Vol 20, No 2 (2013)

Articles
Negative Pressure Wound Therapy for Prevention and Treatment of Purulent Septic Complications in Traumatology and Orthopedics
Obolenskiy V.N., Ermolov A.A., Sychyev D.V., Semenistyi A.Y., Rodoman G.V., Leval’ P.S., Golev S.N., Zagorodniy N.V., Laka A.A., Sampiev M.T., Semyonova T.V.
Abstract
Negative pressure therapy is one of the newest methods used in the wounds treatment. It enables to accelerate and optimize the process of wound healing and hence to reduce the cost of treatment. Negative pressure stimulates proliferation of granulation tissue, provides continuous evacuation of exudate and effectively cleans wound surface. Treatment results for 251 patients with purulent septic complications after surgical intervention are presented. One hundred two patients had open fractures of extremity bones, 51 patients underwent total arthroplasty of large joints and 48 patients — scoliosis endocorrection.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):3-11
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Potentialities of Plastic and Reconstructive Microsurgery in Treatment of Patients with Pathology of Large Joints of Extremities
Tikhilov R.M., Kutyanov D.I., Rodomanova L.A., Kochish A.Y.
Abstract
Potentialities of reconstructive and plastic microsurgery in patients with different pathology of large joints of the extremities were studied. Results of 265 microsurgical operations with pedicle flap (65.7%) and free tissue (34.3%) grafting were assessed. It was shown that use of microsurgical techniques provided reconstruction of full value para-articular soft tissues, increased range of joint movement and created the conditions for effective arrest of local inflammatory process. Besides, they possessed potentialities for the performance and increase of the efficacy in arthroplasty and some other high technology operations on large joints. The more distally the joint is located the higher is the need in reconstructive-plastic microsurgical operations and free tissue grafting on upper and lower extremities.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):12-19
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Use of Asymmetric TLIF Technique for the Treatment of Idiopathic Scoliosis
Baklanov A.N., Kolesov S.V., Shavyrin I.A.
Abstract
Purpose of the study was to determine the possibility of asymmetric transforaminal lumbar interbody fusion (TLIF) application for dorsal spine correction and fixation in patients with idiopathic scoliosis. Dorsal spine correction and fixation using technique of asymmetric transforaminal lumbar interbody fusion on the concave side of lumbar spine deformity was performed in patients, aged 14—58 years, with idiopathic scoliosis. Average preoperative deformity angle made up 78.25° versus 30.25° postoperatively; average correction was 61.6%. For TLIF performance combined implants, i.e. interbody titanium cages filled with autobone, were used. Use of asymmetric TLIF enabled to reduce the slope of lower instrumented vertebra and thus to perform the correction of spine frontal balance. Lordosing effect of cage improved the sagittal profile of the vertebral column while more rapid formation of lumbar corporodesis under conditions of interbody fixation prevented rods and screws fractures in the lower pole of metal constructions.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):20-25
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Efficacy of Spine Segments Radiofrequency Denervation
Nazarenko G.I., Cherkashov A.M., Kuzmin V.I., Nazarenko A.G., Gorokhov M.A., Sharamko T.G.
Abstract
Early and long-term results of radiofrequency facet destruction for 245 patients with cervical, thoracic and lumbar spondyloarthrosis were presented. One hundred six patients (control group) were treated conservatively. Treatment results were assessed by pain syndrome intensity using pain audit. One year after operation good result was observed in 62 (32%) out of 195 patients and satisfactory results — in 117 (60%) patients. That method enabled to eliminate considerably vertebrogenic pain localized in one dermatome when conservative treatment failed. Our experience showed that radiofrequency facet nerves destruction was safe and did not result in soft tissue injuries. All that enabled patients to return to work at maximum short terms.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):26-31
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Standard Acetabular Component or Antiprotrusion Consolidating Design?
Zagorodniy N.V., Kagramanov S.V., Nikolaev I.A., Bukhtin K.M.
Abstract
The purpose of the study was determination of optimum technique for acetabular component revision depending on the volume of bone tissue deficit. Between 1992 and 2012 a total number of 843 partial or total revision hip replacement surgeries were performed. In 664 cases the indication for revision surgery was instability of acetabular component. Depending on the design of implant used (polyethylene cement cups, consolidating constructions, cementless cups) all patients were divided into 3 groups. Subsequently each group was divided into subgroups depending on the acetabular defect degree (by Paporsky classification). It was shown that for provision of maximum implant surveillance and reduction of the risk of most common operative complications the early clinical and radiologic detection of developing acetabular instability and revision performance was essential. In cases of delayed revision operation and significant bone tissue deficit it is reasonable to perform revision surgery using consolidating construction with additional bone defect plasty.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):32-37
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Treatment of Patients with Elbow Osteoarthrosis I-II Stage by Arthroscopy
Kuznetsov I.A., Ryabinin M.V., Zhabin G.I., Salikhov M.R., Rybin A.V.
Abstract
Comparative assessment of conventional (control group, 30 patients) and arthroscopic (main group, 16patients) treatment techniques was performed by the treatment outcomes of 46 patients aged 20-50 years with I-II stage of elbow osteoarthrosis and resultant flexion-extension contracture. Elbow function was evaluated by MEPS scale prior to and 1 month after operation. The advantage of arthroscopic intervention that enabled to eliminate intraarticular pathology, to initiate early rehabilitation and provided good functional result at short terms — 91 points in the main group versus 74 points in control one.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):38-42
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Use of High Frequency Coblation for the Treatment of Achilles Tendon Diseases
Mironov S.P., Orletskiy A.K., Vasil’ev D.O.
Abstract
Actuality of the work was conditioned by wide prevalence of Achilles tendon diseases and considerable number of unsatisfactory treatment results. First native experience in use of high frequency coblation for the treatment of patients with Achilles tendon diseases was presented. Intervention was performed in 26 patients with chronic Achilles tendon paratenonitis and tendinitis, and in 8 patients with tendoperiosteopathy of calcaneal tuber. In all cases treatment results were assessed as good: pain syndrome was completely arrested, restoration of tendon and calcaneal aponeurosis thickness and homogeneity as well as regress of fibrosis were observed. Neither intranor postoperative complications were registered.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):43-45
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Comparative Clinical and Economical Analysis of Drugs for Primary Prevention of Thrombotic Complications after Orthopaedic Operations
Kulinchik T.V., Rebrova O.Y., Margieva A.V., Avksent’eva M.V.
Abstract
Cost minimization analysis was performed on the basis of the efficacy and safety evaluation of dabigatran etexilate (DE, Pradaxa®) versus other common anticoagulants (AC). Total costs including laboratory and instrumental examinations, consultations related to venous thromboembolism (VTE) and post-operative anticoagulation therapy were calculated by the data of 828 individual registration cards. All patients were divided into 2 groups: 761 patients (91.9%) after total hip and knee arthroplasty (1 st group) and 67patients (8.1%) after other orthopaedic operations (2 nd group). In 1 st group costs for drug prophylaxis of VTE and total costs per patient were significantly lower (by 1196.66 and 432.41 rbl, respectively) when DE was used as compared to AC application. After other orthopaedic operations reliable differences neither in costs for drug prophylaxis of VTE nor in total costs per patient were detected. However the significance of obtained results was limited by the number as well as the differences in initial condition of patients.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):46-53
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Role of Lipid Peroxide Oxidation in Pathogenesis of Long Bone Pseudarthrosis
Urazgil’deev R.Z., Kesyan G.A., Varfolomeev V.N., Shtol’ko V.N.
Abstract
The study of peculiarities of lipid peroxide oxidation (LPO) and antioxidant defense in locomotor injuries was presented. There were 49 patients with complicated and uncomplicated ununited fractures as well as pseudarthrosis of ling bones. Control group consisted of 15 healthy persons. Primary products of LPO (diene coniugates (DC) and quantity of double bonds (DB) in unsaturated fatty acids (UFA) were determined in plasma. In patients with pseudarthrosis complicated by purulent inflammatory process content of DC and DB UFA were the highest. In patients with ununited fractures DC and DB were higher in comparison with patients with normal healing fractures. In tested group plasma lipids and erythrocyte osmotic resistance were decreased but ceruloplasmin was increased. Based on data obtained integral indicis for complex evaluation of patient status and possible complications were suggested.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):54-59
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Comparative Study of Certain Serum Markers in Experimental Osteosynthesis Using Implants with Titanium Nitride and Hafnium Coating
Akhtyamov I.F., Shakirova F.V., Gatina E.B., Zubairova L.D., Aliev E.I.
Abstract
Simulation of intramedullary osteosynthesis was performed at experimental tibia fracture in 30 rabbits, 6-7 months aged. In main group pins from medical steel coated by mixture of titanium nitride and hafnium were used, in comparative group pins without coating were used. Comparative study of certain biochemical blood indices, P and Ca content was performed. It was shown that application of implants coated by titanium nitride and hafnium that possessed high firmness and chemical stability did not cause additional reactive changes in experimental animals as compared with implants of medical steel. It confirmed the prospects of bioinert titanium nitride and hafnium coated nanotechnologic implants application for prevention of possible individual intolerance of metals.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):60-64
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Revision Total Knee Arthroplasty due to Allergic Reaction to Cobalt
Zagorodniy N.V., Bukhtin K.M., Kudinov O.A., Chragyan G.A., Berchenko G.N., Nikolaev I.A.
Abstract
Clinical observation of patient undergone two revisions total knee arthroplasty was presented. The cause of revisions was clinical manifestation of inflammatory but no classic signs of infection were detected intraoperatively. Cupping of inflammatory was succeeded after insertion of implant coating by nitride ceramics. Possible inflammatory development as allergic reaction to cobalt was discussed.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):65-68
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First Experience in Thoracoscopic Sympathectomy at Treatment of Patients with Vast Posttraumatic Upper Extremity Defects Using Free Flaps
Golubev I.O., Krupatkin A.I., Maximov A.A., Ruzmichev V.A., Merkulov M.V., Bushuev O.M., Shipyaeva G.N., Kutepov I.A.
Abstract
Two clinical observations of patients with severe upper extremity injury sequelae are presented. Examinations included clinical and ultrasound methods, MRT-angiography, ENMG. Trophic status and microcirculation were studied using computer thermography as well as laser Doppler Flowmetry. Thoracoscopic clipping of sympathetic ganglions at the Th3-Th4 levels were performed in 7 weeks and 3 months following microsurgical forearm reconstruction. Sympathectomy provoked significant microcirculation activation and as a consequence improvement of extremity trophic status including distal region
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):69-73
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Pathophisyologic Aspects of Discoradicular Conflict in Lumbar Osteochondrosis
Kuleshov A.A., Krupatkin A.I., Makarov S.N.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):73-79
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Treatment of Mallet Fingers Deformity
Bugaev D.M., Gorbunkov V.Y., Derevyanko D.V.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):80-84
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Peculiarities of Psychological Adaptation of Patients with Upper Extremity Amputation Defects Resulted from Trauma
Bulyubash I.D.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):84-91
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«Degerative Dystrophic Diseases of Hip Joint (Clinical Experimental Study)» by E.A. Nazarov
Ezhov Y.I.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):92-92
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In commemoration of the 100 anniversary of Z.S. Mironova
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N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):93-93
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G.I. Nazarenko
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N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(2):94-94
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