Vol 19, No 1 (2012)

Articles
Influence of Bone Morphogenetic Protein in Composition of Biocomposite Material upon Osteogenesis and Bone Mineralization
Mironov S.P., Rodionova S.S., Torgashin A.N., Semenova L.A., Mironov S.P., Rodionova S.S., Torgashin A.N., Semenova L.A.
Abstract
Influence of bone morphogenetic protein (BMP-2) in its local application in combination with demineralized lyophilized bone implant (DLBI) upon the process of osteogenesis and bone mineral density in the zone of surgical intervention and the whole segment (tibia) was studied in experiment (40 rats). The animals were divided into 2 groups. In animals from the study group the defect zone was filled with both DLBI and BMP-2 while in control group only with DLBI. In evaluation of morphologic changes by points at terms 7 and 12 weeks no reliable differences between the groups were noted. However at 12 weeks in study group cases of marked osteogenesis with full remodeling of bone implant were observed. It was shown that use of BMP-2 in combination with DLBI reliably increased bone mineral density both in the zone of surgical intervention and in the segment as a whole. That fact was regarded as the evidence of BMP-2 positive effect upon the mechanical strength of the forming regenerate.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):3-7
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Comparative Assessment of Endothelium-Associated Correction of Experimental Osteoporosis with Resveratrol and Etoksidol
Faytel'son A.V., Dubrovin G.M., Gudyrev O.S., Pokrovskiy M.V., Ivanov A.V., Radzhkumar D.S., Faitel'son A.V., Dubrovin G.M., Gudyrin O.S., Pokrovskiy M.V., Ivanov A.V., Radjkumar D.S.
Abstract
Osteoprotective action of resveratrol and etoksidol was studied on the model of experimental osteoporosis (140 female Wistar rats). It was detected that endothelial dysfunction of bone tissue microcirculation bed that led to osteoporosis development. In contrast to etoksidol, resveratrol prevented the reduction of bone tissue microcirculation level and the aggravation of bone remodeling processes in developing osteoporosis that was manifested by delayed bone trabeculae thinning and averting of microfractures in them.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):8-11
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Comparative Analysms of Posterior Interbody Fusion and Transforaminal Interbody Fusion in Combination with Transpedicular Fixation
Krut'ko A.V., Krutko A.V.
Abstract
Results of comparative study of posterior interbody fusion (PLIF) and transforaminal interbody fusion (TLIF) in degenerative lumbar spine pathology are presented. Total number of patients was 101. In 47 patients (1st group) transpedicular fixation, decompression and interbody fusion with one cage (TLIF) was performed. In 54 patients (2nd group) transpedicular fixation via posteromedial approach, decompression of intracanal neurovascular structures and interbody fusion with two interbody implants (PLIF) was applied. Complex evaluation of surgical treatment results was performed in 52 patients in 6-12 months after surgery. It was shown that application of either of the techniques resulted in 95-98% cases of interbody block formation. Differential approach to application of those interbody fusion techniques and the advantages of TLIF over PLIF, i.e. simplicity and higher safety of performance, lower intraoperative blood loss and duration of surgical intervention, were presented.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):12-21
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Version of Tenodizing Operation in Patients with Recurrent Shoulder Dislocation
Sysenko Y.M., Samusenko D.V., Sysenko Y.M., Samusenko D.V.
Abstract
Description of a patent technique for surgical treatment of patients with recurrent shoulder dislocation by creation a ligament that fixes the humerus head is presented. Peculiarities of patients' management in the postoperative period and the order of Ilizarov apparatus dismantling are shown. Use of that technique for the treatment of 32 patients enabled to achieve good results (no relapse) in 96.9% of cases.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):21-23
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Total Hip Arthroplasty with Tantalum Constructions
Murylev V.Y., Terent'ev D.I., Elizarov P.M., Rukin Y.A., Kazaryan G.M., Murylyov V.Y., Terent'ev D.I., Elizarov P.M., Rukin Y.A., Kazaryan G.M.
Abstract
Results of acetabular reconstruction with tantalum constructions were analyzed for 56 patients (25 men and 31 women) aged 35 to 70 years. Primary arthroplasty was performed in 30 and revision intervention in 26 patients. In case of primary total hip arthroplasty the following etiologic factors were considered: posttraumatic acetabulum deformity (21 patients), deficit of acetabular walls resulted from dysplasia (4), femoral head protrusion (5). Evaluation of the defect and selection of tantalum construction were made using defect classification by W.G. Paprosky. Results were assessed by Harris scale at terms 3,6 and 12 months after operation and every year thereafter. Excellent, good and satisfactory results were achieved in 96.8% of cases. The most common complication was the dislocation of hip implant head. It developed in 2 patients after revision arthroplasty and in 1 patient after primary total hip arthroplasty.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):24-29
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Treatment of Patients with Dislocation of Hip Implant Head
Kagramanov S.V., Zagorodniy N.V., Nuzhdin V.I., Buravtsova M.E., Kagramanov S.V., Zagorodniy N.V., Nuzhdin V.I., Buravtsova M.E.
Abstract
Experience in treatment of 40 patients (41 cases) with dislocation of the head of hip joint implant operated on during the period from April 2002 to November 2011 at CITO joint replacement department is presented. Causes and factors of that complication development have been analyzed, techniques of treatment applied at CITO joint replacement department have been described and conclusions on the importance of certain aspects of patients' management have been made.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):30-34
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Complex Functional Evaluation of Long-Term Results of Femoral Neck and Head Revascularization in Degenerative Dystrophic Hip Joint Diseases
Nazarov E.A., Papkov V.G., Seleznev A.V., Musaeva R.F., Nazarov E.A., Popkov V.G., Seleznyov A.V., Musaeva R.F.
Abstract
Long-term results (7 to 26 years) after femoral neck and head revascularization were analyzed for 41 patients with degenerative dystrophic hip joint diseases: 27 patients with aseptic femoral head necrosis (AFHN), 9 patients with coxarthrosis, 5 - with cystoid remodeling of adjacent surfaces. Results were assessed by Harris scale. Degree of functional changes in hip joints was determined using computed stabilometry. Indirect proof of implanted vascular bundle vitality were radiologically, CT and MRI detected canals in the femoral neck and head that where the implants had been inserted. It was shown that revascularization was most effective (100 points by Harris scale) in patients with early (pre-radiologic) stage of AFHN and in patients with cystic remodeling.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):35-41
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Treatment of Posttraumatic Lower Limbs Length Discrepancy without Breach of Bone Integrity in combination with Deformity in Children and Adolescents
Merkulov V.N., Dorokhin A.I., Dambinimaev A.V., Merkulov V.N., Dorokhin A.I., Dambinimaev A.V.
Abstract
During the period from 1994 to 2009 two hundred nine children (aged 2 - 18 years) with posttraumatic lower limbs length discrepancy without breach of bone integrity in combination with deformity were treated on. Corrective osteotomy or the combination with elongating osteotomy by monolocal methods were the main treatment techniques. Bi- and polylocal techniques were mainly applied when deformity was localized in an unfavorable for elongation zone and in significant shortening. A risk group for delayed regenerate ossification was identified. In that group treatment was supplemented with preventive bone plasty using either auto- or allografts in the zone of osteotomy. For objective complex evaluation of distraction regenerate condition in dynamics roentgenologic examination and ultra-sound investigation as well as elaborated method for determination of relative bone regenerate mineral density were used. The latter method enabled to study the regenerate density using digital image of standard roentgenogram and graphic computer program. Differentiated approach to the treatment and monitoring of distraction regenerate condition enabled to achieve excellent and good results in 84% of cases.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):41-46
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Hip Arthroplasty in Adolescents with Juvenile Rheumatoid Arthritis
Malakhov O.A., Alekseeva E.I., Malakhov O.O., Morev S.Y., Valieva S.I., Bzarova T.M., Denisova R.V., Sleptsova T.V., Mitenko E.V., Isaeva K.B., Malakhov O.A., Alekseeva E.I., Malakhov O.O., Morev S.Y., Valieva S.I., Bzarova T.M., Denisova R.V., Sleptsova T.V., Mitenko E.V., Isaeva K.B.
Abstract
Results of total hip replacement (THR) performed in 23 patients (9 male and 14 female) aged from 13 to 18 years with coxarthrosis on the background of juvenile rheumatoid arthritis (JRA) are presented. All patients have been operated on at traumatologic-orthopaedic department of Scientific Center for Children's Health during the period from 2008 to 2012. Main complaints of patients were pain and limitation of movement in hip joints, discrepancy of lower extremities length, claudication, disturbance of weight bearing ability and lower extremities function that in 90% of cases made the movement without additional support impossible. Indications to THR and peculiarities of surgery in young patients with JRA are described. Almost in all patients correction of lower extremities deformity and formation of either normal or close to normal functional status have been achieved. Roentgenologic examination showed good localization of implant components.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):48-52
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Reconstructive Operations on Hip Joint in Children with Epiphyseal Dysplasias
Kamosko M.M., Mel'chenko E.V., Kamosko M.M., Mel'nichenko E.V.
Abstract
Retrospective analysis of examination and treatment results for 100 patients with epiphyseal dysplasias (ED), aged 3 months - 18 years, was performed. In 22 patients conventional palliative surgical interventions for the elimination of defected limb position were performed. Authors have treated 78 patients: in 25 patients corrective shortening femur osteotomy (CSFO) and in 31 - pelvic osteotomy in combination CSFO was performed. Follow up period was from 3 years to 8 years. By the results of clinical and roentgenologic dynamics of hip joint deformity development in children with ED 3 clinic-roentgenologic-anatomic manifestations of the disease were determined: initial changes (from birth to 6 years), marked changes (7 - 11 years) and severe changes (from 12 years). It was shown that reconstructive operations on pelvic and femoral joint components possessed positive effect especially pronounced in children of the younger age group.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):53-60
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Peculiarities of Shin Muscles Bioelectric Activity in Children with Infantile Cerebral Palsy
Shamik V.B., Tupikov V.A., D'yakova V.N., Shamik V.B., Tupikov V.A., D'yakonova V.N.
Abstract
Electroneuromyography (ENMG) indices were analyzed for 207 patients aged from 4 to 16 years with cerebral palsy. All patients had equinus foot deformity and myofascial pain syndrome of various severity degree. One hundred thirty three children were treated conservatively and in 74 patients various surgical interventions were performed. Results of needle ENMG performed to 21 patients with severe myofascial pain syndrome confirmed presence of skeleton muscles lesion with scarry degeneration. In operated children indices of electrogenesis were higher than in conservatively treated patients.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):61-63
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Disturbances of Microcirculation and Antioxidant Potential as a Consequence of Ferrum Exchange in Traumatic Disease
Ivanov A.V., Orlov Y.P., Lukach V.N., Pritykina T.V., Ivanova A.M., Ivanov A.V., Orlov Y.P., Lukach V.N., Protykina T.V., Ivanova A.M.
Abstract
Study of ferrum metabolism was performed in 30 patients with traumatic disease, i.e. fractures of the femur, pelvic bones, ribs accompanied by massive muscular hematomas. It has been detected that in severe bone injury besides extravascular hemolysis the intravascular hemolysis, that affects the ferrum metabolism, takes place. Excess of free ferrum activates free radical oxidation processes and results in reduction of total antioxidant activity that is proved by lability of Fe2+ - induced hemiluminescence indices as well as causes the disturbance of blood rheology that influences the course of traumatic disease. Results of experimental study on 30 male Wistar rats in which the conditions of I stage of traumatic shock were created showed that administration of Desferal contributed to blood viscosity improvement.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):64-69
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Thrombosis Prevention in Arthroscopic Reconstruction of Anterior Cruciate Ligament
Rykov A.G., D'yakov D.D., Korshnyak V.Y., Pryanishnikov R.V., Rykov A.G., D'yakov D.D., Korshnyak V.Y., Pryanishnikov R.V.
Abstract
Results of dabigatrana etexilat (Pradaxa) use for venous thrombosis prevention after anterior cruciate ligament arthroscopic reconstruction are presented. It is shown that after this type of surgical intervention patients are at risk of thromboembolic complications development. Intake if Pradaxa tablets in dose 220 mg daily for 10 days after surgery enables to avoid thrombosis of lower extremity veins.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):70-73
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Idiopathic Extension-Abduction Contracture of Hip Joints
Kozhevnikov O.V., Kralina S.E., Kozhevnikov O.V., Kralina S.E.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):74-76
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Result of Single-Step Correction of Both Feet Deformity in Roth - Charcot - Marie Disease
Levin A.N., Koryshkov N.A., Levin A.N., Koryshkov N.A.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):77-78
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Result of Orthopedic Correction for Femur Nonunion and Shortening
Litvinov I.I., Koltunov A.V., Solov'ev I.N., Litvinov I.I., Koltunov A.V., Solov'yov I.N.
N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):79-80
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Index of Articles published in 2004-2011
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N.N. Priorov Journal of Traumatology and Orthopedics. 2012;19(1):81-96
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