Vol 23, No 1 (2016)

Original study articles

Morbidity of Musculoskeletal Diseases among Children and Adolescents in 2010-2014

Es’kin N.A., Andreeva T.M.

Abstract

On the state statistical observation data the rates and dynamics morbidity of musculoskeletal diseases among children and adolescents are presented. Stabilization of musculoskeletal diseases morbidity among children and steady growth morbidity among adolescents are detected. In structure of musculoskeletal diseases among children and adolescents arthropathies of different genesis and deforming dorsopathies prevail. Overwhelming majority of patients receive outpatient treatment. The ways of specialized orthopaedic out-of-hospital care perfection are discussed.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):5-14
pages 5-14 views

Clinical Efficacy of Minimally Invasive Transpedicular Stabilization for Thoracic and Lumbar Vertebrae Fractures

Byval’tsev V.A., Kalinin A.A., Budaev A.E.

Abstract

Clinical efficacy of percutaneous transpedicular stabilization for the treatment of patients with A2 and A3 traumatic compression thoracic and lumbar fractures was performed. The study included 25 patients with mean age 34 (29-42) years. The male-female ratio was 2:1. Severity of pain syndrome by analog visual scale (VAS), quality of life by Oswestry Disability Index (ODI), duration of surgery and blood loss, patient outcome satisfaction by MacNab's criteria and rate of complications were assessed. Mean duration of surgery made up 120 (90-140) min, median blood loss - 50 (30-80) ml. Marked postoperative reduction of pain syndrome (p<0.01) was achieved and preserved within the 1st observation year. One year after surgery most of the patients evaluated the treatment efficacy as excellent as good by MacNab's criteria. Effective stabilization of the injured segment, reduction of posttraumatic kyphotic deformity and minimal operative trauma promote the reduction of temporary disability as well as the adequate social and labor rehabilitation.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):15-20
pages 15-20 views

Hip Arthroplasty in Patients with Femoral Neck Pseudarthrosis

Kavalerskiy G.M., Murylyov V.Y., Rubin G.G., Rukin Y.A., Elizarov P.M., Muzychenko A.V.

Abstract

Hip arthroplasty outcomes for 202 patients, aged 40-88 years, with femoral neck pseudarthrosis were analyzed. All patients were divided into 3 groups depending on the type of treatment (surgical or conservative) and terms of the removal of previously implanted metal constructions (before or during surgical procedure). Good and satisfactory results by Harris hip score were achieved in 94.6% of observations. The reasons of postoperative complications were considered for every group of patients. It was stated that in 30 (14.9%) cases the formation of pseudarthrosis resulted from ungrounded use of osteosynthesis in Garden III and IV fractures.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):21-25
pages 21-25 views

Elaboration of Universal Approaches to the Treatment of Long Bone Osteomyelitis on the Basis of Reinforced Local Antibacterial Carriers

Dzyuba G.G., Reznik L.B., Erofeev S.A., Odarchenko D.I.

Abstract

Treatment results are presented for 86 patients with long bone osteomyelitis of different genesis (hematogenous, posttraumatic, postoperative). To determine the location of the implant the Cierny-Mader classification was used. In the main group (n=46) debridement of the osteomyelitic focus and placement of local reinforcing antibacterial polymethyl methacrylate implant with pathogen-specific antibiotics were performed. In the control group (n=40) traditional treatment techniques were used. Application of the proposed technique enabled to achieve 1.9 times decrease of infection relapse, to minimize the risk of pathological bone fractures due to its internal reinforcement and to achieve early functional restoration of the extremity.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):26-31
pages 26-31 views

Thromboprophylaxis after Arthroplasty in Practice of Outpatient Trauma and Orthopedic Physician: is it necessary?

Firsov S.A., Matveev R.P., Shevchenko V.P., Tumorin L.S.

Abstract

Analysis of the safety and efficacy of the currently marked oral anticoagulants in patients after large joints arthroplastyat outpatient step was presented for the first time in Russian clinical practice. Total number of 5025 patients after total knee and 5216 patients after total hip arthroplasty were examined. All patients were divided into 3 groups depending on prescribed anticoagulant (dabigatran, rivaroxaban or apixaban). Duration of therapy with corresponding drug after hip and knee arthroplasty was initiated after surgery and made up 35 and 45 days, respectively. Deep vein US examination was performed to all patients in 3 and 6 months after discharge. In patients on dabigatran the rate of clinically significant deep vein thrombosis development was lower than in patients on rivaroxaban and apixaban, and made up 5% vs 7.7 and 16%, respectively. Rate of nonfatal pulmonary embolism (PE) was comparable. Relapse of deep vein embolism development was diagnosed only in patients who received rivaroxaban. A suggestion on the expediency of a longer thromboprophylaxis after surgical interventions on large joints was made that would require extensive studies.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):32-39
pages 32-39 views

Surgical Treatment of Juvenile Femoral Head Epiphysiolysis in Children

Barsukov D.B., Krasnov A.I., Kamosko M.M., Baskov V.E., Pozdnikin I.Y., Aleksandrenko I.P.

Abstract

To optimize the anatomical and functional surgical treatment results in patients with early (I-II) stages of juvenile femoral head epiphysiolysis both pre- and postoperative data of clinical, x-ray and magnetic-resonance examinations were analyzed for 120 patients aged 11 - 15 years. Maximum follow up period after surgical interventions, i.e. femoral head epiphysiodesis (n=60) and femoral head epiphysis fixation (n=60) made up 23 and 3 years, respectively. It was shown that surgical intervention for the fixation of femoral head epiphysis ensured reliable stability of the epiphysis preventing the latter from displacement development and progression, and did not exert significant influence upon either femoral neck and head endochondral growth or the length of the upper extremity.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):40-47
pages 40-47 views

Total Hip Arthroplasty for Coxarthrosis in Children and Adolescents when Conservative Surgery is Impossible

Snetkov A.I., Kotlyarov R.S., Frantov A.R., Batrakov S.Y., Kravets I.M.

Abstract

During the period from 1970 to 2015 total hip arthroplasty was performed in 60 patients (71 surgeries) aged 14 - 18 years at the CITO department for child bone pathology and adolescent orthopaedics. In 11 patients bilateral surgical interventions were performed. The majority of patients had systemic hereditary diseases of the skeleton. Principal indications for total hip arthroplasty were elaborated and optimum implant design with regard for the nosology and patient’s age were determined. Mean follow up period made up 9.5 (1 - 23) years. Preoperative evaluation results by Harris Score varied from 28 to 50 points, postoperative - from 79 to 91 points. Good results were achieved in 91.6% of observations.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):48-54
pages 48-54 views

Orthopaedic and Neurologic Aspects of Early Coxarthrosis Development in Children with Hip Dysplasia

Bakhteeva N.K., Korshunova G.A., Zotkin V.V., Norkin I.A.

Abstract

Comparison of clinical-roentgenologic and electroneuromyographic data was performed for 29 patients, aged 3 - 16 years, at different stages of conservative and surgical treatment for hip joints dysplasia. First group included 18 patients with complicated clinical course; second - 11 patients with favorable process of joint formation. Functional activity of motor neurons, spinal cord and peripheral nerves conductivity was assessed. It was shown that in patients from the 1st group the ENMG indices were statistically significantly lower than in healthy children ( р <0,05). F-waves parameters were typical for the change in spinal cord motor neurons activity of both functional and organic pattern. Decrease in the latent period of F-waves was indicative of axonal demyelinating lesion of spinal cord roots and peripheral nerves. Dynamic control at different stages of treatment showed negative changes in electrophysiological indices in complicated clinical course that confirmed the necessity of neurophysiologic monitoring.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):55-61
pages 55-61 views

Complex Diagnosis in Surgical Treatment of Peripheral Nerves Injuries of the Extremities

Ninel’ V.G., Aitemirov S.M., Korshunova G.A., Norkin I.A.

Abstract

The purpose of the work was to evaluate the role and potentialities of complex diagnosis in surgical treatment of peripheral nerve trunk injuries of the extremities. Complex examination including electroneuromyography, ultrasonography and contrast neurography was performed in 109 patients with injuries of peripheral nerves of the extremities. Examination results enabled to elaborate the algorithm of diagnosis and differential surgical treatment tactics for surgical treatment of peripheral nerves injuries. Management of patients in accordance with proposed algorithm allowed to improve surgical treatment results significantly - by 21%.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):62-66
pages 62-66 views

Differential Diagnosis of Large Joints Chronical Synovitis

Zar V.V., Shatokhina S.N.

Abstract

To determine the genesis of large joint chronical synovitis the morphologic picture (facia) of synovial exudate was studied in 23 patients using the method of cuneate dehydration of biological liquid. Cytologic investigation showed leukocytosis with prevalence of neutrophils in all patients. All patients were divided into two groups. First group included 8 patients in whom septic pattern of inflammation was confirmed by the results of synovial fluid culture inoculation, second group - 15 patients with negative bacteriologic study results. The obtained data enabled to describe two types of synovial fluid facia that allowed differentiating septic pattern of inflammation from the reactive one.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):67-70
pages 67-70 views

Comparative Study of the Adhesive Component of Friction in Hip Endoprostheses

Minasov B.S., Yakupov R.R., Shuster L.S., Chertovskikh S.V., Emaev I.I., Filimonov G.N., Korshunov A.A., Khairov T.E.

Abstract

Kinematic unit friction pairs of human hip endoprosthesis and rabbit hips with induced osteoarthrosis were studied under conditions of either dry or biological medium friction. Deterioration of tribologic characteristics in destructive dystrophic lesions of joints is the key component of joint kinematic properties decompensation. Experimental animal model of osteoarthrosis showed negative influence of dystrophic changes upon the hip joint adhesive characteristics. Study of the adhesive component of friction coefficient in different tribologic pairs of endoprostheses detected that friction characteristics of the studied tribologic pairs depended upon the magnitude of external load and strength of the kinematic unit.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):71-75
pages 71-75 views

Comparative Experimental Study of Custom Made Plate for Anterior Stabilization and Dorsal Fixation Systems at C1-C2 Vertebrae Level

Kuleshov A.A., Shkarubo A.N., Gavryushenko N.S., Gromov I.S., Vetrile M.S., Fomin L.V., Marshakov V.V.

Abstract

Experimental study on the evaluation of strength of fixation with metal constructions at the level of C1-C2 vertebrae was performed on the basis of test laboratory for orthopaedic and traumatologic products. Experiments were performed on the cadaver block preparation (4) and plastic models (8) of craniovertebral spine. Authors’ custom made plate, hook system, screw systems by Magerl and Harms were used as fixators. First step was the imitation of the turning of the head to the right (“twisting”), second step - imitation of head tilting forward (“three point pressure”). It was shown that by its strength and stability of craniovertebral segment the elaborated metal plate was not inferior to dorsal fixation systems.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):76-81
pages 76-81 views

Stabilizing Potential of Fixion Nail with Plastic Deformation for Fixation of Simulated Diaphyseal Bone Fractures (Experimental Study)

Yamkovoi A.D., Gavruyshenko N.S., Zorya V.I.

Abstract

Type A fractures by AO classification were simulated on eight human cadaveric specimens (2 shoulder segments, 3 femur and 3 crus segments). Fixion nails with plastic deformation were used for fixation. The magnitude of force resulting in bone fragments displacement was determined using universal machine at CITO test laboratory. On the basis of the obtained results the recommendations on the potential load in early postoperative period were given.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):82-84
pages 82-84 views

Short communications

Hip Subluxation in a Patient with Charcot-Marie- Tooth Disease and Osteo-Onychodysplasia

Pozdnikin I.Y., Kamosko M.M., Barsukov D.B., Barlova O.V.

Abstract

Clinical observation of an 8 years old patient with hip joints instability against the background of two genetic syndromes - Charcot-Marie-Tooth motor and sensory neuropathy and osteo-onychodysplasia is presented. Peculiarities of clinical, roentgenologic, neurologic picture, diagnosis and approaches to the treatment are described. Thorough examination enabled to develop the individual treatment plan and prevent neurologic complications.
N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):85-92
pages 85-92 views

Anniversary

In commemoration of the 100 anniversary of A.F. Kaptelin

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N.N. Priorov Journal of Traumatology and Orthopedics. 2016;23(1):93-93
pages 93-93 views

Articles

pages 94-95 views


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