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Vol 24, No 3 (2017)

Articles
Surgical Correction of Spine Deformity in Patients with Spinal Muscular Atrophy: Multicenter Analysis of Domestic Experience and Literature Review
Ryabykh S.O., Filatov E.Y., Savin D.M., Ochirova P.V., Ryabykh T.V., Medvedeva S.N., Tret’yakova A.N., Kolesov S.V., Baklanov A.N., Shavyrin I.A., Artem’eva S.B.
Abstract
Purpose: to analyze the domestic experience in surgical correction of spine deformity in patients with spinal muscular atrophy (SMA). Patients and methods. Retrospective multicenter nonrandomized study (evidentiary level III) was performed. Treatment results were analyzed for 26 patients aged 6 - 25 years who were operated on at four RF centers. Inclusion criteria: patients with neurogenic scoliosis on a background of SMA, genetically confirmed diagnosis of type II and III SMA, frontal-plane Cobb angle over 40°, availability of radiologic archives. Results. Preoperative scoliotic curve ranged from 40° to 135° (mean 92°), postoperatively - from 10° to 92° (mean 52°). Correction index varied within 13-75% (mean 40%). Frontal balance correction made up 23%, frontal pelvic tilt - 17%. Indices of external expiration functions showed a slight increase. Functional status by GMFCS was determined preoperatively as class 4 in 2 (8.3%) and class 5 in 24 (91.7%) patients; after intervention as class 10 (38.5%) and 16 (61.5%) patients, respectively. Conclusion. Patients with axial skeleton deformity on a background of SMA are at high risk group and require multidisciplinary examination and peri/postoperative management. Surgical correction is indicated in decompensated deformity over 40°. Surgical rehabilitation improves the self-care of patients as well as the life quality of both the patients and their surroundings.
N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):6-13
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Optimization of Diagnosis and Treatment for Periprosthetic Knee Infection
Shpinyak S.P., Barabash A.P., Barabash Y.A.
Abstract
Purpose of study: to analyze the modern approaches to classification of large joints periprosthetic infection (PPI) and evaluate the results of revision surgical interventions in patients with deep PPI of the knee. Patients and methods. One hundred fifty three patients, 51 men and 102 women (mean age 57.3±12.4 years), with deep PPI were operated on. Treatment tactics was determined by the term after primary operation. In early PPI (n=31) sanitation interventions with implant preservation and in late PPI (n=122) - two step interventions with long period between the operations (over 4 weeks) were performed. Results. Follow up made up from 2 to 5 years. Sanitation interventions with implant preservation were successful in71% of patients. In group of patients with late PPI satisfactory results were achieved in 89.6% of cases. On the basis of the obtained data the variants of diagnosis and treatment tactics optimization as well as its adaptation to domestic public health system were proposed.
N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):14-19
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Experience in Use of Buvanestin and Other Modern Local Anesthetics in Traumatology and Orthopaedics
Vasil’kov V.G., Marinchev V.N., Emelina N.G., Tryashkina T.I., Shilov A.Y., Polich A.S.
Abstract
Clinical experience in use of Buvanestin and other local anesthetics (Marcaine,Naropin) in traumatology and orthopaedics is presented. Careful evaluation of the effect of various drugs (Refortan, Ringer’s solution, Mafusol) preinfusion upon the status of hemodynamics in elderly and senile patients at operations for femoral fractures has been performed. It has been shown that by the anesthetic properties Buvanestin practically does not differ from Marcaine. Preinfusion of Mafusol has shown the advantages over the Ringer’s solution and Refortan in ensuring more stable hemodynamics during operation and in the early (within 20-30 min) postoperative period.
N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):20-26
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Influence of Radiofrequency Desrtruction on the Nerve Tissue Morfology in Experiment
Sharamko T.G., Kuleshov A.A., Cherkashov A.M., Kuz’min V.I., Yudakova M.E., Gorokhov M.A.
Abstract
Introduction. Clinical efficacy of radiofrequency destruction (RFD) for the treatment of vertebrogenic pain syndrome and pain in coxarthrosis is confirmed by multiple studies. However the matter on morphologic changes in the nerve and surrounding tissue after directed local radiofrequency effect. Materials and methods. The study was performed on autopsy material - fragments of tibial nerve from 6 patients with lethal outcomes. Radiofrequency destruction was performed according to a standard protocol: within 90 sec under 80 C°. The sections were stained with hematoxylin and eosin by Bilshowski-Gros method. Results. It was shown that RFD causes the coagulation lesions of the nerve tissue such as spiral deformation, axon fragmentation and nerve fibers dissociation. Conclusion. The data obtained may serve as a morphologic basis of RDF clinical efficacy. The presence of undamaged Schwann cells allows assuming the tropism of the effect upon the nerve tissue.
N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):27-31
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Epidemiology of Proximal Femur in the Republic of Belarus’
Romanov G.N., Chernyanin I.Y., Rudenko E.V., Lesnyak O.M., Zakroeva A.G.
Abstract
Purpose: to determine the incidence of proximal femur (PF) fracture in the inhabitants of the Republic of Belarus aged 50 years and over. The study was initiated by the Russian Association on Osteoporosis with support from International Osteoporosis Foundation. Material and methods. The data collection is performed by the protocol that assumes an active search of PF fracture cases for 3 years in all available sources with their subsequent verification within one city of the Republic of Belarus with population over 100 000 residents. Results. Standardized indices of PF fracture incidence in the Republic of Belarus for males and females aged 50 years and over made up 147 and 250 cases per 100 000 inhabitants, respectively. The obtained data are in line with the general information on PF fracture incidence in the neighboring countries. According to the population growth forecast the 25.8% increase of PF fracture cases in this age group is expected by 2050.
N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):32-36
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Potentialities of 3D-Visualization in Preoperative Planning of Primary and Revision Total Hip Arthroplasty
Sadovoy M.A., Pavlov V.V., Bazlov V.A., Mamuladze T.Z., Efimenko M.V., Aronov A.M., Panchenko A.A.
Abstract
A variant of preoperative planning for revision interventions on a hip joint named “Method of layer by layer 3D visualization of the defect zone” is suggested. The method is realized via three consecutive steps with the ultimate aim to obtain data on the real acetabular defect geometry and bone tissue density. Using that method 9 patients (mean age 60±2 years) with pelvic bones defects were examined preoperatively. Based on the evaluation results of bone tissue condition in the defect zone the model and size of individual augment within the limits of weight bearing bone were corrected, the points of augment and acetabular component fixation were determined.
N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):37-42
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Minimally Invasive Derotational Osteotomy of the Forearm Bones in Congenital Radioulnar Synostosis in Children
Kozhevnikov O.V., Kralina S.E.
Abstract
Clinical experience of surgical treatment for radioulnar synostosis in 6 children is presented. In all cases forearm derotational osteotomy at the level of synostosis with pin fixation has been performed. The technique of the intervention, peculiarities of fixator placement and other nuances of the surgery that allow avoiding potential complications are described in details. Follow up period made up 1 year after surgery. Improvement of operated extremity function was achieved in all patients. Presented technique of surgical treatment is effective, comparatively safe and enables to improve spatial position of the forearm and hand in short terms.
N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):43-45
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Experience in Use of Modified McLaughlin Procedure for Neglected Locked Posterior Subluxation of the Humeral Head
Belyak E.A., Prizov A.P., Lazko M.F., Grigor’ev I.V., Zagorodniy N.V., Lazko F.L.
Abstract
Treatment results for 7 patients who were operated on for neglected locked posterior subluxation of the humeral head with reverse Hill-Sachs lesion during 2013-2016 are presented. Surgical intervention included the open reduction of subluxation and transposition of thelesser tubercle of the humerusto a defect zone. Mean followup period was 14±3 months. Range of motion in shoulder joint and its function were restored almost completely with only small restriction in external rotation. No recurrence of subluxation was observed. All patients returned to professional and day-to-day activity.
N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):46-50
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Late Diagnosis of Mucopolysaccharidosis Type IV (Maroteaux-Lamy syndrome)
Mikhailova L.K., Polyakova O.A., Zakharova E.Y., Voskoboeva E.Y., Kuleshov A.A., Vetrile M.S., Lisyanskiy I.N.
Abstract
Peculiarities of the clinical manifestation of mucopolysaccharidosis type IV diagnosed at the age of 30 years only are presented. In spite of favorable disease course after the age of 30 years combined vertebral canal stenosis more marked at C0-C1 level, cervical myelopathy and spastic tetraparesis that required surgical intervention. Special attention was paid to the genetic aspects of diagnosis and potential causes of delayed disease development.
N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):51-55
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Anatomic and Physiological Features of Facet Joints. Evolution of Facet Fixation for the Treatment of Patients with Lumbar Spine Degenerative Diseases
Byval’tsev V.A., Kalinin A.A., Okoneshnikova A.K., Pestryakov Y.Y.
Abstract
The literature review presents the anatomical features of facet joint structure and their pathologic changes in lumbar spine degenerative diseases as well as the steps of development and modern methods of facet fixation, their technical peculiarities and results of application
N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):56-62
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Risk Factors and Potentialities of Dislocation Prevention after Total Hip Arthroplasty
Stafeev D.V., Efimov N.N., Sorokin E.P., Chugaev D.V., Gudz A.I., Boyarov A.A.
Abstract
The literature review is dedicated to the problem of femoral component dislocation after primary and revision total hip arthroplasty. Modern data on surgeon-dependent and -independent risk factors for this complication development are analyzed. Potentialities for dislocation prevention using constrained liners and dual mobility system are considered
N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):63-72
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Chronic Patellar Instability: Anatomic Precondition and Approaches to Surgical Treatment
Avdeev A.I., Kuznetsov I.A., Shulepov D.A., Salikhov M.R.
Abstract
The literature review is dedicated to the problem of recurrent patella dislocation treatment. The key anatomic predispositions to patellar instability development are presented. The principles on which the techniques for surgical treatment of recurrent patella dislocation have been developed and used since the early 19th century are described. Thirty years’ experience in use of various surgical techniques for patellar stabilization that show both obvious advantages and certain disadvantages is generalized. Actual problems and issues of recurrent patella dislocation surgical treatment are reflected.
N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):73-80
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Report on the I Congress of Trauma and Orthopedic Surgeons of the Central Federal District of the Russian Federation
Ochkurenko A.A., Perminov V.A.
N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):81-83
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V.A. Sokolov
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N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):84-85
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M.V. Lekishvili
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N.N. Priorov Journal of Traumatology and Orthopedics. 2017;24(3):86-86
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