Vol 18, No 3 (2011)


Orthopaedic Aspects and Peculiarities of Operative Treatment for Funnel Breast in Children and Adolescents

Malakhov O.A., Zherdev K.V., Chelpachenko O.B., Malakhov O.A., Zherdev K.V., Chelpachenko O.B.


Results of operative treatment using radical thoracoplasty in 31 patients with funnel breast were analyzed. Mean age of patients was 14.98±4.36 years. All patients had concomitant spine deformity. For purpose of cosmetic effect improvement the mini-invasive submammary accesses were used. Fixatives of sternocostal complex from nickel-titanium with shape-memory were worked out. The shape memory effect was achieved by cooling of the implant that resulted in implant plasticity. After being inserted the implant restored its original shape. That technique allowed achieving full correction of the deformity and positive cosmetic effect in all patients. No complications associated with plate migration were revealed. Radical thoracoplasty with thoracocostal complex stabilization by plate with shape-memory effect is pathogenetically justified and allows correcting the funnel chest of any degree and form and is indicated to patients of any age groups.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):3-9
pages 3-9 views

Use of Brace Therapy in Patients with Idiopathic Scoliotic Spine Deformities

Tesakov D.K., Tesakov D.K.


Efficacy of brace therapy was studied in 976 patients with idiopathic scoliosis (IS) aged, 5 to 17 years. The principal curvature made up from 18° to 160°. Chкneau braces were used as orthoses. Treatment course was divided into the period of adaptation to brace wearing, period of primary correction, period of brace retention and period of follow up after brace treatment completion. Achieved results showed that in IS brace treatment provided good corrective and stabilizing effect upon scoliotic spine deformity. Clinically it enabled to eliminate completely, diminish or stabilize deformity manifestations of orthopaedic disease. In severe forms of IS it enabled to control the pathologic process conservatively until the spine growth completion.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):9-21
pages 9-21 views

Version of Surgical Tactics for Spondyloptosis Treatment

Afaunov A.A., Kuz'menko A.V., Basankin I.V., Afaunov A.A., Kuz'menko A.V., Basankin I.V.


Tactics of surgical treatment of spondyloptosis including use of transpedicular external fixation device is presented. There were 4 patients with L5 spondyloptosis. The tactics is characterized by minor traumatization of lumbosacral spine with external fixation device, decrease of neurologic complications rate owing to gradual L5 reduction, possibility of spine deformity elimination, significant technical simplification of internal transpedicular osteosynthesis performance. Clinical results showed normalization of anatomic interrelation in lumbosacral spine, elimination of vertebroradicular conflict, restoration of trunk balance and anthropometric proportion as well as stabilization of L5-S1 segment by osteo-metalic block.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):22-26
pages 22-26 views

Pathological Knee Joint Synovial Folds in Children and Adolescents (diagnosis, arthroscopic treatment)

Merkulov V.N., Berchenko G.N., Chikvatiya L.V., El'tsin A.G., Minnikov D.S., Avakyan A.P., Merkulov V.N., Berchenko G.N., Chikvatiya L.V., El'tsin A.G., Mininkov D.S., Avakyan A.P.


Basing on the analysis of 817 arthroscopic interventions on the knee in children and adolescents with various knee joint pathology it was detected that pathology of synovial folds was one of the main causes of knee pain and discomfort in that group of patients. Pathological pattern of synovial folds was visualized in 127 patients. Treatment of this pathology requires knee arthroscopy for verification of preliminary diagnosis made by results of clinical and radiologic examinations, determination of the stage of various folds pathologic process as well as elaboration of surgical tactics.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):27-33
pages 27-33 views

Chemical Composition of Solitary Bone Cysts Contents in the Process of Combined Treatment Using Transosseous Osteosynthesis

Luneva S.N., Stogov M.V., Mitrofanov A.I., Luneva S.N., Stogov M.V., Mitrofanov A.I.


Treatment results were analyzed for 22 patients, aged 5-27 years, with long bone cysts. Combined treatment (transosseous osteosynthesis and drug punctures) was used in all cases. Activity of alkaline and acid phosphatase total proteolytic activity, total protein content in blood serum and cyst contents was determined in dynamics. Biochemical examination of solitary bone cysts contents showed that their qualitative composition was identical to chemical contents of blood serum. During treatment osteolytic activity of cyst contents decreased considerably with reduction of low molecular and rise of high molecular components that evidenced of «structurization» cyst cavity.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):33-37
pages 33-37 views

Complications after Elastic Stable Intramedullar Osteosynthesis of Femur Diaphysis Fractures in Children

Yandiev S.I., Yandiev S.I.


Results of surgical treatment for femur diaphysis fractures were analyzed for 115 children (119 operations of osteosynthesis). In all cases technique of elastic stable intramedullar osteosynthesis (ESIO) was used. Analysis of complications after ESIO was performed in 13 (11.3%) patients according to their types and time of development. It was detected that in femur diaphysis fractures a great number of ESIO complications could be either avoided or minimized with strict determinations of indications to ESIO, correct preoperative planning, observance of osteosynthesis technique and rational postoperative rehabilitation program.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):38-43
pages 38-43 views

Prevention of Orthopaedic Consequences in Hip Joint Area in Children after Epimetaphyseal Osteomyelitis

Skvortsov A.P., Gil'mutdinov M.R., Akhtyamov I.F., Skvortsov A.P., Gil'mutdinov M.R., Akhtyamov I.F.


Comparative analysis of treatment results for 152 children who underwent acute hematogenic osteomyelitis at age under 3 years is presented. Introduction of individual preventive measures during the course of acute hematogenic osteomyelitis treatment and follow up period resulted in 1.32 time decrease of potential orthopaedic complications in the area of hip joint.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):44-47
pages 44-47 views

Patellar Articular Surface Replacement in Total Hip Arthroplasty

Sagradyan A.S., Gritsyuk A.A., Stoyko Y.M., Matushevskiy G.A., Kuz'min P.D., Sereda A.P., Sagradyan A.S., Gritsyuk A.A., Stoiko Y.M., Matushevskiy G.A., Kuz'min P.D., Sereda A.P.


Examination of 249 patients with unilateral coxarthrosis was performed after total knee arthroplasty with (group 1) and without (group 2) patellar resurfacing performed at orthopaedic department of National Medical Surgical Center named after N.I. Pirogov. Total arthroplasty outcomes were assessed using knee-specific Oxford Knee Score (OKS), general questionnaire Medical Outcome Study 36-item Short-Form Health Survey (MOS Sf-36) and patellofemoral-specific questionnaire (PFQ). The following indications to patellar resurfacing were determined: body weight over 95 kg, patellar lateral shift ratio over 9%, 3rd and 4th degree of patellar chondromalacia by Outerbridge. Outcomes of patellar resurfacing were independent of patellar tilt angle (б), Insall-Salvati index, patient's height, body mass index, 1st and 2nd degree of patellar chondromalacia by Outerbridge.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):47-53
pages 47-53 views

Experience in Use of Dabigatran at Knee Arthroplasty

Reyno E.V., Zhairova T.A., Kuznetsova N.L., Antropova I.P., Reino E.V., Zhirova T.A., Antropova I.P.


Primary knee arthroplasty under combined spinal epidural anesthesia (CSEA) was performed to 30 patients with III stage of gonarthrosis. Anticoagulant prophylaxis of venous thromboembolism was started 12 hours prior to surgery - subcutaneous injections of 40 mg enoxaparine sodium (Clexane®). Postoperatively all patients were taken direct inhibitor of thrombin - dabigatran etexilate (Pradaxa®) by standard scheme: 110 mg in 3 hours after operation and than 220 mg once a day for 14 days. Deep vein thrombosis (DVT) was diagnosed in 2 cases (6.7% of patients). This rate was not higher than in case of prophylaxis with low molecular weight heparins. No hemorrhagic complications were noted. Maximum growth of total coagulation index was observed on 3 - 7 days after surgery that was manifested by raise of fibrinogen concentration, soluble fibrin-monomer complexes (SFMC) and increased activity of coagulation enzymic link. Indices returned to norm by 14th postoperative day. Use of dabigatran etexilate in knee arthroplasty provides an adequate prophylaxis of venous thromboembolism and does not increase the risk of hemorrhagic complications.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):54-58
pages 54-58 views

Complications in Hip Arthroplasty

Slobodskoy A.B., Osintsev E.Y., Lezhnev A.G., Slobodskoi A.B., Osintsev E.Y., Lezhnev A.G.


Experience in follow up of 1399 patients after 1603 hip joint arthroplasties is presented. Bilateral operations were performed in 102 patients. In 111 patients revision total hip replacement was performed. Age of patients ranged from 18 to 94 years. Different complications were present in 4,3% of cases: pyo-inflammatory - in 1,37%, implant head dislocation - 1,93%, periprosthetic fractures - 0,19%, postoperative neuritis - 0,49% and pulmonary thrombosis - in 0,31% of cases. Elderly and senile patients, severe concomitant pathology (diabetes mellitus, rheumatoid arthritis and other systemic diseases), acute proximal femur injury, earlier operated dysplastic coxarthrosis, revision and complicated total hip replacement, history of pyo-inflammatory processes in the zone of hip joint are to be considered as risk factors to complication development. Scale for complications prognosis in hip joint arthroplasty is presented.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):59-63
pages 59-63 views

Deforming Arthrosis of First Metetarsophalangeal Joint (etiology, pathogenesis, peculiarities of surgical treatment)

Mazalov A.V., Zagorodniy N.V., Protsko V.G., Sultanov E.M., Khamokov Z.K., Mazalov A.V., Zagorodniy N.V., Protsenko V.G., Sultanov E.M., Khamokov Z.K.


Algorithm for the choice of surgical techniques for the treatment of first metetarsophalangeal joint arthrosis is presented. New aspects of etiopathogenesis are determined. It is shown that syndrome of progressing flat valgus foot causes overloading of dorsal articular surfaces of first metatarsophalangeal joint resulting in fast progression of arthrosis in this joint. Schemes of various types of operations, their correlation by frequency of use and efficacy depending on the degree of pathology severity are presented.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):63-69
pages 63-69 views

Regeneration of Knee Joint Cartilage under the Effect of Low-Molecular Fraction of Cord Blood (up to 5 kDa)

Gulevskiy A.K., Ivanov E.G., Gulevsky A.K., Ivanov Y.G.


The effect of the cattle cord blood low-molecular fraction (up to 5 kDa) (FCB) on regeneration of knee joint cartilage following mechanical injury was studied in rats using biochemical, histological and roentgenological methods. It was shown that intramuscular injection of FCB significantly stimulated the accumulation of the basic components of matrix, the most important structural proteins in cartilage regeneration as well as provided the positive effect on morphologic state of cartilage and surrounding tissues. That positive effect was noted during both stage of granulation and stage of chondrocyte development. It was shown that injection of FCB promoted normalization of motor activity in injured limb.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):69-74
pages 69-74 views

Morphometric Indices of Hepatocytes in Shin Bones Injury

Ocheretina R.Y., Stogov M.V., Ocheretina R.Y., Stogov M.V.


Morphometric indices of mononuclear hepatocytes (volumes of cells and nuclei, nucleo-cytoplasmic index, percentage of parenchymal cells of different classes) in peripheral and central zones of hepatic lobules were determined 3 days after experimental fracture of shin bones in CBA mice. Increase of hepatocyte nuclei size within the range of K3, K4 and K5 classes was revealed. This is indicative of the involvement of hepatic parenchymal cells into the process of adaptive reorganization of the organism in loco-motor system injury.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):76-78
pages 76-78 views

Treatment of Shoulder Deforming Arthrosis

Zorya V.I., Zarayskiy A.S., Zorya V.I., Zaraiyskiy A.S.


Analysis and systematization of data on various methods for conservative and surgical treatment of different forms of shoulder deforming arthrosis is presented. Detailed characteristics of various treatment techniques for the elements of shoulder joint in its different pathology is described. Complex approach to the treatment of such pathology will enable to achieve better clinical and functional results in this group of patients as well as to improve their life quality.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):79-87
pages 79-87 views

Modern Aspects of Spine Instability

Vissarionov S.V., Popov I.V., Vissarionov S.V., Popov I.V.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):88-92
pages 88-92 views

A.P. Barabach

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N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):94-94
pages 94-94 views

A.V. Scoroglyadov

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N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):95-95
pages 95-95 views

L.B. Puzhitskiy

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N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(3):53-53
pages 53-53 views

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