patients with the fractures of talus and calcaneus is shown. A brief analysis concerning different techniques of conservative and surgical treatment of such patients. Different techniques of arthrodesis of subtalar joint is discribed.
Traumatology and Orthopedics of Russia. 2009;(2):144-149
pages 144-149 views

Therapeutic approach at pathologic fractures (review)

Tarasov A.N.

Abstract

Pathological fractures are leading complication of tumors and tumor-like diseases of bones. Principles of treatment of pathological fractures have the features. The comparative analysis of surgical methods for stabilization of pathological fractures is perfomed, optimum tactics of treatment depending on the localization, specific properties of the amazed bone and involving adjacent the soft tissue structures is certain. Operative treatment of pathological fractures on a background of malignant processes at lesion of the articulate end assumes replacement, and at lesion diaphysis of long bones - a segmentary resection with application of osteal cement or plastics and fixing metal designs. At pathological fractures on a background of good-quality tumors and tumor-like lesions it is necessary to adhere to active surgical tactics and to carry out a resection of a bone in a combination to an osteosynthesis in the first days after its occurrence.
Traumatology and Orthopedics of Russia. 2009;(2):150-156
pages 150-156 views

Povrezhdeniya oporno-dvigatel'nogo apparata u detey, poluchennye vsledstvie nasil'stvennykh deystviy

Solov'eva K.S., Bityukov K.A., Martynova M.V.

Abstract

Circumstances of 469 cases of trauma in children who have seen a traumatologic department of an out-patient hospital because of violent actions of surrounding persons at home, in the street or in the school were studied. Among patients there were 71.6% of boys. Often physical violence was combined with psychological one. 41.2% of afflicted injuries were superficial contusions, 0.4% the burns, 8.1% the superficial wounds and grazes localized mostly in the head and face. To these patients an ambulatory care was rendered. 50.3 per cent of those who has been suffered from physical violence were hospitalized because of bone fractures and closed craniocerebral injury.
Traumatology and Orthopedics of Russia. 2009;(2):157-159
pages 157-159 views

ALEKSANDR FEDOROVICh KRASNOVk 80-letiyu so dnya rozhdeniya

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Traumatology and Orthopedics of Russia. 2009;(2):160-161
pages 160-161 views

VAGRAM VAGANOVICh AGADZhANYaNK 60-LETIYu SO DNYa ROZhDENIYa

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Traumatology and Orthopedics of Russia. 2009;(2):162-163
pages 162-163 views

ARShIN VLADIMIR MIKhAYLOVIChk 50-letiyu trudovoy i nauchno-pedagogicheskoy deyatel'nosti

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Traumatology and Orthopedics of Russia. 2009;(2):164-
pages 164- views

Pravila dlya avtorov

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Traumatology and Orthopedics of Russia. 2009;(2):165-166
pages 165-166 views

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