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Vol 25, No 3-4 (2018)


Potentialities of low invasive fixation of the anterior pelvic ring with threaded pin

Solod E.I., Lazarev A.F., Petrovskiy R.A., Ovcharenko A.V., Abdulkhabirov M.A., Alsmadi Y.M.


Purpose of study: to present the first experience of using the proposed method of pubic bones fixation and to determine the potentialities of its practical application. Patients and methods. During the period from 2016 to 2018 twenty patients (mean age 33.48 ± 10.85 years) with pelvic ring injuries were operated on. In all cases the pubic bones osteosynthesis with threaded pins was performed. In 15 (75%) cases the fractures (1980) were of type B1, in 5 (25%) - type C1 by Tile classification. In 14 (70%) patients the fractures of the pubic bones corresponded to Nakatani II, in 6 (30%) - Nakatani I. The quality of the reposition was assessed by Tornetta-Matta criteria and functional results were evaluated by Majeed score. The follow-up period varied from 6 to 24 months (14.2±5.6 months). Results. The average duration of fixation procedure of the pubic bone made up 10.4±4.2 min; the average volume of intraoperative blood loss in one pubic bone fixation was 6.3±1.4 ml. In all cases excellent and good reposition was achieved. In no one case the fixator migration was observed. Twelve months after surgery the functional results by Majeed score were assessed as excellent (15) and good (4) in 19 followed up patients. Conclusion. The use of the proposed method of the pubic bones fracture fixation with threaded pins can be recommended for patients with Nakatani I, II fresh fractures in the absence of soft tissue interposition. Rigid fixation of fragments with minimal risk of fixator migration provides conditions for early rehabilitation of patients and enables to achieve excellent and good functional results.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):6-11
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Anatomical anterograde plasty of the anterior cruciate ligament with lateral extraarticular tenodesis from semitendinosus tendon

Zayats V.V., Zagorodniy N.V., Dulaev A.K., Dydykin A.V.


Purpose of the study: to provide a scientific basis for the recommendations on clinical use of lateral extraarticular tenodesis (LEAT) from semitendinosus tendon (ST) graft as an additional element for knee stability in anterior cruciate ligament (ACL) anatomical anterograde reconstruction. Patients and methods. Treatment results were evaluated for 162 patients (mean age 27.2±2.8) with marked rotational joint instability (Pivot shift test 3+) after arthroscopic anterior cruciate ligament reconstruction (ACL-R). In 44 (27.2%) observations ACL-R was supplemented by LEAT from ST (group 1), in 118 (72.8%) the isolated anatomical anterograde plasty of ACL was performed (group 2). Lysholm Knee Scoring Scale, KOOS and 2000 IKDC were used for the assessment of the results. Results. Follow up period made up at least 2 years. Statistically significant differences between the groups were recorded in 21 months after intervention and later. In 43 (97.7%) patients from the 1group and 111 (94.1%) patients from the 2group excellent and good results (A and B by 2000 IKDC) were achieved. In 1 (2.3%) and 7 (5.9%) patients the results were assessed as satisfactory (C by 2000 IKDC), respectively. No statistically significant differences between the groups were recorded by Lysholm Knee Scoring Scale and 2000 IKDC (p>0.05). The average scores by KOOS that indicated the presence of pathological processes in the knee joint and characterized patient’s sport activity were statistically (p<0.05) better in patients from the 1group. Conclusion. LEAT from ST is a clinically effective supplement to the anatomical anterograde ACL-R in patients with marked rotational joint instability (Pivot shift test 3+) that enables not only to improve the overall knee stability but also to reduce the rate of unfavorable symptoms at follow up terms over 21 months after operation.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):12-18
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Additive technologies in surgical treatment of spinal deformities

Kuleshov A.A., Vetrile M.S., Shkarubo A.N., Docenko V.V., Es’kin N.A., Lisyanskiy I.N., Makarov S.N.


Purpose of study: to summarize the experience in three-dimensional biomodeling and custom made metal constructions for surgical treatment of spinal deformities of different localization and etiology, evaluate its advantages, potentialities and efficacy. Patients and methods. During the period from 2011 to 2018 three-dimensional (3D) custom-made spinal models were used in 52 patients with different spinal deformities: congenital multilevel spinal deformity (n=20), upper cervical spine deformities (n=12), III-IV degree of spondylolisthesis (n=10), neurogenic scoliosis (n=8), neurofibromatosis (n=2). 3D models were created in scale 1:1 by stereolithographic technique on the basis of computer model designed by spiral CT results. In all cases 3D models were used for preoperative planning including the intended deformity correction, decompression and spine fixation. In 26 cases 3D spinal models were used to manufacture the custom made metal constructions for the deformity correction and spine fixation: plates for the upper cervical spine anterior fixation, cervicothoracic junction, plates and cages for lumbosacral fixation, and implants for spinopelvic fixation. Results. In all cases the use of spine bio models enabled to achieve important additional information at preoperative planning and intraoperatively. Long-term follow up made up 3 years. After neural structures decompression and deformity correction good clinical and roentgenologic results were observed in all patients. Use of custom made implants ensured stable spine fixation in all cases with the exception of 3 patients in whom the implants were removed due to infectious complication (n=1) and poor postoperative wood healing. Conclusion. In deformities of different etiology the full-scale spine models provide better assessment of the deformity pattern and preoperative planning. 3D models and computer modeling make possible the manufacture of individual metal constructions for spine fixation that is especially topical in severe deformities.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):19-29
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Early functional results of total knee arthroplasty in patients with alimentary obesity

Helo M.D., Akhtiamov I.F., Said F.M., Gilmutdinov I.S., Yousef A.I., Abdullah A.M., Kuznetsova R.G.


Introduction. Total knee replacement has become a standard planned intervention at specialized clinics. The study of surgical results is not as urgent as the follow up of the patients with concomitant pathology because various complications are most often registered in this group. Purpose: to evaluate the efficacy of total knee arthroplasty in patients with increased body mass index at early rehabilitation steps. Patients and methods. Open prospective comparative study included 75 patients with III-IV stages of gonarthrosis by Kellgren-Lawrence. Mean age of the patients made up 63.8±6.87 years. Main group included 48 patients with excessive body mass and alimentary-constitutional obesity of different degree, the control group - 27 patients with normal body mass index. The duration of intervention, volume of blood loss intraoperatively and drainages was assessed. Evaluation of clinical functional results was performed OKS, KSS and visual analog scale (VAS) before surgery, at discharge, 3 months and 1 year after surgical intervention. Results. In comparison to the patients with normal body mass index the patients from the main group showed slightly higher duration of the intervention and intraoperative blood loss - by 13.05% (p=0.027) and 12.8% (p=0.003), respectively. In the main group the severity of pain syndrome by VAS decreased from 90.4±14.4 to 9.6±0.4 mm (p=0.0001), evaluation of clinical functional results by KSS increased from 47.39±1.63 to 88.02±2.01 points, by OKS - from27.3±4.3 to 43.2±6.5 points (p=0.001). In the control group the severity of pain syndrome by VAS within 1 year follow up decreased from 86.2±2.4 to 3.8±0.7 mm (p=0.002) and clinical functional indices by KSS increased from 52.2±10.1 to 93.8±1.3 points (p=0.001), by OKS - from28.4±1.6 to 44.7±1.9 points (p=0,001). Conclusion. The study results demonstrate the high potentialities of arthroplasty in patients with alimentary obesity and confirm the necessity of its performance for the improvement of the patients’ future quality of life.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):30-35
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Assessment of blood loss in total knee arthroplasty depending on the type of the endoprosthesis

Abelevich A.I., Abelevich O.M., Marochkov A.V.


Introduction. In the modern conditions arthroplasty of joints has become one of the main methods of treatment that enables to restore joint movements, weight bearing ability and quickly return the patient to an active lifestyle. Total knee arthroplasty (TKA) is accompanied by a significant blood loss resulting in a decrease of hemoglobin level and higher requirements in postoperative blood transfusion. Purpose of the study: to estimate the volume of blood loss in patients after total knee arthroplasty depending on the design of the endoprosthesis. Patients and methods. Retrospective study included 73 patients with stage 3 gonarthrosis by Kosinskaya. All patients were divided into groups: in group 1 (n=50) the standard total cemented knee joint endoprosthesis; in group 2 (n=23) - the associated rotational constructions were used. Hemoglobin and hematocrit tests were performed prior to and in 24 hours after operation. The volume of intra- and postoperative (in 24 hours) blood loss was calculated by the of hemoglobin balance formula. Results. In 24 hours after operation the hemoglobin level was 122.5 ± 9.6 g/l in patients from group 1 and 105.1±8.2 g/l (p=0.001) in patients from group 2. The difference in hemoglobin levels in patients within group 1 was 10.5±6.6 g/l, within group 2 - 28.5±7.5 g/l (p=0.006). The volume of intra- and postoperative (in 24 hours) blood loss for the 1st and 2nd patient groups of made up 420.5±276.7 ml, in group 2 it was 1163.0±302.5 ml (p<0.05), respectively. Fresh frozen plasma transfusion in intra- and postoperative period was performed to 23 (57.5%) patients from group 1 and 21 (91.3%) patients from group 2. Conclusion. The revealed features of blood loss after knee arthroplasty, depending on the type of implant construction, require appropriate organizational measures to ensure effective transfusion therapy in surgical interventions on the knee joint.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):36-41
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Efficiency of infiltration anesthesia with levobupivacaine and ropivacaine after the knee arthroplasty

Ageenko A.M., Baitov V.S., Pervukhin S.A.


Purpose: to study the efficacy and safety of levobupivacaine as the main component of infiltration anesthesia after knee arthroplasty. Patients and methods. Open randomized study included 284 patients (20 - 81 years) after total knee arthroplasty. Patients were divided into 2 groups, 142 patients in each group, depending on the anesthetic used (levobupivacaine or ropivacaine). The severity of pain syndrome within the first 48 hours after the operation by VAS, the need for the use of narcotic analgesics, presence of side effects was evaluated. Results. The mean time of acute pain occurrence was 255±83 min in ropivacaine group and 238±87 min in levobupiavacaine group (p=108). In 4 hours after surgical intervention 30 and 43% of patients from ropivacaine and levobupiavacainegroups required narcotic analgetics, respectively. Neither serious side effects nor complications directly related to infiltration anesthesia were recorded. Conclusion. Infiltration anesthesia with both levobupivacaine and ropivacaine is simple, safe and effective method for pain arrest after surgical interventuions of the knee joint.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):42-46
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Surgical correction of foot deformities as a method for prevention and treatment of diabetic foot syndrome

Parshikov M.V., Bardyugov P.S., Galstyan G.R., Yarygin N.V., Golovchak V.M., Bakunov M.Y.


Purpose: to study the potentialities of orthopaedic surgery in foot deformities as a method for prevention and treatment of diabetic foot syndrome (DFS). Patients and methods. During the period from 2014 to 2017 thirty seven patients (13 men and 24 women aged 47 - 75 years) with DFS were operated on for feet deformity. According to Texas University classification 4 patients had grade 0, 7 - grade 3 and 26 patients - grade 4a pathology. Primary deformities were observed in 13 cases, secondary deformities resulting from DFS - in 24 cases. Forty seven different surgical interventions were performed. All interventions were grouped according to D.G. Armstrong classification for DFS surgical treatment. The surgical task was the correction of biomechanics, unloading of foot segments that were subjected to high mechanical effect caused by the deformity. Results. The follow up period was from 2 moths to 3 years. Primary healing of the ulcers was observed after 32 surgical interventions. In 2 cases revision (more radical) surgical intervention was performed. No deformity relapse was noted. Postoperative wound suppuration was recorded in 1 case. Ulcer relapse was observed in 1 case. Conclusion. The study results allow suggesting a significant role and wide-ranging potentialities of surgical orthopaedics for the effective and functional treatment of patients with DFS.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):47-57
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Patella instability in children: surgical treatment results

Sautenko A.A., El’tsin A.G., Mininkov D.S., Stuzhina V.T., Merkulov V.N.


Introduction. Despite the fact that instability of the patella is a common pathology within the structure of knee joint diseases and injuries in children, currently there is no complete information on the basis of which one could judge the effectiveness and preference of a particular method of treating instability of the patella in children. Purpose of study: to evaluate the efficacy of surgical treatment techniques in children with post-traumatic instability of the patella. Patients and methods. The study was performed on the basis of examination and treatment data on 127 patients aged from 8 to 17 years with post-traumatic instability of the patella. Arthroscopic stabilization by Yamamoto technique, modified at our department, was performed in 49 patients, patella stabilization with transposition of the tibial tuberosity - in 67 patients, with the medial patellofemoral ligament autoplasty - 9, corrective osteotomy - in 2. Treatment efficacy was assessed using AKPS and 2000 IKDC knee joint assessment scores. The questionnaires were carried out at admission, in 1, 2-4 and 4-7 years after surgery. Results. At early terms after operation (up to 2 years) in the group of children after stabilization of the patella by modified Yamamoto technique good and excellent results were observed in 77.8% of cases, after transposition of the tibial tuberosity - in 73.3%, after stabilization of the patella with medial patellofemoral ligament autoplasty - in 88.9%. Long-term follow up (5-7 years) showed 90.9 and 86.5% of cases from the 1st and 2nd groups, respectively. Conclusion. The proposed algorithm for examination and treatment provides the most effective treatment and enables to obtain good and excellent results in the majority children with post-traumatic instability of the patella.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):58-64
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Patella instabi instability in children: surgical treatment results

Pozdeev A.P., Zakharyan E.A., Vilensky V.A.


Introduction. The main task of the surgical treatment of patients with latent form of the congenital pseudarthrosis of tibia (LFCPT) is the prevention of pathologic fracture and development of true pseudarthrosis. Purpose of the study: to evaluate the efficacy of preventive bone plasty in patients with LFCPT. Patients and methods. Treatment results for the period from 1980 to 2017 were studied in 38 children and adolescents (25 boys and 13 girls) aged from 9 months to 16 years, with the LFCPT. Transplantation of demineralized bone allografts onto the concave surface of bone was performed to all patients. Results. Follow up of surgical treatment results made up 1-16 years. In 6 months after operation bone graft projection showed active formation of bone tissue, in 12 months - the formation of compact bone tissue. Within the 4-years follow up pathological fractures were noted only in6 (15.8%) patients. Conclusion. Early indicated surgical intervention in children with LFCPT enables to prevent the pathological fracture in 84.2% of cases and preserve weight bearing ability.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):65-70
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Biomechanically validated transosseus fixation in patients with femur pseudarthrosis complicated by chronic osteomyelitis

Tsiskarashvili A.V., Zhadin A.V., Kuzmenkov K.A., Bukhtin K.M., Melikova R.E.


The aim of the study is to evaluate results of follow-up in patients with femur pseudarthrosis complicated by chronic osteomyelitis who underwent biomechanically validated transosseus fixation. Materials and methods. A retrospective study of transosseus fixation in 72 patients with femur pseudarthrosis complicated by chronic osteomyelitis was conducted. Described fixation was completed according to the biomechanical fixation conception from 2011 to 2017. Hybrid external fixator was applied to 38 (52,8%) patients, rod-based external fixator - to 34 (47,2%). Results. Full bone consolidation and pyoinflammatory process remission in treated femur bone is achieved in all cases. Results classified as excellent were acquired in 21 patients (29,5%), good - in 41 (57,7%), satisfactory - in 7 (9,8%), unsatisfactory - in 2 (3%). patients results were classified as unsatisfactory because of lacking of weight-bearing ability of the leg because of other reasons not related to consolidation. Conclusion. In patients with infected femur pseudarthroses external fixation using biomechanical conception allows to provide up to 97% positive clinical outcomes of the treatment.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):71-78
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The results of the application of the carbon nanostructured implant for tumorous, tumor like and inflammatory spinal diseases in pediatric bone pathology

Balametov S.G., Batrakov S.Y., Gavryushenko N.S.


Purpose: to study the results of the use of the carbon nanostructured implants (CNI) for tumorous, tumor like and inflammatory spinal diseases in the department of pediatric bone pathology. Patients and methods. Fifty two patients aged from 11 to 18 years with tumorous, tumor like and inflammatory spinal diseases were operated on. Carbon nanostructured implants were placed into post-resection bone defects either separately or in combination with auto- and allografts. Comparative analysis of the osteointegration processes was performed with radiologic methods of examination (roentgenography, radioisotope examination, CT). Maximum follow up period made up 12 months. Results. At application of both isolated CNI and in combination with auto- and allografts neither graft rejection nor local inflammatory reactions were recorded in 3, 6 and 12 months after operation. In case of isolated CNI application CT did not show fresh periosteal reactions in the zone of implant - native bone at all observation terms that was indicative of poor osteointegration into CNI. Combined application also showed poorly pronounced osteointegration into CNI but with periosteal reaction between the native bone and auto- and allografts that was a condition for more reliable biological fixation of CNI in the post-resection defect. Conclusion. The data obtained allow suggesting the possibility of CNI application in pediatric bone pathology. In small, up to 4 cm, marginal bone defects the use of isolated CNI is not excluded as poor osteointegration into the graft will not affect the rehabilitation process under conditions of early axial loads. In bone defects over 4 cm it is reasonable to use CNI in combination with auto- and allografts as the activization of the osteointegration processes may be assumed.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):79-88
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Possibilities for obtaining the length-measured images of skeleton using modern X-rays equipment

Artemiev A.A., Silin A.Y., Ivashkin A.N., Maximov B.I., Shipulin A.A., Solovyov Y.S.


Modern traumatology and orthopaedics is inconceivable without high-quality X-rays diagnostics. In the recent years special equipment that enables to obtain the length-measured images of different parts of a human body was introduced into clinical practice. The details of examination process, i.e. the position of a patient, position of an extremity and many others require special knowledge and experience. The aim of the study is to optimize the possibilities for obtaining the length-measured images of the different parts of a skeleton using modern X-rays equipment. The peculiarities of the determination of segments’ axes and length in patients with lower extremity deformities and shortening are presented; the most typical mistakes are analyzed. The results of the study are of great importance for medical expertise as well as for data documentation in practical, scientific and teaching activities.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):89-94
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Surgical correction of thorax deformity in Currarino-Silverman syndrome

Korolev P.A., Kozhevnikov O.V.


Currarino-Silverman syndrome (combined thorax deformity (CTD)) is a rare form of TD. Quite often this type of the deformity is combined with the failure of heart development (coarctation of aorta, prolapse, mitral stenosis). We mark out 2 types of CTD that enables to determine the tactics of surgical treatment. From the point of view of surgical correction potentialities the 2type of the deformity with protrusion of the manubriosternal junction but without sternum retraction is most perspective. Surgical results are presented for 3 patients, in one of them the pathology was combined with Poland syndrome.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):95-98
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Treatment of central pain syndrome with spinal cord stimulation

Yakovlev A.E.


Central pain syndrome (CPS) is a neurological disorder caused by damage or dysfunction of the central nervous system. Both conservative and operative methods of treatment are used in its treatment, but in most cases their effectiveness is rather low. We are presenting the clinical observation of a 60-year-old patient with spinal cord injury at the level of Th10 due to a car accident that occurred 44 years before the treatment in our clinic, who suffered from phantom pain that occurred after bilateral above the knee amputation because of advanced peripheral vascular disease. Due to the ineffectiveness of the conservative treatment, it was decided to proceed with spinal cord stimulation. The presence of pronounced postoperative changes in the area of spinal cord injury has complicated the transcutaneous placement of trial leads at the L1-L2 and Th12-L1 level. We managed to introduce leads at the level of Th7-Th8 and position them at the level of Th5-Th7. During continuous neurostimulation the pain in the sacrum, in the area of the hip joints, the phantom pain was relieved. The patient stopped using all pain medications. Spinal cord stimulation can be utilized as an alternative treatment for patients with intractable CPS.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):99-103
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Endoprosthesis of metacarpophalangeal joints of the hand

Prokhorenko V.M., Simonova E.N., Aleksandrov T.I.


The literature review presents information about the main types of prostheses for metacarpophalangeal joints that were elaborated from 1950 to 2017. Metacarpophalangeal joints arthroplasty shows good functional results enabling to eliminate the pain syndrome, improve social adaptation of a patient and cosmetic view of the hands. Special attention is paid to the modification of constructions in 3 generations of the implants. The changes in hinged joints, stem shape and methods of fixation are stipulated. Based on the analysis of complications for the implants of each generation the cause-effect relationships between the constructions, side-effects and the elaborated modifications are determined. The question on the choice of the material is discussed separately. In spite of the difficulties in retaining silicone implants in the bone marrow canals and the risk of ruptures, silicone is the only material that survived all the generation of implants with practically no changes. It can be considered as a starting point for further studies.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):104-112
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Postarthroscopic osteonecrosis of femoral and tibial condyles

Torgashin A.N., Rodionova S.S.


Osteonecrosis of femoral and tibial condyles is a serious disease resulting in severe forms of arthrosis/arthritis and requiring arthroplasty. Postarthroscopic osteonecrosis is rather rare complication after arthroscopic intervention on the knee joint usually due to meniscus rupture. The surgeons and patients are often not prepared for this complication development. The review covers the common cases of femoral and tibial condyles osteonecrosis after arthroscopic intervention. Potential risk factors are identified; the peculiarities of diagnosis and treatment tactics are described.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):113-118
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Heterotopic ossification after central nervous system injuries: understanding of pathogenesis

Gareev I.F., Beylerli O.A., Vakhitov A.K.


Available data on the pathogenesis, cellular interactions, role of inflammation, humoral and genetic factors in the formation of heterotopic ossifications resulting from injuries of the brain or spinal cord are presented.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):119-124
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Clinical manifestations of mucopolysaccharidosis type I (Orthopaedic aspects)

Mikhailova L.K., Polyakova O.A.


The difficulties of differential diagnosis of mucopolysaccharidoses (MPS) type I are conditioned by low population rate of the pathology that results in untimely and inadequate treatment. Case reports for 20 patients with MPS I are presented. Special attention is paid to the orthopaedic manifestations of the pathology that can be determined since the first months of life.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):125-133
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Contribution of Professor G.I. Turner to domestic traumatology and orthopaedics (to the 160th anniversary of birth)

Morgoshiia T.S.


The article presents the main milestones of the life of the outstanding scientist G.I. Turner (1858-1941) - a man who made an invaluable contribution to the formation and development of domestic orthopedics, military surgery. At the beginning of medical activity as a general surgeon, he mastered the basic principles of treatment of pathology of the musculoskeletal system, which played an important role in all its subsequent activities. It was G.I. Turner who had the idea of creating specialized hospitals for the wounded and special institutions for the rehabilitation of war invalids. It should be noted his active participation in the popularization of information on the prevention of diseases and injuries, in the practical training of methods of primary care to victims. Much effort and energy has been devoted to helping sick children with physical defects and restoring the working ability of crippled children. For many years he led the work of the orphanage in St. Petersburg, which in 1932 was transformed into the Institute of rehabilitation of physically defective children and adolescents, named after G.I. Turner.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):134-138
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Anniversary of the Kazan school of traumatology and orthopaedics

Akhtiamov I.F., Pankov I.O.


Two acting heads of the chairs of Kazan universities present a short historical background on the formation of the Kazan School of Traumatology and Orthopedics. The organization by Professor M.O. Friedland of a prosthetic-orthopedic infirmary in 1918 and subsequent organization of the chair of traumatology and orthopaedics at Kazan state institute for the improvement of physicians’ knowledge and skills is considered to be the starting point. However since the middle of the 19century the medical care was rendered in injuries and at Kazan University students were trained in surgical science and treatment of fractures. The first experience in anesthesia, introduction of antiseptics, improvement of desmurgy and the treatment of gunshot wounds were the basis for any surgical specialty. German professors, the founders of Kazan University, laid down the foundations and their first students N.I. Studenskiy, V.I. Razumovskiy and M.O. Fridland has contributed to the formation of a specialty in Kazan. At present time the chairs of traumatology and orthopaedics are organized at three universities and at the Center for High Technologies every physician and surgeon have an opportunity and to acquire new knowledge and skills.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):139-143
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Obituary N.P. Omelyanenko

- -.
N.N. Priorov Journal of Traumatology and Orthopedics. 2018;25(3-4):144-144
pages 144-144 views

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