No 4 (2008)

ARTICLES

Ispol'zovanie ostrovkovykh loskutov iz lateral'noyshirokoy myshtsy bedra v lechenii patsientovs gnoynymi oslozhneniyami posleendoprotezirovaniya tazobedrennogo sustava

Tikhilov R.M., Kochish A.Y., Razorenov V.L.

Abstract

The short-term results of treatment and follow-up in 37 patients with the osteomyelitis of proximal femoral part and the area of acetabulum including 26 patients with deep periprosthetic infection after hip replacement were followed in period from 6 till 44 months after the carrying out of operations according to worked up technique supposing the radical surgical debridement of infectious nidi and the single-stage replacement of cavities by means of island flap from lateral wide hip muscle. Good results were received at the medium terms of observation 21,3±9,2 months in 70,6% of cases and the recidivation of osteomyelitis was detected in 5,9%. The carried out analysis of clinical material allowed to determine indications for the operation and contraindications to surgery.
Traumatology and Orthopedics of Russia. 2008;(4):7-14
pages 7-14 views

Vliyanie D,L-karnitina na regeneratsiyuperifericheskogo nerva pri ego polnom pereryve

Seryakov V.I.

Abstract

The aim of the work - to study the influence of impulsive magnetic field and D,L-carnitine on the processes of peripheric nerve degeneration and regeneration after the carrying-out of epiperineural suture. 30 rabbits - the males of the breed "chinchilla", which were assigned to 3 groups, were operated. 10% solution of D,L-carnitine was daily introduced to III group during 10 days after the operation into ear vein in dose 30 mgДg diluted with physiologic saline. Carnitine as many other biomolecules thanks to the presence of asymmetrical C-atom in their structure in β-position may be in two isomeric forms that have equal chemical composition but different spatial configuration and each configuration is the mirror reflection of another one - L-carnitine (left form) and D-carnitine (right form), this difference leads to their absolutely different value for human organism. D,L-carnitine stimulates not only the utilization of decayed axons and myelinic membranes but the regeneration of the nerve fibers of anatomically restored peripheric nerve, greatly reduces the area of neurotrophic ulcers, hastens their healing.
Traumatology and Orthopedics of Russia. 2008;(4):15-20
pages 15-20 views

Povyshenie vnutrifutlyarnogo davleniya i vozmozhnost'fastsiotomiy pod endovideoskopicheskim kontrolem u postradavshikh s perelomami kostey goleni

Khubulava G.G., Dulaev A.K., Dydykin A.V., Zayats V.V., Gladkov R.V., Fomichev S.V., Shuginov A.A.

Abstract

From 2004 till 2008 the index of intracompartmental pressure was analysed at 58 patients with comminuted fractures of the lower legs and significant damage of soft tissue. 72,4% of them had moderate rise of intracompartmental pressure (from 15 to 29 mm Hg) and in 27,6% the pressure was high (more than 30 mm Hg). We develop the subcutaneous endoscopy-assistant method of the fascial dissection. This technic had a lower risk of damage the vessels, nerves and muscles. 12,1% patients had an open decompression, 34,5% - subcutaneous, and in 53,4% by endoscopy-assistant fasciotomy. The tibial fractures was treated by external fixations or locked tibial nails. Monitoring of intracompartmental pressure showed the high effectivenes of subcutaneous endoscopy-assistant fasciotomy, such as after the open decompression.
Traumatology and Orthopedics of Russia. 2008;(4):21-27
pages 21-27 views

Reabilitatsiya bol'nykh posle khirurgicheskogo lecheniyavnutrisustavnykh perelomov krupnykh sustavov

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

Abstract

The aim of study - to elaborate the complex of rehabilitation measures for correction of structural changes and functional violation in supporting organ, developed after a surgical treatment of intraarticular fractures, which form knee and ankle joints. Rehabilitation of 19 patients with stable contractures in combination with posttraumatic osteoarthritis was carried out with the use of mechanotherapy in the swimming-pool with nitric-siliceous radoncontaining mineral water, pelotherapy, low-frequency magnetotherapy, amplipulse therapy, intra-articular introduction of the medication "Alflutop", lidase and 15% solution of polyvinylpyrrolidone. Clinical orthopedic checkup, arthrophonography, arthrosonography and ultrasonic dopplerography showed the decrease of painful syndrome by Visual-Analogous Scale intension, stimulation of reparative chondrogenesis (increase of articular cartilage thickness in knee joint from 2,37±0,19 to 2,82±0,08 mm, p<0,05 and in ankle joint from 2,04±0,08 to 2,31±0,07 mm). Thus the elaborated complex let simultaneous positive effect on the structural changes and functional violations in supporting organ appeared after surgical treatment.
Traumatology and Orthopedics of Russia. 2008;(4):28-34
pages 28-34 views

Modifitsirovannye sposoby Bristow-Latarjet pri lechenii perednego privychnogo vyvikha plecha

Dlyasin N.G.

Abstract

The modifications of Bristow-Latarjet operation were developed. 228 patients were operated using these methods. The trauma was the origin of repeated dislocations in 134 cases, and the dysplasia of joint - in the rest 94 cases. There were 194 (85,1%) men and 34 (14,9%) women. Patients at the age of 20 till 40 prevailed - 157 (68,9%). The treatment follow-up was studied in 209 (91,7%) patients in the period from 1 till 15 years. The examination included: radiography and the contrast arthrography of joint in two projections, computer tomography and contrast computer tomography, the US (ultrasonic scanning) of humeral joints, the electromyogram and electroneuromyogram of shoulder girdle muscles. According to the results of the examination operations for the replacement of the bony defect of the anterior edge of glenoid cavity, operations for the increase in the articular platform of scapula and capsular plasty were carried out. These methods allow not only to restore anatomical interrelation in humeral joint and strengthen its anterior wall, but also to eliminate the persistent disjunction of the jointed surfaces of humeral bone head and glenoid cavity that allows to generate the dynamic stability of humeral joint.
Traumatology and Orthopedics of Russia. 2008;(4):35-40
pages 35-40 views

Vosstanovlenie dvustoronnego skhvata pri travmaticheskikh defektakh pal'tsev i kisti metodomperemeshcheniya ee segmentov

Azolov V.V., Aleksandrov N.M., Petrov S.V.

Abstract

The article presents the overview of hand and fingers reconstruction practice applying finger, finger stump, and metacarpal transfer, covering 184 cases with 203 fingers reconstructed in 189 hands. It describes a novel approach to hand segment transfer based on the application of delayed phenomenon in the segment transfer, which ensures reliable prevention of ischemic complications. Pedicle distraction credibly enhances indications for segment transfer eliminating dependency on its location and the nature of hand or finger defect (P=0.02 - 0.0001). Complete recovery of handgrip was achieved in 83.3% of cases, including the most severe ones.
Traumatology and Orthopedics of Russia. 2008;(4):41-45
pages 41-45 views

Otdalennye funktsional'nye rezul'tatyartroplastiki tazobedrennogo sustava u detey s posledstviyami ostrogo gematogennogo osteomielita

Garkavenko Y.E., Pozdeev A.P.

Abstract

52 patients aged from 14 to 37 years with sequelae of the acute haematogenous osteomyelitis in the proximal femoral metaepiphysis were examinated. These patients had a hip arthroplasty with demineralized osteochondral allografts. In 73,1% cases satisfactory results of the treatment were observed.
Traumatology and Orthopedics of Russia. 2008;(4):46-53
pages 46-53 views

Lechenie deformatsiy luchezapyastnykh sustavov u detey s artrogripozom

Agranovich O.E., Petrova E.V.

Abstract

The purpose of research was carrying out of the comparative analysis of results of treatment of wrist deformities in children with arthrogryposis at use of various techniques of surgical interventions: tendons plastics on a forearm and hand, resections of bones of a wrist in an isolated kind, and also to a combination of the given interventions. The basic variants of a pathology are revealed and classification of flexion wrist contractures is offered. Depending on degree of deformation tactics of surgical treatment is developed.
Traumatology and Orthopedics of Russia. 2008;(4):54-62
pages 54-62 views

Mikroflora ran otkrytykh perelomovrazlichnoy lokalizatsii (I soobshchenie)

Gostev V.V., Naumenko Z.S., Martel' I.I.

Abstract

The work deals with the results of wound discharge microbiological investigation in patients with open fractures, who were treated at RISC "RTO". The microflora of infected wounds has been established to differ depending on fracture localization, and this dependence is reflected in both - the different composition of species and the ratio of founded gram-positive and gram-negative bacterial monocultures and their associations as well. The greatest number of the wounds, complicated by infection, has been found in patients with open fractures of foot bones (90%). The microflora of gunshot fractures and those of foot bones is characterized by the presence of the great number of bacterial associations. There were no reliable differences found in the number of gram-positive bacterial cultures isolated depending on fracture localization. At the same time, wounds in patients with leg and foot fractures were found to be disseminated with gram-negative bacteria to the greatest extent (17,5% and 14,2%, respectively).
Traumatology and Orthopedics of Russia. 2008;(4):63-66
pages 63-66 views

Issledovanie osteokonduktivnykh svoystvgranulirovannogo steklokeramicheskogo materiala«Biosit» v eksperimente

Abolin A.B., Zaytseva M.Y., Afinogenova A.G., Netyl'ko G.I.

Abstract

The osteoconductive properties of granulated glass-ceramic material "Biosit-SR-Elkor" were confirmed in experimental study on animals. In fine-granulated "Biosit" (0,1 - 0,3 mm), introduced into the femoral medullary space of rats, bone structures were growing deeply into heterogeneous mass column. The osteointegration of big-granulated "Biosit" (0,1 - 0,3 mm) was limited to the zone of the contact of the material with bone tissue as a result of the late development of inflammatory macrophage giant-cell reaction. Fine-granulated "Biosit" may be used for the filling of bone cavities where the material will be in static state and gradually grow with bone structures. The duration of the processes of osteogenesis and the maturation of growing into the material bone limits its use for the fixation of the components of constructions at endoprosthesis replacement.
Traumatology and Orthopedics of Russia. 2008;(4):67-71
pages 67-71 views

Vliyanie tsementnogo i bestsementnogoendoprotezirovaniya krupnykh sustavov na sistemnyyimmunnyy otvet

Chepeleva M.V., Volokitina E.A., Shved N.S., Kolotygin D.A.

Abstract

With the purpose of the study of organism systemic immune response to the use of the cement and cementless fixation of endoprostheses in the nearest and remote terms after implantation the analysis of the indices of the immune state of 109 patients with gonarthrosis and coxarthrosis of III stage aged from 40 to 73 was carried out. The authors draw a conclusion that the reaction of immune system to actively functioning implant makes itself by the moderate activation of humoral immunity and the hyperproduction of TNFa against the background of the moderate depression of a cellular component of immune system. The dynamics of the indices of systemic immune response to large joints replacement are conditioned by surgical intervention directly and don't depend on the type of the fixation of implant.
Traumatology and Orthopedics of Russia. 2008;(4):72-77
pages 72-77 views

Novye sposoby kostnoy plastiki pri osteosintezeperelomov myshchelkov bol'shebertsovoy kosti

Voronkevich I.A.

Abstract

Two methods of bone autoplasty at the osteosynthesis of the fractures of condyles of tibia were described allowing to guarantee the painlessness of donor site; approximate the form and size of autograft to bone cavity maximally; reduce the traumatism of graft sampling; decrease in the work content of surgical intervention; create conditions for the incomplete structural restoration of donor site.
Traumatology and Orthopedics of Russia. 2008;(4):78-84
pages 78-84 views

Sberegatel'naya taktika pri nepolnykh povrezhdeniyakhperedney krestoobraznoy svyazki kolennogo sustava

Kuznetsov I.A., Bezgodkov Y.A., Ryabinin M.V., Rybin A.V.

Abstract

The data about 376 patients with the partial acute (61,4%) and old (38,6%) injuries of knee anterior crucial ligament in which we didn't resort to its reconstruction were analyzed. Two variants of the policy were assessed: the resection of stump or the injured part of the ligament and non-intervention in anterior crucial ligament. Basic factors influencing the choice of the variant of treatment were detected. The analysis of the results of the clinical and biomechanical assessment of the outcomes of treatment with the use of the methods of mathematical statistics testifies that saving policy at the incomplete injuries of anterior crucial ligament gives persistent positive effect.
Traumatology and Orthopedics of Russia. 2008;(4):85-89
pages 85-89 views

Gemotransfuzionnaya terapiya pri khirurgicheskomlechenii bol'nykh s metastaticheskimi porazheniyamipozvonochnika i s pozvonochno-spinnomozgovoytravmoy

Myl'nikov Y.N., Usikov V.D., Ptashnikov D.A.

Abstract

The comparative analysis of 40 case reports of patients with vertebrocerebrospinal trauma and 60 - with the metastatic lesions of spine detected that maximum hemorrhage is observed at the carrying-out of spondyloectomy with the plasty of interbody defect and spondylosynthesis on account of metastatic lesions. At surgical interventions on account of vertebrocerebrospinal trauma the application of preoperational blood autosampling, techniques of intraoperative collection and reinfusion of blood using apparatus Cell Saver, the collection of draining losses and their return by sac Handy Vak allow to lower the extent of hemotransfusion therapy by the preparations of donor blood. The connection between the kind of decompressive-stabilizing spine intervention and hemorrhage volume was detected. It allows to plan the operation, anesthetic and operative risks, measures to provide surgical intervention anesthetically.
Traumatology and Orthopedics of Russia. 2008;(4):90-94
pages 90-94 views

Ustroystvo dlya issledovaniya perednezadneynestabil'nosti kolennogo sustava

Tikhilov R.M., Trachuk A.P., Beresnev V.N., Serebryak T.V.

Abstract

The device for the objective study of knee stability in sagittal plane was described. It allows to carry out the quantitative assessment of anterior and posterior shin dislocation at the deficiency of cruciform ligaments. Suggested device differs in the simplicity of its use and guarantees the lesser error of measurements in comparison with analogs. The introduction of new device into practice will allow to assess quantitatively the degree of knee instability after the injury of cruciform ligaments as well as analyze objectively the functional results of surgical treatment.
Traumatology and Orthopedics of Russia. 2008;(4):95-99
pages 95-99 views

Dinamika osnovnykh pokazateley travmatizmai zabolevaemosti kostno-myshechnoy sistemyu naseleniya Leningrada - Sankt-Peterburga(itogi tridtsatiletnego monitoringa, provedennogo s 1976 po 2007 gg.)

Tikhilov R.M., Vorontsova T.N., Luchaninov S.S.

Abstract

The analysis of the dynamics of the basic indices of traumatism was carried out on the basis of statistical data received during the monitoring of the state of traumatism and musculoskeletal system morbidity in the adult population of Leningrad - Saint-Petersburg. The article in generalized form acquaints with master data received during long-term study. For greater information evidence some of the indices are presented in comparison with analogous data throughout RSFSR - Russia during the same temporal period.
Traumatology and Orthopedics of Russia. 2008;(4):100-106
pages 100-106 views

Kriterii otsenki ogranicheniya zhiznedeyatel'nostibol'nykh v pervyy god posle operatsiiendoprotezirovaniya tazobedrennogo sustava

Aliev D.A.

Abstract

59 patients were examined in the period till one year after total hip replacement. The experimental group of 10 persons was chosen. There were no postoperative complications at final examination. Active function-restorative treatment was carried out to all of them. Clinical and working prognoses are favorable. The analysis of the employment assistances of these patients detected that the people of easy physical labor and mental work, become invalids, work by profession without restriction. Consequently the authors came to conclusion that it is necessary to change the practice of the acknowledgement of patients as the invalids of II and I groups, prolong medical certificates for larger term.
Traumatology and Orthopedics of Russia. 2008;(4):107-110
pages 107-110 views

Faktory riska vozniknoveniya vyvikha posletotal'nogo endoprotezirovaniya tazobedrennogosustava (obzor literatury)

Zagorodniy N.V., Zakharyan N.G., Kardanov A.A., Ondar A.V., Elkin D.V., Panteleeva A.S.

Abstract

Dislocation is the frequent complication of total hip arthroplasty and the second most common cause for revision surgery, after loosening. There are many causes of unstable total hip arthroplasty: the incorrect positioning of the prosthetic components, multiple revisions, the weakness or imbalance of gluteal muscles, implant design and other factors.
Traumatology and Orthopedics of Russia. 2008;(4):111-116
pages 111-116 views

Shevtsov Vladimir Ivanovich(k 70-letiyu so dnya rozhdeniya) .

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Traumatology and Orthopedics of Russia. 2008;(4):117-118
pages 117-118 views

Rumyantseva Valentina Vasil'evna(k 90-letiyu so dnya rozhdeniya)

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Traumatology and Orthopedics of Russia. 2008;(4):119-120
pages 119-120 views

Ukazatel' statey, opublikovannykh v zhurnale«Travmatologiya i ortopediya Rossii» v 2008 godu

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Traumatology and Orthopedics of Russia. 2008;(4):121-124
pages 121-124 views

Avtorskiy ukazatel'

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Traumatology and Orthopedics of Russia. 2008;(4):125-126
pages 125-126 views

Pravila dlya avtorov

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Traumatology and Orthopedics of Russia. 2008;(4):127-128
pages 127-128 views

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