Vol 20, No 4 (2013)

Articles
Information Provision for Data Collection on Injuries in Foreign Countries
Mironov S.P., Andreeva T.M., Kakorina E.P., Ogryzko E.V.
Abstract
Database on injuries in various countries including USA, Canada, Australia and European Union is presented
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):3-8
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Surgical Treatment for Unstable Pelvic Ring Injuries
Donchenko S.V., Dubrov V.E., Slinyakov L.Y., Chernyaev A.V., Lebedev A.F., Alekseev D.V.
Abstract
Treatment results for 67 patients (43 men, 24 women), aged 15–70 years, with unstable pelvic ring injuries are presented. In 15 cases conservative treatment (control group) and in 52 cases various surgical interventions (main group) were performed. In the main group of patients a strategy of two5step surgical treatment of the victims with multiple and concomitant injuries Damage control concept was applied. It included urgent stabilization of pelvic ring with external fixation devices and C-frame, bleeding arrest, final fixation within first 5–7 days after stabilization of patient’s condition. Restoration of the anterior semi5ring was performed using either external fixation device or a reconstructive plate. Stabilization of sacroiliac junction was per5 formed with cannulated screws. All patients were allowed to walk on crutches within 1–5 days after operation. In control and main groups the duration of hospitalization made up 43.7±2.5 and 25.7±3.1 days (p<0.05), respectively. Long term (1 year) treatment results were assessed by Majeed scale and SF-36 questionnaire were used. By Majeed scale excellent results in main group were achieved in 35 (67.3%), good – 11 (21%) and satisfactory – in 6 (11.5%) patients. In control group no excellent results were obtained, good results were obtained in 6 (40%) and satisfactory in 9 (60%) patients. By SF-36 questionnaire treatment results in main group statistically significant (p<0.001) surpassed the results achieved in control group. Thus, stable fixation of both anterior and posterior semirings enables to initiate early mobilization without risk of reposition loss that is very important for the patients with multiple and concomitant injuries.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):9-16
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Matrix Properties, Biocompatibility and Osteoplastic Potentialities of Composite Materials Based on Polylactoglycolide and Natural Coral Skeleton Granules of Various Dispersity
Sergeeva N.S., Sviridova I.K., Frank G.A., Kirsanova V.A., Akhmedova S.A., Shanskiy Y.D., Krotova L.I., Popov V.K.
Abstract
Results of in vitro and in vivo medico5biological study of mineral-polymer composites (MPC) based on high molecular polylactoglycolide and natural A. cervicornis coral skeleton with vari5 ous dispersity (<200 µm, 200-600 µm and >600 µm) as materials for bone defects substitution are presented. On the model of human fibroblasts in vitro it was shown that MPC were not toxic and possessed satisfactory matrix (for cells) properties. The optimum for composite size of natural coral granules made up 200-600 µm. MPC biocompatibility was shown in subcutaneous test in mice. However comparatively slow subcutaneous substitution of both polylactoglycolide and MPC on its basis by connective tissue. Study of MPC and its components’ osteoplastic potential showed that in the zone of fenestral tibia defect in rats polylactoglycolide was substituted by connective tissue. Periosteal osteogenesis that in MPC was supplemented by enchondral osteogenesis was observed around the particles of natural coral skeleton.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):17-23
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NFLUENCE OF THE DEGREE OF CALCIUM SUBSTITUTION BY ARGENTUM IN TRICALCIUM PHOSPHATE ON ITS BIOLOGICAL PROPERTIES IN VITRO
Khon V.E., Zagorodniy N.V., Komlev V.S., Fadeev I.V., Bulgakov V.G., Sergeeva N.S., Sviridova I.K., Tolordava E.R., Didenko L.V.
Abstract
Results of in vitro study of argentum containing tricalcium phosphate (TCPh-Ag) are presented. It is shown that biomaterial does not possess radical forming activity. Argentum containing forms of TCPh render bacteriostatic effect upon Staphylococcus haemolyticus and Escherichia coli. Dose-dependent effect of TCPh-Ag in relation to antibacterial and cytotoxic properties is demonstrated. It is determined that TCPh with rated substitution 0.5 is characterized by moderate cytotoxicity with preservation of antibacterial properties.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):23-28
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Osteoplastic Substitution of Acetabular Defects at Revision Hip Arthroplasty
Zagorodniy N.V., Nuzhdin V.I., Nikolaev I.A., Kagramanov S.V., Komlev V.S.
Abstract
First experience in application of synthetic and natural osteoconductive biocompatible materials of calcium orthophosphates that gradually resorb and are substituted by newly formed bone tissue is presented. Those osteoplastic materials were used in 11 patients aged 45–78 years at revision hip arthroplasty due to unstable acetabular component. According to W. Paprosky classification II A type of acetabular defect was diagnosed in 2 patients, II B type — in 2, II C type — in 3, III A type — in 3 and type III B — in 1 patient. Volume of used material was determined by the size of bone defect and ranged from 10 to 50 g. At terms from 3 to 18 months satisfactory treatment result was observed in all patients. Control X-rays and computed tomograms showed that structure of remodeled bone tissue approximated to the acetabular structure and its’ density almost corresponded to pelvic bones density.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):29-33
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Surgical Treatment of Congenital Kyphosis
Kolesov S.V., Snetkov A.A., Sazhnev M.L., Shaboldin A.N.
Abstract
Surgical treatment results of 24 patients, aged 3 — 57 years, with congenital kyphotic deformities of thoracolumbar spine are presented. Disturbance of vertebrae formation was diagnosed in 13 patients, segmentation disorder — in 4, mixed abnormalities — in 1, nonclassifying abnormalities — in 3, congenital dislocations (subluxation) — in 3 patients. Neurologic disorders were observed in 12 patients. Five surgical techniques were used for the treatment of congenital kyphotic deformities: posterior fusion (8 patients), combined dorsal and ventral fixation (6), spinal cord decompression in combination with correction and stabilization (4), resection of hemivertebra (3), VCR (Vertebral Column Resection — 4). After surgical correction the angle of kyphotic deformity made up from 7 to 68° (mean 42°), degree of correction from 6 to 84% (mean 34%). Differentiated use of surgical techniques enables to achieve good treatment results, formation of proper frontal and sagittal balance as well as to create conditions for an adequate spine development.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):34-40
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Comparative Evaluation of Various Techniques of Arthroscopic Tenodesis for Tendon of Long Head of Biceps (multicenter study)
Dubrov V.E., Zaitsev R.V., Dokolin S.Y., Rakhmankulov E.R., Fomenko S.M., Radimov K.F.
Abstract
Fifty six patients under 50 years participated in a multicenter study on the comparison of long term (12 – 14 months) results after application of different tenodesis techniques, i.e. sub- and suprapectoral one with fixation by interferent and anchor fixatives. Dicision on patient’s participation in the study was made intraoperatively if rotator cuff pathology was identified and indications to the tendon of long head of biceps were determined. Results were evaluated by Constant – Murley score and SF-36 questionnaire. Statistically significant (p<0.000001) improvement of postoperative indices versus preoperative was noted independently of tenodesis technique applied.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):41-44
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Low Invasive Subtalar Joint Arthrodesis
Samkov A.S., Zeynalov V.T., Levin A.N., Koryshkov N.A., Dzyuba A.M., Khodzhiev A.S., Sobolev K.A.
Abstract
At present arthrodesis of subtalar joint is recognized to be the most common and effective technique for the treatment of patients with malunited fractures of talus and calcaneal bones, deforming subtalar joint arthroses and posterior foot deformity. From 2010 through 2012 twenty patients with posttraumatic arthroses of subtalar joint accompanied by marked pain syndrome and no significant deformities in the posterior foot segment. New low invasive treatment technique was applied. Examinations and treatment were performed at outpatient clinic. Follow up period ranged from 1 to 2 years. All results were recognized as good. No intra- and postoperative complications were noted.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):45-49
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Guided Growth Technique for Correction of Lower Extremity Deformities in Children
Kenis V.M., Klychkova I.Y., Mel’nichenko E.V., Ivanov S.V., Sapogovskiy A.V.
Abstract
Guided growth technique with temporary epiphysiodesis is used for the correction of lower extremities axial deformities in children before skeletal maturity. From 2009 to 2013 one hundred fifty epiphysiodesis procedures were performed in 93 children aged 3–15 years. Technique was performed both in patients with idiopathic deformities and in patients with severe systemic pathology (skeletal dysplasias, neuromuscular disorders, metabolic nephropathies). Treatment results were assessed at terms from 12 to 48 months after surgical intervention. Good results were achieved in 67 (72%), satisfactory — in 18 (19.3) and poor — in 8 (8.6%) patients. Mean rate of correction made up 0.81±0.17° per 1 month of epiphyseodesis with its maximum in valgus knee and ankle deformities. Advantages of the procedure included low invasiveness and simplicity of performance, low complication rate, possibility of simultaneous intervention on several levels as well as combination with other interventions. Thorough selection of patients, proper intervention technique and regular postoperative followup enable to avoid complications and unsatisfactory results.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):50-55
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Reduction of Shoulder Dislocation by Dzhanelidze
Zolotov A.S., Feshchenko M.S., Fadeev M.F.
Abstract
The most physiologic and low invasive method for reduction of anterior shoulder dislocation is Dzhanelidze technique that has been proposed in about 100 years ago. However this technique is not often applied in practical work. The authors have analyzed the efficacy of original Dzhanelidze technique at treatment of 6 patients and its popularity among practical trauma- and orthopaedic surgeons (n=54) from different hospitals in Vladivostok and Primorski Territory. It is shown that original shoulder dislocation reduction technique by Dzhanelidze without morphine use is not effective. Out of all surgeons who participated in questionnaire survey only 10 (18.5%) specialists apply Dzhanelidze method in practice. Physicians use various modifications of this method that considerably differ from the original technique. Description of Dzhanelidze technique in modern textbooks and manuals of surgery and traumatology are contradictory and significantly differ from the author’s technique.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):56-59
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Treatment of Infectious Complications after Transpedicular Fixation: Case Report and Analysis of Modern State of the Problem
Pas’kov R.V., Plyushchenko D.S., Sergeev K.S., Faryon A.O., Yapryntsev I.M., Katrenko I.N.
Abstract
Female patient was treated for wound suppuration after transpedicular fixation of complicated unstable spine injury. Step-by-step treatment technique was used. First step included removal of transpedicular fixative, wound debridement and extrafocal external transpedicular fixation to prevent spine deformity relapse. Second step was performed after wound healing – external fixative was replaced by the internal (ventral) one. Duration of fixation in the apparatus and hospitalization made up 36 and 90 days respectively.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):60-63
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Surgical Treatment of Severe Spine Deformity in Patients with Spinal Muscular Atrophy
Kolesov S.V., Kudryakov S.A., Shavyrin I.A., Shaboldin A.N.
Abstract
Two-step surgical treatment was conducted in a 17 year old woman with extremely severe kyphoscoliotic deformity on the background of spinal muscular atrophy. At first step a ring of haloapparatus was assembled and gradual halotraction was performed in an armchair within 21 days. Second step included dorsal correction and stabilization of scoliosis by hybrid fixation system at Th3-L4 level with pelvis fixation. As a result of surgical intervention a proper trunk balance was formed, pelvic deformity was diminished, selfservice and use of wheelchair in a sitting position was improved.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):64-67
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Diagnostic Potentialities of Multispiral Computed Tomography for Hip Joint Evaluation in Children and Adolescents
Ogaryov E.V., Morozov A.K.
Abstract
Multispiral computed tomography (MSCT) is a method of choice for evaluation of bone structure condition, as well as for visualization of growth zones, main and additional ossific nuclea of the articular elements. Besides, MSCT provides precise evaluation of spatial orientation of hip joint components, pattern of bone fragments displacement in traumatic injuries, localization of pathologic focus in bone pathology and degree of adjacent anatomic structures involvement. Contrast enhancement (double-contrast technique) markedly widens potentialities of this method as it enables to evaluate the condition of articular cartilage and soft tissue structures that is the most actual in young children.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):68-75
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Traumatic dislocations of crus (part 2)
Morozov A.A., Zorya V.I.
Abstract
Second part of the lecture describes detailed characteristics of associated neurovascular fascicle injury in shin dislocations and presents data on treatment tactics, techniques and complications.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):76-80
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Problems in Acetabular Fractures Treatment
Lazarev A.F., Solod E.I., Gudushauri Y.G., Kakabadze M.G., Stoyukhin S.S., Sakharnykh I.N.
Abstract
Modern approaches to the treatment of patients with acetabular fractures are considered. Peculiarities of diagnosis and surgical interventions performed for the fracture itself as well as for related complications and sequelae are presented.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):81-85
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Modern Tendencies of Synovial Fluid Substituting Drugs Based on Bound Hyaluronic Acid Use in Treatment of Patients with Loco-Motor System Pathology and Injuries
Strakhov M.A., Skoroglyadov A.V.
Abstract
Analysis of literature on hyaluronic acid role and properties as well as on the use of synovial fluid substituting drugs based on bound hyaluronic acid (HA) shows the significance of this type of therapy for the arrest of articular and periarticular pain syndrome, and high efficacy in complex treatment of osteoarthritis. Recent data enabled to understand better the mechanisms of HA metabolism and to determine the advantages HA drugs use depending on the production technology, molecular weight and other pharmacodynamics properties.
N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):85-91
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V.L. Andrianov
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N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):92-92
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V.V. Azolov
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N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):93-93
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Index of Articles Published in 1–4, 2013
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N.N. Priorov Journal of Traumatology and Orthopedics. 2013;20(4):94-96
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