Vol 20, No 1 (2013)

Articles

New Functional Classification of Severe Hand Injuries (FU-classification)

Afonina E.A., Golubev I.O., Pshenisnov K.P.

Abstract

New functional classification of severe hand injuries is suggested. Concept of hand functional unit of the hand, i.e. finger segment containing joint, blood vessels and all surrounding soft tissues, is introduced. New functional classification of severe hand injuries is related to the algorithm of patient’s treatment depending on the level ofpreserved functional units. Division of the hand into functional units and primary evaluation of every unit condition enables to choose surgical treatment tactics directly after injury as well as to prognosticate the outcome.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):3-9
pages 3-9 views

Register of Dupuytren’s Disease (Contracture) in Tatarstan Republic: Efficacy of Surgical Treatment

Magomedov R.O., Mikusev G.I., Baykeev R.F., Mikusev I.E., Nikitina A.E.

Abstract

Analysis of Dupuytren’s contracture (DC) surgical treatment efficacy according to the Tatarstan Republic DC Register (258 patients, 343 hands) was performed. Partial wedge-shaped excision of palmar aponeurosis was the most common intervention on both the right and left hand. Late (1 year and over) postoperative complications (POC) — relapse, dissemination, progression were detected in 41.8% of patients at terms up to 15 years. Presence of POC on the operated hand caused disturbance of its function in 11.9% of cases on the right and 16.3% of cases on the left. Curability from DC made up 34.9 — 73.8% depending on the operated hand. Complete restoration of hand function was achieved in 22.2—100% of observations. Surgical treatment of DC enabled to ensure favorable patient’s condition at term 1 year and over in 67.5 and 59.9% of cases on the right and left hand respectively.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):10-17
pages 10-17 views

Results of Monolithic and Modular Femoral Components Use at Total Hip Revision Arthroplasty

Zagorodniy N.V., Nuzhdin V.I., Bukhtin K.M., Kagramanov S.V.

Abstract

Results of 28 total hip revision arthroplasties using distal fixation stems were analyzed. In 18 operations revision stems Wagner SL (1 st group) and in 10 interventions modular revision stems Cerafit revision (2 nd group) were used. Mean follow up period made up 3 years. Course of operation and peculiarities of bone canal treatment prior to stem implantation were described in detail. In 1 st group excellent results were achieved in 2 (11.11%), good in 8 (44.44%) satisfactory in 4 (22.22%) and poor in 4 (22.22%) of patients. In 2 nd group in 2 (20%), 4 (40%), 3 (30%) and 1 (10%) patient, respectively. Poor treatment outcomes resulted from suppuration and distal migration offemoral component. Rate of intraoperative femur cracks and fractures for two study groups was not higher than at revision arthroplasty using other implants. Taking into account intraoperative advantages the use of modular femoral components in complicated cases is a good alternative to monolithic stems.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):18-26
pages 18-26 views

Surgical Methods for Treatment of Patients with Ankle Joint Injuries

Kaplun V.A., Kopysova V.A., Martel I.I.

Abstract

From 2001 through 2010 one hundred eighty six patients were treated for I-III degree pronation (134) and supination (52) ankle joint injuries. In 150 (80.6%) patients (main group) fixation of bone fragments and tibiofibular syndesmosis were performed using tightening anchors with shape memory effect and in 36 (19.4%) from control group conventional osteosynthesis techniques were applied. Consolidation of bone fragments and restoration of injured extremity function was achieved in 141 (94.0%) and 15 (41.7%) patients from the main and control groups, respectively. Long term results were analyzed at terms 3 — 5 years for 80 patients from the main and 22 patients from the control group: statistically significant disorders and degenerative changes in the ankle joint were detected in 5 (6.3%) and 8 (34.4%) patients, respectively. Comparative analysis of different techniques for bone fragments fixation and tibiofibular syndesmosis showed that elastic-strained osteosynthesis with tightening anchors was as effective as conventional techniques and transosseous osteosynthesis by Ilizarov and even exceeded those methods by terms of limb function restoration.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):27-33
pages 27-33 views

Experience in Arthroscopic Treatment of Adhesive Shoulder Joint Capsulitis

Lomtatidze E.S., Lazko F.L., Kubashev A.A., Savitskiy P.P., Prizov A.P.

Abstract

Arthroscopic treatment results were presented for 74 patients, aged 38— 69 years, with adhesive capsulitis (78 shoulder joints). In 68 cases idiopathic capsulitis was diagnosed. Tactics of arthroscopic intervention was proposed and surgical procedure was described in detail. Active movements were initiated on 5-7 day. Mean value of shoulder joint function prior to operation made up 11 (7—14) points, in 2 weeks after intervention — 27 (23—30) points that corresponded to good and excellent result. In 6 months after operation range of movements in the operated joint was equal to that in the healthy joint.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):34-37
pages 34-37 views

Treatment of Fractures of the Distal Femur at Polytrauma

Plotnikov I.A., Bondarenko A.V., Rodionov A.M.

Abstract

Retrospective analysis of treatment results of 157 patients with 163 fractures of the distal femur at polytrauma was perfomed. Used an osteosynthesis distal a pins with blocking, plates with angular stability, devices of external fixing. Estimated frequency and character of complications, duration and number of the hospitalisation, the remote results of treatment. It is revealed that at patients with polytrauma at supracondylaris fractures of the distal femur and sagittalis intraar- ticulate fractures without displacement by an optimum method of treatment the osteosynthesis nails with blocking is, at intraarticulate splintered fractures with displacement and a face-to- face line of a break is shown opened reposition with an osteosynthesis plates with angular stability.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):38-45
pages 38-45 views

Correction of Spine Pathology in Patients with Meningocele

Kolesov S.V., Baklanov A.N., Shavyrin I.A.

Abstract

Treatment results for 8 patients aged 3 to 17 years with neuromuscular spine deformities on the background of meningocele are presented. In all patients spine deformities were accompanied by spinal dysraphias. Average curvature arch was 86°. Surgical treatment was performed either in one (5patients) or in two (3 patients) steps. In 2 patients vertebral column resection (VCR) was performed. Average achieved scoliotic deformity correction made up62% and postoperative value of thoracic/thoracolumbar kyphosis approximated the physiologic one (40°). Surgical treatment of kyphoscoliosis on the background of meningocele that consisted of extensive spine instrumentation with pelvis fixation favoured the normalization of trunk balance, improved cardiopulmonary function, patients’ appearance and life quality. In this group of patients surgical intervention is associated with high intraoperative risk and rate of postoperative complications.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):46-52
pages 46-52 views

Outcomes of Innovative Programmed Treatment of Children with Malignant Loco-Motor System Tumors in Moscow

Shvarova A.V., Volkova L.D., Ochkurenko A.A., Ivanova N.V.

Abstract

During the period from 2005 to 2010 forty nine patients from Moscow city aged 1 — 16 years (mean age 9.4 years) were treated for malignant tumors (MT) of loco-motor system. Localized process was diagnosed in 25 (51%) patients, IV stage of disease in 24 (49%) children. Use of adopted treatment program including intensive polychemotherapy, organ-saving surgical treatment and radiotherapy enabled to achieve optimistic results. Overall 2-years survival rate for children with loco-motor system MT made up 64.3±7.2%, i.e. 86.5±7.2% in localized and 42.6±10.5% in disseminated process.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):52-57
pages 52-57 views

Role of Cytological Examination in Diagnosis and Monitoring of Large Joints Peri-Implant Inflammation

Voloshin V.P., AV E.V., Zubkov V.S., Shatokhina S.N., Martynenko D.V., Zakharova N.M., Oshkukov S.A.

Abstract

Cytologic specimens from pathologic foci of 20 patients aged 20— 80 years with acute, chronic and low-grade inflammation in the area of large joint implants were examined. Three variants of cystograms were differentiated: reactive state in response to foreign body, chronic proliferative inflammation and chronic inflammation with bone tissue resorption. Tactics foe surgical treatment of peri-implant inflammation was chosen according to the variant of cytologic picture. Inflammation process was arrested in all patients. Cytologic method can be recommended as a component of complex examination for patients with forthcoming large joints revision arthroplasty as well as measure to prognosticate the inflammation relapse after sanitation procedures
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):58-62
pages 58-62 views

Evaluation of Methods for Correction of Spinal Root Microcirculation Disorders in Intervertebral Disk Hernia

Krupatkin A.I., Kuleshov A.A., Shvets V.V., Makarov C.N.

Abstract

Qualitative and quantitative assessment of the influence of various drugs upon spinal root microcirculation before and after spinal canal decompression in lumbar osteochondrosis was performed. Study included 87 (41 female and 46 male) patients aged 26 — 68 years with clinical manifestations of radiculopathy on the background of intervertebral disk hernia in lumbar osteochondrosis. All patients were operated on by Caspar technique. Indices of laser Doppler flowmetry in infrared channel were taken directly from the spinal nerve root before and after decompression. Patients from 1 st group (n=56) received no drugs. In patients from the 2 nd group (n=31) either euphyllinum (subgroup 2E), dexamethasone (subgroup 2D) or rheopolyglucin (subgroup 2R) were injected intravenously prior to decompression. All study drugs were effective and the most significant influence on the microcirculatory indices was exerted by rheopolyglucin. Initial index of microcirculation was 30 p.u. in 1 st group, 32 p.u. in subgroup 2E, 40 p.u. in subgroup 2D and 32p.u. in subgroup 2R. After decompression that index increased up to 36±6 p.u. in 1 st group and up to 40±8, 47±7, 44±12p.u. in three subgroups, respectively.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):63-67
pages 63-67 views

Peculiarities of Bone Regenerate Structural Condition in Patients with Achondroplasia and Congenital Varus Deformity

Menshchikova T.I., Aranovich A.M.

Abstract

Peculiarities of osteogenesis course in patients with achondroplasia at crus lengthening and in patients with congenital varus deformity in the process of correction were studied using US methods. Qualitative and quantitative US criteria that characterized normal, high and low reparative osteogenesis activity were presented. It was established that distraction regenerate with low level of osteogenesis was characterized by delayed organotypical reconstruction and disturbance of microcirculatory bed formation. The necessity of dynamic US examination during the whole period of treatment was shown.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):68-73
pages 68-73 views

Surgical Correction of Abnormal Foot and Ankle Position

Koryshkov N.A., Levin A.N., Khodzhiev A.S., Sobolev K.A.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):74-75
pages 74-75 views

Traumatic dislocations of crus (part 1)

Zorya V.I., Morozov A.A.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):76-81
pages 76-81 views

Modern Aspects of Treatment for Pseudarthrosis of Long Bones of the Extremities

Urazgil’deev R.Z., Kesyan G.A., Berchenko G.N.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):81-88
pages 81-88 views

Low Invasive Knee Arthroplasty

Sikilinda V.D., Alabut A.V.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):88-93
pages 88-93 views

Osteoporosis in traumatology and orthopedics

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N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(1):94-95
pages 94-95 views

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