N.N. Priorov Journal of Traumatology and Orthopedics

Peer-review medical journal published quarterly since 1994.

Editor-in-Chief

Publisher

Founder

About

The journal covers current issues of modern traumatology and orthopaedics, such as multiple and combined (including firearms) damage to the musculoskeletal system, joint and spine pathology, metabolic osteopathy, skeletal system diseases, tumors and tumor-like processes.

The journal is the official publication of Russian Association of Traumatologists and Orthopedists (https://ator.su/).

The journal is wellcome for articles with results of experimental pathophysiological, morphological and biomechanical studies in traumatology and orthopaedics, as well as methods of pharmacological correction descriptions, an also anesthesiological aid and rehabilitation in case of diseases and damages of movement and support organs.

The main sections

  • Original study articles
  • Clinical case reports
  • Reviews
  • Short communications
  • Editorial articles
  • Clinical Practice Guidelines

Publications

  • quarterly since 1994
  • continuously in Online First (Ahead-of-Print) mode
  • with NO APC or ASC
  • manuscripts in English and Russian are accepteble

Distribution

  • articles published online in Online First mobe are available in Open Access;
  • regular issues available for subscription within embargo period (Delay Open Access) for 12 monthes;
  • preprins, accepted manuscripts and not final versions of articles may be openly distributed by authors (we support Green Open Access);
  • there are Gold Open Access option for authors to be choose.

Indexing

  • SCOPUS
  • Russian Science Citation Index
  • Google Scholar
  • Ulrich's Periodicals directory
  • Dimensions
  • Crossref
  • EMbase

Announcements More Announcements...

 

Prof. Sergey P. Mironov, Editor-in-Chief of the 'N.N. Priorov Journal of Traumatology and Orthopedics' has passed away

Posted: 15.08.2023

 

On August 14, 2023, at the 76th year of life, after a short illness, Sergey Pavlovich Mironov - an outstanding scientist, excellent organiser, excellent clinician, erudite teacher, remarkable public figure, Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences, Editor-in-Chief of the journal "N.N. Priorov Bulletin of Traumatology and Orthopaedics" - passed away suddenly.


 

'N.N. Priorov Journal of Traumatology and Orthopedics' journal accepted for indexing in SCOPUS

Posted: 20.07.2023

 

The 'N.N. Priorov Journal of Traumatology and Orthopedics' journal has been successfully evaluated and accepted for indexing in the SCOPUS database.

The Scopus Content Selection & Advisory Board (CSAB) has reviewed the journal and approved it for coverage. The message from CSAB was received on 11.07.2023.

Journal evaluation tracker URL: https://suggestor.step.scopus.com/progressTracker/?trackingID=2414A6BCE0086B1D 

All articles published in the journal from 2023 are subject for indexation.


 

Current Issue

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Vol 30, No 4 (2023)

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Original study articles

Clinical tests in the diagnosis of scapholunate ligament injuries
Golubev I.O., Gazimieva B.M., Sautin M.E., Korolev A.V.
Abstract

BACKGROUNDNon-invasive instrumental methods of scapholunate ligament injuries, one of the main wrist joint stabilisers, are complicated by frequent false results of examination, and therefore clinical testing is essential in making the diagnosis. At the same time, the limited number of existing specific tests requires evaluation of their prognostic accuracy.

AIM: Evaluating the diagnostic significance of alternative specific tests in the diagnosis of scapholunate ligament injuries.

MATERIALS AND METHODS: In this study, we performed clinical examination and testing of both carpal joints in 50 subjects who had no complaints of carpal joint dysfunction or pain and denied a history of trauma. In clinical testing, the presence or absence of pain during palpation in the projection of the scapholunate ligament was analysed, as well as the specific Watson test, the navicular balloting test and the Kleinman test, for which specificity was assessed.

RESULTS: The specificity of scapholunate ligament palpation as a diagnostic test was 84.0%, Watson test — 96.0%, navicular balloting test — 98.0%, Kleinman test — 87.0%. The overall specificity of clinical tests was 79.0%. A combination of Watson test, navicular balloting test and Kleinman test achieved the highest specificity (86.0%).

CONCLUSIONS: Clinical testing is an important diagnostic tool in suspected scapholunate ligament injuries, however the benefit of isolated clinical tests is not absolute and therefore the best algorithm for clinical examination of the wrist joint may be the use of several specific clinical tests in combination.

N.N. Priorov Journal of Traumatology and Orthopedics. 2023;30(4):385-392
pages 385-392 views
Analysis of the early results of using the direct anterior approach with a skin incision “bikini” in primary hip arthroplasty
Eremin I.K., Daniliyants A.A., Ogarev E.V., Zagorodniy N.V.
Abstract

BACKGROUND: The use of less invasive techniques in hip arthroplasty is on the rise, which has led to an increased interest in direct anterior access and contributed to a significant expansion of its use over the past two decades. From an anatomical point of view, the use of direct anterior access in hip arthroplasty is associated with less soft tissue trauma.

AIM: To evaluate the results of primary hip arthroplasty using direct anterior access with a "bikini" skin incision.

MATERIAL AND METHODS: 163 patients with coxarthrosis were enrolled in the study, including 71 men and 92 women, who were then randomised into 2 groups: group 1 (comparison) — 78 patients in whom a standard (lateral) access was used for primary hip arthroplasty, and group 2 (main) — 85 patients in whom a direct anterior access was used for primary hip arthroplasty. To study the effectiveness of the proposed approach to hip arthroplasty, we used the results obtained by dynamic assessment of complaints (severity of pain syndrome) and functional status of the affected joint using Harris Hip Score and Western Ontario and McMaster Universities osteoarthritis Index WOMAC scales. When analysing the surgical treatment safety, the incidence of postoperative complications was taken into account.

RESULTS: In total, 3 cases of complications (3.9%) were noted in the comparison group, whereas in the main group the number of complications in the early postoperative period after endoprosthesis was lower — 1 case (1.2%). The assessment of inpatient treatment duration showed that in the comparison group the value of this index was equal to 5–6 days, whereas in the main group it was lower, being 2–3 days. Studying the dynamics of the pain syndrome assessment index by the patients according to the visual analogue scale showed that a day after the operation the index value in group 2 was 7.94±0.41 points which was statistically significantly lower (p <0.05) than the corresponding index in group 1 — 8.21±0.39 points.

CONCLUSION: In the postoperative period, the use of direct anterior access in hip arthroplasty is associated with a lower severity of pain syndrome, faster recovery of hip joint functionality, and shorter in-patient stay compared with anterolateral access.

N.N. Priorov Journal of Traumatology and Orthopedics. 2023;30(4):393-407
pages 393-407 views
Joint-sparing surgery in patients with acetabular dysplasia complicated by sphericity of the femoral head
Teplenky M.P., Bunov V.S., Fozilov J.Т.
Abstract

BACKGROUND: Acetabular dysplasia combined with ischaemic deformity of the femoral head contributes to rapid progression of coxarthrosis in young adults. The issues of treatment tactics for this pathology remain unresolved.

AIM: Analysis of the immediate and mid-term results of extra-articular and intra-articular combined reconstructive interventions performed in patients with acetabular dysplasia combined with femoral head sphericity disorder.

MATERIALS AND METHODS: Treatment outcomes were studied in 23 patients with acetabular dysplasia associated with femoral head deformity. The average age at the operation was 19.0±1.2 years (14–34). The mean follow-up period was 3.4±0.4 years. Anatomical and functional results were evaluated according to the criteria of D’Aubigne-Postel, Tonnis and according to the Russian Scientific Center “Restorative Traumatology and Orthopedics” system. Extra-articular reconstructive interventions on both articular components were performed in 14 patients. In 9 cases, intra-articular operations were performed.

RESULTS: Functional results after extra-articular interventions: good (15–17 points) — 8 joints, satisfactory (12–14 points) — 6 joints. The average score was 5.05±0.06 points. Functional results after intra-articular interventions: good (15 points) — 3 joints, satisfactory (13–14 points) — 5 joints, unsatisfactory (7 points) — 1 joint. The average score is 4.3±0.07 points. Rapid progression of arthrosis was noted in one case. In other cases, the degree of arthrosis did not change. Anatomical results of treatment after extra-articular interventions: good (2.6±0.03) — 8 joints, satisfactory (1.95±0.06) — 6 joints. Anatomical results of treatment after intra-articular interventions: good (2.55±0.01) — 2 joints, satisfactory (2.1±0.04) –— 6 joints, unsatisfactory (1.6) — 1 joint.

CONCLUSION: Differential application of extra-articular and intra-articular joint-saving interventions makes it possible to slow down the progression of the pathological process in the joint in conditions of sphericity disturbance of the articular surfaces, which makes it possible to consider them as a temporary alternative to endoprosthesis in adolescents and young adults.

N.N. Priorov Journal of Traumatology and Orthopedics. 2023;30(4):409-418
pages 409-418 views
Evaluation of the effectiveness of preoperative halo-traction in patients with severe spinal deformities using dynamography
Kolesov S.V., Tsykunov M.B., Bagirov S.B., Kazmin A.I., Pereverzev V.S.
Abstract

BACKGROUND: Surgical treatment is the main method of treatment for patients with severe forms of idiopathic scoliosis. In severe spinal deformities, halo-traction can be used as a preoperative preparation stage. However, it is difficult to assess the results of traction preparation in rigid deformities. Nevertheless, the Tergumed Pegasus 3D biofeedback device can be used to assess changes in spinal mobility.

AIM: To evaluate the effectiveness of preoperative halo-traction preparation in patients with severe spinal deformities using dynamography.

MATERIALS AND METHODS: We prospectively analysed the results of 15 patients with severe spinal scoliotic deformities preoperatively. All patients received halo-traction while standing in a walking frame or sitting in a wheelchair as a preoperative preparation. We calculated the deformity mobility index, measured the volume of movement and static strength of spinal muscles in three planes using the dynamographic method before and after traction preparation. The data were statistically analysed using the Wilcoxon test.

RESULTS: Changes in the mobility index before and after preoperative preparation were statistically insignificant (p >0.05). Analysis of changes in the spinal movement volume revealed an increase in the range of motion in almost all dimensions, except for extension and lateral bending to the convex side of the deformity. A statistically significant increase in the movement volume was observed in axial rotations to the convex and concave sides of the deformity, and in lateral bends to the concave side (p <0.05), while spinal flexion showed a statistically insignificant improvement. The study of static spinal muscle strength showed an increase in strength in all angles, but statistically significant changes were found in lateral bending to the convex and concave sides, turning to the convex side, and back extension.

CONCLUSION: The data obtained demonstrate an increase in the strength of the spinal muscles after halo-gravity training, as well as an increase in mobility. Dynamography has been shown to be effective in assessing preoperative halotraction preparation in patients with severe spinal deformities, but further studies with a higher level of evidence are required.

N.N. Priorov Journal of Traumatology and Orthopedics. 2023;30(4):419-430
pages 419-430 views
Determining the effectiveness of a xenogeneic bone matrix decellularization protocol in in vitro and in vivo studies
Smolentsev D.V., Lukina Y.S., Bionyshev-Abramov L.L., Serejnikova N.B., Kovalev A.V., Berchenko G.N.
Abstract

BACKGROUND: Restoration of tissue integrity, including bone tissue, is currently an extremely urgent task, both because of the increasing number of high-energy traumas accompanied by severe skeletal injuries and the growing number of revision endoprosthetics requiring the use of bone-plastic materials.

AIM: To determine the efficacy of the developed protocol for decellularization of xenogenic bone matrix in preclinical in vitro studies aimed at defining the purification matrix degree, on the basis of histological, microtomographic evaluation, cell culture method, and in vivo studies aimed at identifying the biocompatibility and osteogenic properties of the materials.

MATERIALS AND METHODS: Xenogenic spongiosis tissue of bovine femoral bones was fragmented to the size of 10×10×10 mm and treated with water, hypotonic solution and 3% hydrogen peroxide solution, deep purification by supercritical fluid extraction was applied. The efficiency of the optimal protocol was tested in vitro by cell culture method and in vivo.

RESULTS: The ideal interaction of cell culture with bone-plastic material was revealed, which may be associated with the absence of cytotoxic substances in the matrix, optimal roughness and good adhesive properties of the surface suitable for the formation of focal contacts by bone marrow stromal cells, their adhesion, spreading and proliferation. A pronounced bone callus with formed bone bridges running along the surface of the implanted material was determined 30 days after implantation. By this study period, the defect was practically closed due to the intermedial bone callus, the implanted material is found in the form of individual small osteocyte-free fragments.

CONCLUSIONS: The xenogenic bone matrix purified according to the developed protocol is bio- and cytocompatible, has pronounced osteoconductive properties, effectively stimulates regenerative osteogenesis in living organism.

N.N. Priorov Journal of Traumatology and Orthopedics. 2023;30(4):431-443
pages 431-443 views

Clinical case reports

A case series of combined Ilizarov method and suture button fixation in neglected syndesmosis injury. Case series
Sutyagin I.V., Burtsev A.V.
Abstract

BACKGROUND: There are known open, minimally invasive and reconstructive-plastic interventions to restore the distal intercostal syndesmosis, the postoperative rehabilitation protocols of which assume no load on the operated limb and immobilisation for 2 to 6 weeks with progressively increasing load after immobilisation with a plaster cast or orthosis. Closed percutaneous osteosynthesis of the shin bones with the Ilizarov fixator of the ankle and subtalar joints is a self-sufficient method in the treatment of ankle joint injuries accompanied by the failure of the distal intercostal syndesmosis. Neutral stable osteosynthesis with the Ilizarov fixator with a dosed volume of movement and joint decompression in combination with immersion fixators of the distal intercostal syndesmosis has not been described before.

CLINICAL CASES DESCRIPTION: The article presents three clinical cases demonstrating the possibilities of neutral stable osteosynthesis with the Ilizarov fixator both as a stand-alone method in the treatment of chronic lateral foot subluxations as well as in combination with fixation of the distal intertrochanteric syndesmosis using a button fixator. The new technology consists in the combined use of the Ilizarov apparatus in the treatment of chronic lateral foot subluxations due to its repositioning capabilities in rigid foot subluxations with the creation of controlled forces and controlled degree on fixation rigidity at any stage of treatment, fixation of the joint in a functionally favourable position to create a stable and correct position of implants and suture material for a period corresponding to the formation of mature scars, decompression and mechanical unloading in order to create a favourable condition of the foot.

CONCLUSION: The Ilizarov fixator in combination with dynamic systems of distal intertrochanteric syndesmosis fixation allows levelling the disadvantages of the method (restoration of relationships in the distal intertrochanteric joint by minimally invasive interventions with a minimum number of implants without compromising stability, short fixation time, which reduces the risk of complications, the requirement for outpatient follow-up, negative psychological aspects of external fixation conditions), while retaining its advantages (minimally invasive, manageable, and easy to use).

N.N. Priorov Journal of Traumatology and Orthopedics. 2023;30(4):445-456
pages 445-456 views
Features of treatment of hip fractures in children with severe forms of cerebral palsy
Tomov A.D., Gabidullina L.F., Shlyapnikova N.S., Hachubarov H.H., Popkov D.A.
Abstract

BACKGROUND: The increased incidence of fractures in children with severe spastic paralysis due to low-energy trauma is associated with poor bone mineral density, lack of adequate verticalization, and use of antiepileptic drugs. The most frequent localization of fractures is the lower extremities, especially the femur. The increased frequency of traumatization at this level correlates with a high level of impairment of global motor functions — levels IV–V according to the Gross Motor Function Classification System.

CLINICAL CASE DESCRIPTION: Surgical treatment of a femur fracture in a child with cerebral palsy was performed. Given the ineffectiveness of repositioning due to spasticity of the adductor and iliopsoas muscles, one-stage repositioning of the fragments, myotomy and osteosynthesis were performed. Treatment of fractures in 3 more children with cerebral palsy was also described in the article. The results were evaluated at least 6 months after the end of treatment. Surgical treatment is preferable, providing sufficient stabilization of the fracture, reducing the time of plaster immobilization and the probability of associated risks, as well as preventing delayed consolidation and nonunions.

CONCLUSION: Elastic intramedullary reinforcement used in the treatment of osteopenic fractures is a method of preventing fracture recurrence in the distant period or preventing significant fragment displacement.

N.N. Priorov Journal of Traumatology and Orthopedics. 2023;30(4):457-466
pages 457-466 views
A clinical case of sacrum and coccyx chordoma having a massive intrapelvic component (surgical treatment with a brief review of the literature)
Nazarenko A.G., Karpenko V.Y., Kolondaev A.F., Lyubeznov N.A., Berchenko G.N., Karpov I.N., Alekseev M.V., Kuzminov A.M., Alimova Y.V., Karasev A.L., Antonov K.A.
Abstract

BACKGROUND: Chordoma is a rare malignant tumor that develops from the remnants of the notochord and is located in the axial skeleton in the absolute majority of cases. It is most often localized in the sacrum, coccyx and pelvis, and is characterized by an initially asymptomatic long-time course, making early diagnosis difficult. Radical surgical treatment is the leading factor allowing to prolong the recurrence-free and overall survival of patients with chordoma, but it is often difficult due to complex anatomical localization of the tumor, as well as delayed medical treatment, frequently accompanied with the subsequent development of neurological complications, while in elderly patients with high comorbidity it is not always feasible.

CLINICAL CASE DESCRIPTION: We present a clinical case of radical surgical treatment of a patient with a S4-5 vertebral and coccyx chordoma showing a massive intrapelvic component. Clinical manifestations of the disease in the form of pain syndrome and pelvic organ dysfunction developed only when the tumor reached a larger size, forming a massive intrapelvic component up to 20 cm in size. The examination, including computer and magnetic resonance tomography, trepan biopsy with pathomorphologic examination, allowed to establish the diagnosis. Taking into account the size and localization of the tumor, the multidisciplinary team performed radical surgical intervention including sacral resection at the S3 level, coccygectomy with tumor removal. Morphological study of the removed tumor confirmed the diagnosis. In the early postoperative period, the wound healed by primary tension, the development of pelvic organs dysfunction was noted, which partially regressed by discharge. The article presents a brief review of the current problems of diagnosis and treatment of patients with chordoma.

CONCLUSION: Diagnosis and treatment of sacral chordoma is one of the most difficult problems of orthopedic oncology. A full preoperative examination and a multidisciplinary approach in this case made it possible to perform radical surgical intervention, reduce the risks of tumor progression, intra- and postoperative complications, and preserve the patient’s quality of life as much as possible.

N.N. Priorov Journal of Traumatology and Orthopedics. 2023;30(4):467-480
pages 467-480 views
Revision surgeries following ankle arthrodesis fixed with retrograde intramedullary nails affected by mechanical complications
Grazhdanov K.A., Zuev P.P., Kauts O.A., Baratov A.V., Norkin I.A.
Abstract

BACKGROUND: 25 percent of all musculoskeletal diseases that involve joints of the lower extremities accrues to ankle arthrosis. Late stages of this disease are indications for ankle arthrodesis. To date, surgeons who perform ankle arthrodesis do not agree about both the treatment technique for ankle articular surfaces and the method of their fixation, but other studies and our own observations suggest that 8 to 20 percent of the surgeries performed with retrograde locking rods lead to revision interventions due to the disorder of ankle ankylosis formation caused by mechanical complications associated with the implanted fixators (aseptic loosening of their parts, stress fracture of the intramedullary nail or locking screws, peri-implant tibia fracture).

CLINICAL CASES DESCRIPTION: The aim of this work was to study and demonstrate the results of revision surgical interventions performed for failed ankylosis after ankle arthrodesis with intramedullary rod fixation against the development of mechanical complications. Clinical observations of revision interventions for failed ankylosis of the ankle joint against the complications due to mechanical origin using a retrograde blockable intramedullary rod as the primary fixator were carried out. Our work presents the technology of revision surgical interventions in case of compromised processes of ankle joint bone block formation associated with aseptic loosening of the structural elements, stress fracture of the intramedullary rod and blocking screws, tibial peri-implant fracture.

CONCLUSION: Revision surgery for complications due to mechanical origin after ankle arthrodesis with intramedullary rod fixation requires an individual approach in each clinical case.

N.N. Priorov Journal of Traumatology and Orthopedics. 2023;30(4):481-490
pages 481-490 views
Diagnostic value of magnetic resonance imaging using contrast enhancement, high-field tomographs in the detection of Morton’s neuroma
Bolshakova D.A., Kardanov A.A., Maysigov M.N., Korolev A.V.
Abstract

BACKGROUND: Magnetic resonance imaging (MRI) is becoming more and more widespread in our country, being one of the leading methods in diagnosing injuries and diseases of the ankle joint and foot. From year to year the number of tomographs and studies is steadily increasing, and the absence of ionising radiation, the possibility of visualising both soft tissue and bone structures makes this procedure more attractive for patients. Reproducibility of the study, the possibility of obtaining a second opinion distinguish MRI as a leading tool in the diagnosis of neuromas. Despite its relatively frequent use, the significance of MRI diagnosis in patients with suspected intertarsal neuroma using paramagnetic imaging, 3 tesla and 1.5 tesla MRI has not been fully reported.

СLINICAL CASES DESCRIPTION: The article presents a series of illustrative studies of patients with intermetatarsal neuroma: using paramagnetic imaging tools, without the use of paramagnetic imaging tools, with large slice thickness, with high-field tomography.

CONCLUSION: Despite the obvious advantages of using high-field imaging in the diagnosis of peripheral nervous system diseases, in our opinion, the informative value of this study in the routine diagnosis of Morton's neuroma does not exceed that of the currently most common 1.5 tesla MRI.

N.N. Priorov Journal of Traumatology and Orthopedics. 2023;30(4):491-500
pages 491-500 views

SCIENTIFIC REVIEWS

Osteochondritis dissecants of the femur in children. Treatment. Modern tendencess
Yeltsin A.G., Ivanov I.A., Mininkov D.S., Gushchina D.A.
Abstract

Osteochondritis dissecants is a pathological condition characterized by the manifestation of subchondral osteonecrosis, which subsequently leads to the separation of the cartilage plate from the femoral condyle. It is a serious condition that can significantly affect patients' quality of life. Despite a significant amount of research, there is still a need to better understand this pathology and to develop effective diagnostic and treatment strategies to achieve optimal clinical outcomes. The aim of this work was to analyze the literature on osteochondritis dissecants of the knee joint and to substantiate modern treatment methods for this disease, as well as to find out the preferred treatment options depending on the age group of patients. Literature sources were analyzed. The search was carried out in the databases RSCI, NCBI Pubmed, Medline for the last 10 years. Osteochondritis dissecants is a disease requiring a modern approach to treatment. With the advent of new technologies and techniques, various therapeutic options have emerged, such as collagen membrane replacement of the defect, mosaic chondroplasty, etc. However, the question of the preferred treatment method remains relevant, especially in view of the age-related characteristics of patients. An individualized approach, taking into account their age, stage of injury and clinical features, is an important aspect for effective treatment of osteochondritis dissecants. Further research and clinical follow-up are needed to better define the most effective treatment strategies and prevent complications.

N.N. Priorov Journal of Traumatology and Orthopedics. 2023;30(4):501-512
pages 501-512 views

Short communications

VII Congress of Traumatologists and Orthopedists of the Far Eastern Federal District
Shigaev E.S., Davydov S.O., Miromanov A.M.
Abstract

The brief message provides information about the VII Congress of Traumatologists and Orthopedists of the Far Eastern Federal District held on August 25–26, 2023 in Ulan-Ude together with the interregional scientific and practical conference with international participation “Topical Issues of Traumatology and Orthopedics of the Far East”. The work of the VII Congress was held in a dynamic and fruitful format, which made it possible to achieve the goals set — modern issues of prevention, diagnosis, treatment of injuries, diseases and conditions of the musculoskeletal system, medical rehabilitation of patients were considered, which made it possible to improve existing or master new knowledge, skills, and abilities and the competence of students to carry out high-quality professional activities in the specialty “Traumatology and Orthopedics”, which will ultimately form labor functions in accordance with the professional standard “traumatologist-orthopedist”. At the end of the Congress, the delegates adopted a resolution reflecting the most problematic aspects of the service, the solution of which will significantly increase the availability and quality of the provision of traumatological and orthopedic care in the Far Eastern Federal District.

N.N. Priorov Journal of Traumatology and Orthopedics. 2023;30(4):513-519
pages 513-519 views

Anniversary

On the centenary of birth!
Abstract

The year 2023 marks the 100th anniversary of the birth of many famous scientists who worked at the N.N. Priorov Central Institute of Orthopaedics and made a tremendous contribution to the development of our profession.

N.N. Priorov Journal of Traumatology and Orthopedics. 2023;30(4):521-528
pages 521-528 views


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