Vol 23, No 2 (2016)

Original studies

Organizational of Mechanisms of Innovation Management and Their Realization in Public Health (on the example of the Tsiv’yan Novosibirsk Research Institute of Traumatology and Orthopedics)

Totskaya E.G., Sadovoy M.A.


The main directions in innovations of the largest scientific and research institute in Siberian region are presented. Organizational mechanisms of management in the field of treatment and diagnostic technologies are substantiated. Their influence on the indices of medical organization activity including the quality as well as the availability of specialized and high-tech medical care is demonstrated. The ways of public health service improvement on the basis of principally new methodological approaches to the management in expert level medical organizations are defined.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):5-11
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Evaluation of the Influence of HaloGravity Traction upon the Results of Severe Neuromuscular Deformity Treatment

Kolesov S.V., Baklanov A.N., Shavyrin A.I., Kudryakov S.A., Shaboldin A.N., Kaz’min A.I.


Evaluation of the effect of traction preoperative preparation on the degree of neuromuscular spinal deformity correction was performed. Treatment results for 50 patients with paralytic deformities operated on in 3 different clinics were analyzed. The patients were divided in 2 comparable groups, 25 patients in each group. In group 1 one-step intervention, i.e. dorsal correction under halo-traction and Ponte osteotomy was performed. In group 2 two-step correction, i.e. 12-14 days gradual halo-gravity traction followed by dorsal correction and Ponte osteotomy. Postoperative deformity correction made up 49 and 50% in the 1st and 2nd groups, respectively. In patients from the 2nd group the postoperative period was smoother. Thus, the study did not detect any influence of traction preparation on the degree of the deformity correction.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):12-17
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Surgical Treatment of Severe Congenital Scoliosis

Snetkov A.A., Kolesov S.V., Sazhnev M.L., Shaboldin A.N.


Retrospective analysis of treatment results for 36 patients (31 females, 5 males) aged 2 - 31 years with congenital scoliosis was performed. Malformation of vertebrae was present in 23 patients, disorder of segmentation - in 9, combined anomalies - in 4 patients. Posterior fusion was performed in 15, combined anterior and posterior fusion - in 7, removal of the semivertebra - 13, and VEPTR technique - in 1 patient. Treatment results were assessed by roentgenographic data and the results of SRS-24 questionnaires. Follow up period made up from 1 to 7 years. Differentiated approach to treatment enabled to create conditions for the proper development of the spine and formation of adequate frontal and sagittal balance as well as to increase patient’s self-appraisal and daily activity.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):18-24
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UseofCannulated Screws in Pelvic Injury Surgery

Bondarenko A.V., Kruglykhin I.V., Voitenko A.N.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):25-34
pages 25-34 views

Peculiarities of Femoral Head Aseptic NecrosisProgression in Bilateral Lesion after One JointArthroplasty

Shumskiy A.A., Rodionova S.S., Kagramanov S.V.


Evaluation of the effect of one hip arthroplasty upon the course of the pathologic process in the contralateral joint in case of bilateral aseptic femoral head necrosis (AFHN) was performed. The study included 151 patients (207 joints) with AFHN (mean age 45 years). All patients were divided into 3 observation groups. In groups 1 and 3 the patients were on complex therapy (bisphosphonates, nonsteroidal anti-inflammatory drugs, drugs for improving microcirculation). Patients from 2nd group were treated by drugs for improving microcirculation. Patients from group 3 underwent unilateral hip arthroplasty before the study was initiated. In all cases the joint unloading with crutches was used. Follow up period made up 3 years. Joint function by Harris score and “joint survival” were assessed. It was shown that despite the prescription of contemporary metabolic therapy after one joint arthroplasty the prognosis for the contralateral joint worsened considerably.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):35-39
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Use of PlateletRich Autoplasma in Complex Therapy of Knee Osteoarthrosis

Gorbatenko A.I., Kostyanaya N.O.


Efficacy of platelet-rich autoplasma (PRA) in treatment of osteoarthrosis was evaluated. Prospective study included 120 patients (83 females, 37 males, mean age 52.8±4.5 years) with clinical and roentgenologic diagnosis of II-IV stage osteoarthrosis by Kellgren-Lawrence classification. The patients from the main group (n=60) were on courses of PRA intraarticular injections (3 injections with 1-2 weeks interval). In the control group the patients received nonsteroidal anti-inflammatory drugs (NSAIDs) and periodically injections of glucocorticoids when indicated. Results were assessed by the verbal efficacy scale, Lequesne index and the pain visual analog scale. Follow up period made up 6 months. Use of PRA enabled to eliminate pain syndrome and improve knee joint function without adverse effects. In 6 months the number of patients who noted the efficacy of treatment was 31% higher in the main group than in the control one. The obtained results allow recommending PRA use for knee osteoarthrosis treatment as an alternative to NSAIDs especially in contraindications to the latter.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):40-45
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Arthroscopy in Treatment of Knee Arthroplasty Complications

Alabut A.V., Sikilinda V.D., Kubasov D.O.


Results of the operated joint arthroscopy were presented for 16 patients with complications after knee arthroplasty. The reasons for arthroscopic intervention were: implant instability - 1 case, breaking of implant hinge - 1 case, arthrofibrosis - 2 cases, recurrent hemarthrosis with synovial membrane vessels malformation - 2 cases, reactive aseptic necrosis - 4 cases and resistant medial pain syndrome resulting from neuropathy of the infrapatellar branch of subcutaneous femoral nerve - 6 cases. Arthroscopy after knee arthroplasty enables with high accuracy to diagnose knee joint pathology, to avoid revision arthrotomy, to minimize intraoperative trauma, to improve functional results and patient’s quality of life as well as to reduce the cost of treatment.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):46-49
pages 46-49 views

Factors Affecting theTerms of Fracture Consolidation

Matsukatov F.A., Gerasimov D.V.


Dependence of the consolidation of spiral tibial fracture treated with transosseous osteosynthesis upon the initial transverse fragments dislocation, patient’s age, remoteness of injury, reposition accuracy and fixation stability was analyzed. Priority factors that will allow realizing the maximum potentialities of the technique are determined.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):50-56
pages 50-56 views

Prevention of Thromboembolic Complications afterSurgical Treatment for Lower Extremity BoneFractures: Experience in Rivaroxaban Use in ClinicalPractice

Kaplunov O.A., Biryukov S.N., Nekrasov E.Y.


Comparative evaluation of rivaroxaban (main group, n=37) and enoxaparin (control group, n=29) safety in thromboprophylaxis at closed lower extremity bone fractures treatment was performed. All patients were operated on at terms from 8 to 12 day after injury using external fixation devices. The volume of intra- and perioperative blood loss in the groups did not differ significantly ( p >0.05). The rate of symptomatic thromboembolic complications, i.e. calf deep vein thrombosis confirmed by clinical data, was significantly lower in patients from the main group (2.7%) as compared to the control group (6.8%; p <0.05). No one case of clinically important pulmonary embolism was diagnosed. The obtained data showed that in comparable with enoxaparin clinical efficacy for prevention of venous thromboembolic complications the use of rivaroxaban ensured the better clinical safety, convenience of intake and completeness of prophylaxis scheme without the change of pharmacological support.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):57-61
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Study of Intraosseous Implant Osteointegration withVarious Types of Coating in Experiment

Nazarov E.A., Papkov V.G., Kuz’manin S.A., Vesnov I.G.


Bone tissue formation around the pins made of medical steel (1st group, n=9), titanium alloy BT6 with modified by chemical and thermal treatment surface (2nd group, n=8), titanium alloy BT6 with calcium phosphate and 1% germanium coating sprayed using microarc oxidation technique (3rd group, n=5) and of the same alloy with calcium phosphate and 5% germanium coating (4th group, n=7) was studied on 28 mongrel cats. The pins were inserted into the proximal femur. In 3 months (after euthanasia) roenthenography, CT with densitometry, biomechanical testing (to determine the strength of implant-bone adhesion) and histologic examinations were performed. It is shown that osteointegration processes were the most marked in the animals from 3rd and 4th groups.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):62-67
pages 62-67 views

Reviews, literature review

Massive Retroperitoneal Bleeding in Pelvic Fractures

Lazarev A.F., Borozda I.V.


The review covers the problems of treatment of patients with unstable pelvic injuries accompanied by massive retroperitoneal bleeding. The questions of the determination of the source of intrapelvic bleeding, its intensity, volume and duration, methods for circulatory disorders correction and surgical hemostasis are considered in detail.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):68-76
pages 68-76 views

Analysis of the Experience of Carbon Nanostructured Implants Use in Traumatology and Orthopaedics

Borzunov D.Y., Shevtsov V.I., Stogov M.V., Ovchinnikov E.N.


Analysis of the carbon nanostructured implants (CNI) safety and efficacy for the treatment of bone pathology was performed at different clinics of the Russian Federation. Devices showed their efficacy at substitution of intervertebral disc and vertebral body defects as well as at plasty of long bone defects of various etiology. The rate of effect absence did not exceed 6.1%. No serious adverse effects were recorded. It is concluded that CNI possesses the number of characteristics (osteoinduction, bioinertia, safety) that allow using it in traumatology and orthopaedics.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):77-81
pages 77-81 views


S.T. Vetrile

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N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):82-83
pages 82-83 views

M.Sh. Khubutiya

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N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):83-84
pages 83-84 views

Yu.I. Ezhov

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N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(2):85-85
pages 85-85 views


pages 86-87 views
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