Vol 18, No 4 (2011)

Articles
Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine
Krut'ko A.V., Akhmet'yanov S.A., Kozlov D.M., Peleganchuk A.V., Bulatov A.V., Krut'ko A.V., Akhmet'yanov S.A., Kozlov D.M., Peleganchuk A.V., Bulatov A.V.
Abstract
Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):3-10
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Results of Extraosseous Osteosynthesis with Extra Stabilization of Plate by Tightening Clamps
Kopysova V.A., Kaplun V.A., Svetashov A.N., Kopysova V.A., Kaploon V.A., Svetashov A.N.
Abstract
Results of extraosseous osteosynthesis in 160 patients with fractures and pseudarthroses of lower extremities long bones were analyzed. In 80 patients from the main group the plate was additionally fixed to the bone with ring-shaped tightening clamp with shape memory to prevent screw migration.. In 65 (81.3%) patients from control group consolidation of bone fragments with excellent results was achieved in 66.3% of cases. In 15 (18.7%) patients with mainly peri- and intraarticular femoral fractures the migration of screws and plate destruction were noted. In main group the fractures consolidated in anatomically correct position in 76 (95.0%) and good functional results of treatment were achieved.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):11-14
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Treatment Results after ACL Plasty with M. Semitendenous and M. Gracilis Tendons, and Patellar Ligament
Orletskiy A.K., Butkova L.L., Timchenko D.O., Orletskiy A.K., Butkova L.L., Timchenko D.O.
Abstract
Treatment results for 60 patients with anterior cruciate ligament injuries (ACL) are presented. As a graft either tendons of m. semitendenous and m. gracilis (group 1, 30 patients) or patellar ligament (group 2, 30 patients) were used. Clinical instrumental and roentgenologic examination was performed at least 8 months after surgical intervention. Good and excellent results (85-100 by Lysholm scale) were achieved in 29 (96.7%) patients from the first group and in 27 (92.0%) patients from the second group. However examination on arthrometer KT-1000 showed that in 4 (13.3%) out of 30 patients from the second group anterior shift of the shin exceeded 5 mm. X-ray examination showed early signs of deforming arthrosis in 7 (27.7%) patients from the first and 15 (50%) patients from the second group.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):16-18
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Malleoli Fractures: Peculiarities and New Potentialities for Treatment
Solod E.I., Lazarev A.F., Gudushauri Y.G., Kakabadze M.G., Raskidaylo A.S., Solod E.I., Lazarev A.F., Gudushauri Y.G., Kakabadze M.G., Raskidailo A.S.
Abstract
Experience in treatment of 62 patients with fractures in the zone of ankle joint is presented. Two statistically similar groups of patients with malleolus fractures were studied. In one group (34 patients) low invasive techniques of osteosynthesis were applied. In the other group (28 patients) osteosynthesis was performed by conventional technique. Comparative analysis of early and long-term treatment results for two groups was performed. Advantage of closed osteosynthesis techniques was proved.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):19-22
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Surgical Correction of Congenital Planovalgus Foot Deformity in Children
Vlasov M.V., Bogos'yan A.B., Tenilin N.A., Vlasov M.V., Bogos'yan A.B., Tenin N.A.
Abstract
During the period from 2002 to 2008 seventeen children with III degree of congenital planovalgus foot deformity (29 feet) were operated on at orthopaedic department of Nizhniy Novgorod Scientific Research Institute of Traumatology and Orthopaedics using new technique of surgical correction. In all cases long term results were assessed within the period from 3 to 10 years after operation. Good and satisfactory results were achieved in 21 and 8 feet, respectively. Neither poor results nor recurrences were observed.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):23-26
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Peculiarities of Arterial Architectonics in the Posterior Foot Segment
Privalov A.M., Fomin N.F., Emel'yanov V.G., Koryshkov N.A., Zaytsev O.V., Privalov A.M., Fomin N.F., Emel'yanov V.G., Koryshkov N.A.
Abstract
Peculiarities of arterial blood supply in the posterior segment of the foot were studied on 20 lower extremities of 15 cadavers. Zones with feeble-marked blood supply were detected and rational surgical approaches to the posterior foot bones and joints within those zones were suggested. Fifty nine surgical interventions were performed via suggested approaches: subtalar joint arthrodesis - 47 (79.6%), metal osteosynthesis of the calcaneous - 7 (11.9%), operation for plantar fasciitis - 3 (5.1%), resection of calcaneous neoplasms - 2 (3.4%). Good clinical result was achieved in 86% of cases.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):27-31
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Endoprothesis of the Ankle Joint at Defeat by Tumours of Distal Part of Tibia
Sokolovskiy V.A., Aliev M.D., Sokolovskiy A.V., Sergeev P.S., Sokolovsky V.A., Aliev M.D., Sergeev P.S., Sokolovsky A.V.
Abstract
In a current of two years with 2008 for 2010, to six patients with primary malignant and aggressively benign bone tumors of the distal tibia executed six operations, in value of tumor resection with the subsequent reconstruction of defect by an ankle joint endoprosthesis. In group of patients there were five males and one female, with a mean age of 30 years. Among the treated patients 2 were with an osteosarcoma, 2 with Ewing's sarcoma and 2 with giant cell tumor. The mean duration of follow-up after the operation was 14,7 months (7 to 28). Reconstruction of the distal tibia defect was carried out using oncological modular endoprosthesis of the ankle joint. Common free of recurrence surviving during 2,4 years was 83%. Progressing of the primary disease is revealed in 50 % in the form of occurrence of the remote metastasis in lungs. A mean functional result assessed with the using of the MSTS system and consisted 75%. During the whole period of supervision no patient of six had complications such as periprosthesis infection, instability of a design of endoprosthesis or its fracture. At one patient with the diagnosis an osteosarcoma, through a floor of year after endoprosthesis, revealed a local recurrence during the spent of conservative treatment, in communication, with what amputation has been executed. For achievement of good clinical and functional result observance of indications to carrying out of reconstructive operations of area of an ankle joint, careful selection of patients taking into account effect on the spent conservative treatment is necessary.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):32-36
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Comparative Evaluation of Low-Molecular Weight Hyaluronic Acid and Autologous Conditioned Serum in Coxarthrosis
Noskov S.M., Shirokova L.Y., Bakhtiarova T.I., Shirokova K.Y., Parulya O.M., Noskov S.M., Shirokova L.Y., Bakhtiarova T.I., Shirokova K.Y., Parulya O.M.
Abstract
For the first time the results of a comparative evaluation of low-molecular weight hyaluronic acid (synocrom forte) and autologous conditioned serum (ACS) in coxarthrosis (CA) are presented. Throughout the 12-month monitoring we examined 54 patients with CA who were divided into 2 groups of comparable age and sex composition and the duration of the disease. Group №1 had a 3-week course of local therapy of synocrom forte and group №2 - of ACS. It is concluded that the use of ACS at CA to achieve favorable clinical effects is almost as good as hyaluronic acid, but it characterized by a greater duration of their conservation (from six to twelve months).
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):38-41
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Effect of Tourniquet upon Development of Intra- and Postoperative Complications in Total Knee Replacement in Patients Treated with Pradaxa
Girkalo M.V., Puchin'yan D.M., Voskresenskiy O.Y., Derevyanov A.V., Mandrov A.V., Girkalo M.V., Puchinyan D.M., Voskresenskyi O.Y., Derevyanov A.V., Mandrov A.V.
Abstract
Results of comparative study of intra- and postoperative blood loss, rate of thromboembolic complications at total knee replacement with and without tourniquet application on the background of anticoagulant therapy with Pradaxa. It was shown that application of pneumatic tourniquet considerably decreased blood loss during the most laborious steps of operation but did not decreased the total blood loss and simultaneously increased the risk of thromboembolic complications development in the early postoperative period. Anticoagulant therapy including oral Pradaxa 220mg/day provided the convenience for the patient to continue thromboprophylaxis after discharge that greatly increased its efficacy.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):42-44
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Relation of Efficacy of Combined Use of Ibandronic Acid and Alfacalcidol with Bone Tissue Remodeling in Women with Postmenopausal Form of Osteoporosis
Rodionova S.S., Elovoy-Vronskiy A.A., Rodionova S.S., Elovoy-Vronskiy A.A.
Abstract
Study of 51 female patients showed high efficacy of alfacalcidol (Alfa D3 - Teva) and ibandronic acid (Bonviva) combination for the treatment of postmenopausal form of systemic osteoporosis. Dependence of mineral bone density (MBD) on the primary intensity of bone tissue remodeling was observed. Assumption on the necessity of bone metabolism markers assessment at ibandronate use was confirmed. The fact that use of active form of vitamin D 3 eliminates such side effects of bisphosphonates as secondary hyperparathyroidism and hypocalcemia has been proved.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):45-49
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Comparison of Curative Effect of Cryosupernatant and Fresh Frozen Plasma at Complex Treatment of Disseminated Intravascular Coagulation Syndrome in Patients with Severe Concomitant Injury
Tseymakh E.A., Men'shikov A.A., Bondarenko A.V., Kuznetsov S.Y., Gontarev I.N., Komleva I.B., Smirnova O.I., Tseimakh E.A., Men'shikov A.A., Bondarenko A.V., Kuznetsov S.Y., Gontarev I.N., Komleva I.B., Smirnova O.I.
Abstract
Results of comparative study of cryoplasmic therapy applied at complex treatment of 168 patients with disseminated intravascular coagulation syndrome were presented. In 56 patients complex therapy included cryosupernatant plasma (CSNP) and 112 patients received fresh frozen plasma (FFP). Study of coagulation and fibrinolysis system showed that restoration of fibrinolysis activity, physiologic anticoagulants and normalization of plasma fibrinogen levels occurred sooner when CSNP was used. Application of CSNP promoted the relaxation of disease severity, prevention of thrombotic complications and decrease of lethality (by 14.2%) to a greater extent as compared to FFP use.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):49-53
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Principles for Surgical Treatment of Long Bones Fractures Complicated by Purulent Infection
Amiraslanov Y.A., Zhukov A.O., Borisov I.V., Ivanov A.P., Amiraslanov Y.A., Zhukov А.O., Borisov I.V., Ivanov A.P.
Abstract
Modern concept for the treatment of long bones fractures complicated by purulent infection is presented. The main principles of this concept are the determination of volume and pattern of bone and soft tissue injury, radical debridement, stable bone fragments' fixation, use of primary and early reconstructive-restorative operations for substitution of bone and soft tissue defects. Treatment results for 268 patients (289 extremity segments) have been analyzed. Applied method of grouping patients with complicated long bone fractures by the pattern and volume of injury enables to determine the volume of debridement, terms and steps of osteosynthesis and reconstructive-plastic operations. Good and satisfactory results have been achieved in 88% of cases.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):53-59
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Semiotics of Proliferative Changes in Femur in Chronic Osteomyelitis Developed after Acute Hematogenous Osteomyelitis
D'yachkova G.V., Mitina Y.L., Diachkova G.V., Mitina J.L.
Abstract
Semiotics of osteonecrosis and sequestration in femur has been studied on the basis of the data from roentgenography, linear tomography and computer tomography in 39 patients with transformation of acute hematogenous osteomyelitis into chronic one with the purpose of revealing the possible and most typical variants of proliferative changes in bone. It was established that during the process of assimilation the periosteal layers can convert into both compact bone and spongy bone. The average extent of periosteal layers in the shaft zone exceeded the size of destruction by 6.1±2.1 cm and the border of endosteal borders corresponded to that of periosteal layers. In metaphyseal zone the border of periosteal layers corresponded to the border of periosteal cambial layer and was not visualized by destruction spreading: the border of destruction could be located both proximally and distally to the periosteal layers' border.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):60-64
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Peculiarities of Superficial Peroneal Nerve Surgical Anatomy at Malleolus Fracture Treatment
Zolotov A.S., Dubovyy S.A., Kudran' S.P., Zolotov A.S., Dubovyi S.A., Kudran' S.P.
Abstract
Peculiarities of superficial peroneal nerve surgical anatomy are presented. Data on 100 patients operated on for malleolus fractures have been analyzed. In external approach to the fibula and lateral malleolus superficial peroneal nerve was detected in 20% of cases. It crossed the anterior margin of the fibula 55-150 mm (mean 79.2±24.4 mm) above the apex of the lateral malleolus. In 17 cases the nerve was located subcutaneously, in 3 cases - subfascially. Awareness of the detected peculiarities of the superficial peroneal nerve anatomy may increase the efficacy of its' iatrogenic injury prevention.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):64-67
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Ponseti method of treatment of severe and neurogenic clubfoot
Kenis V.M., Klychkova I.Y., Stepanova Y.A., Kenis V.M., Klychkova I.Y., Stepanova J.A.
Abstract
Primary results of treatment for neurogenic clubfoot of various genesis using Ponseti technique are presented. During the course of treatment and follow up period clinical and roentgenologic changes were assessed in 34 children. Mean age of patients at treatment initiation was from 4 months to 8 years. Treatment efficacy was in direct dependence upon the patient's age. The best results were achieved in children under 12 months. Use of Ponseti method in neurogenic forms of clubfoot is characterized by a number of technical features. In severe forms of disease it is reasonable to use this technique as a first step of correction which enables to reduce the volume of following surgical intervention.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):67-70
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Extracorporeal Reposition and Osteosynthesis of the Head of the Radius (two clinical cases)
Kalantyrskaya V.A., Golubev I.O., Kalantyrskaya V.A., Golubev I.O.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):72-73
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Road-Traffic Injuries
Sokolov V.A., Sokolov V.A.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):74-79
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Treatment of the Achilles Tendon Ruptures
Kesyan G.A., Berchenko G.N., Urazgil'deev R.Z., Nakhapetyan T.G., Kesyan G.A., Berchenko G.N., Urazgil'deev R.Z., Nakhapetyan T.G.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):80-86
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Eminent Russian Traumatologist (Commemorating the 130th Anniversary of Professor V.V. Gorinevskaya Birth)
Knopov M.S., Taranukha V.K., Knopov M.S., Taranukha V.K.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):87-90
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Aidyn Salarovich Imamaliev
Zorya V.I., Zorya V.I.
N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):90-91
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N.V. Zagorodniy
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N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):92-92
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Index of Articles Published in 1-4, 2010
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N.N. Priorov Journal of Traumatology and Orthopedics. 2011;18(4):94-95
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