Vol 17, No 3 (2010)

Articles
Low Back Pains in Athletes and Ballet Dancers: Apophysitis of Vertebral Bodies
Mironov S.P., Burmakova G.M., Mironov S.P., Burmakova G.M.
Abstract
Experience in diagnosis and treatment of lumbar vertebrae apophysitis in 29 athletes and ballet dancers aged from 13 to 29 years is presented. In 25 patients pathology of thoracolumbar and upper lumbar spine was diagnosed. In 4 patients S1 apophysitis was detected including 3 patients with combination of S1 apophysitis and L4-L5 spondylolysis. Diagnosis consisted of clinical-neurologic, roentgenologic (standard including functional tests) and ultrasonographic examinations. In combination of apophysitis and spondylolysis radionuclide examination was performed. All patients were under conservative treatment which included individual complex of exercise therapy, massage, intramuscular, sympathetic trunk, ilipsoas muscle blockades, ozone-oxygen mixture injections into paravertebral muscles, use of vascular drugs, chondroprotectors and stimulating therapy. Analysis of the results confirmed high efficacy of the proposed methods for diagnosis and treatment of lumbar apophysitis in athletes and ballet dancers.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):3-11
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Total Hip Arthroplasty with Some Home-Produced Implants
Nazarov E.A., Ryabova M.N., Seleznev A.V., Nazarov E.A., Ryabova M.A., Seleznyov A.V.
Abstract
Outcomes of total hip arthroplasty performed using home-produced «Sfen-C», «Isko-Rudn» implants for cemented fixation and «Fenix», «Compomed» for non-cemented fixation were studied in 156 patients with degenerative-dystrophic joint lesions (174 operations). Dynamics of peri-implant bone mineral density (comparative standard computed roentgenodensitometry), roentgenologic parameters of the operated joint (computed roentgenometry), weight bearing function of the lower extremities after arthroplasty (stabilometric analysis) were evaluated. Reasonability of application of home-produced implants «Sfen-C», «Isko-Rudn» and «Compomed» was substantiated. Recommendations on implant Fenix use limitations were given.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):12-18
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Total Hip Arthroplasty with Bicon-Plus Cup in Patients with Dysplastic Coxarthrosis
Zagorodniy N.V., Nuzhdin V.I., Kagramanov S.V., Chragyan G.A., Zagorodniy N.V., Nuzhdin V.I., Kagramanov S.V., Chragyan G.A.
Abstract
Results of 633 total hip arthroplasties using Zweymuller endoprosthesis with Bicon-Plus cup were studied in 532 patients with dysplastic coxarthrosis. The follow-up was up to 12 years. The peculiarities of that implant application were shown. Complications occurred were discussed. Excellent and good results by Harris score were achieved in 84.7% of cases, satisfactory in 15% and poor in 0.3% of cases.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):18-24
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Risk Factors for Venous Thromboses Development in Knee Joint Arthroplasty
Agadzhanyan V.V., Vlasov S.V., Safronov N.F., Vlasova I.V., Agadzhanyan V.V., Vlasov S.V., Safronov N.F., Vlasova I.V.
Abstract
Retrospective analysis of case histories of 125 patients (36-77 years) after total knee arthroplasty for III-IV stage of gonarthrosis was performed. On 4-5 day after operation deep vein thrombosis was diagnosed in 30 (23.6%) patients. It was stated that additional factors which trustworthily influenced the risk factors of thromboembolic complications development were the following: application of tourniquet to the femur for more than 1 hour; application of tourniquet to the patients with initial venous pathology (varicosis of vena saphena magna and vena saphena parva, consequences of thrombophlebitis); obesity of II-III degree in women. No reliable influence of various methods of anesthesia and infusion therapy upon the risk of thrombosis development was detected. Obtained data confirm the necessity to perform compulsory examination of lower extremities veins in patients prior to knee joint arthroplasty and take additional measures on thrombosis prevention in high risk groups. Observance of the proposed antithrombotic protocol in the postoperative period prevents vein thrombosis progression, thrombus fragmentation and floating as well as promotes accelerated recanalization of thrombotic veins.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):25-29
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Tribochemical Component of Oxidative Stress Development when Implantating of Artificial Joints. Part 2. Oxidative and Antiproliferative Effect of Wear Debris of Orthopedic Materials
Bulgakov V.G., Il'ina V.K., Gavryushenko N.S., Shal'nev A.N., Omel'yanenko N.P., Bulgakov V.G., Il'ina V.K., Gavryushenko N.S., Shal'nev A.N., Omel'yanenko N.P.
Abstract
Using modeling reaction with constant production of metal radical-generated wear debris it was determined increasing intensification of oxidative processes. Generated free radicals enabled to oxidize polymeric component of endoprostheses. Radical-generated wear debris significantly decreased the proliferative ability of human osteogenic cells. Inert ceramics particles showed antiprolifirative effect only in their high concentration. Those particles prevented growth of osteogenic cells. Worsening in mechanical properties of polymeric implant components and disturbance of bone remodeling under radical-generated wear debris may be one of the causes of further development of implant loosening and its instability.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):29-33
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Refractive Introscopy and Dual Energetic X-Ray Absorptiometry in Bone Formation Evaluation
Rodionova S.S., Torgashin A.N., Podurets K.M., Pogorelyy D.K., Semenova L.A., Rodionov S.V., Rodionova S.S., Torgashin A.N., Podurets K.M., Pogorelyi D.K., Semenova L.A., Rodionov S.V.
Abstract
The possibility of refractive introscopy use on synchronic radiation source (multitarget complex Mediana) and dual energetic X-ray absorptiometry for the prognosis of bone formation in bone implant remodelling was studied in experiment. Experimental study was performed on 93 samples of rats' tibia. It was shown that refractive introscopy on synchronic source enabled to detect correctly the margins of allograft and native rat's bone tissue. Using this technique and dual X-ray absortiometry it was possible with high probability to prognosticate both the presence and absence of bone formation in the zone of bone-plastic material implantation.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):34-42
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Complex Treatment of Patients with Osteoporosis Complicated by Vertebral Bodies Fractures
Astapenkov D.S., Astapenkov D.S.
Abstract
Assessment of the efficacy of complex approach to the treatment of patients with osteoporosis complicated by pathologic vertebral body fractures was performed. Eighty seven patients were randomized into 2 groups. Main group (62 women) obtained complex treatment. In control group (25 female patients) the treatment measures were of fragmental pattern.Prior to and after treatment all patients were clinically examined including evaluation of pain intensity by visual analog scale and life quality by Karnovski scale, assessment of fractures by Riggs, Kleekoper and Genant, frontal lumbar spine densitometry (Lunar Prodigy 3, General Electric), study of resorption marker β-Cross-Laps ELISA. It was shown that complex treatment of that group of patients was more effective as compared with fragmental treatment. Algorithm for choice of techniques to influence the structure and mineralization of bone tissue was suggested
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):43-47
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Parmacologic Correction in Experimental Osteoporosis and Osteoporotic Fractures
Faytel'son A.V., Dubrovin G.M., Gudyrev O.S., Pokrovskiy M.V., Ivanov A.V., Faitel'son A.V., Dubrovin G.M., Gudyrev O.S., Pokrovskiy M.V., Ivanov A.V.
Abstract
Osteoprotective effect of enalapril and losartan was studied using experimental model of osteoporosis and osteoporotic fractures (222 female Wistar rats). It was detected that in rats after ovariectomy endothelial vascular dysfunction of microcirculation in bone tissue bed developed. Those changes caused osteoporosis and delayed experimental fracture healing. Enalapril and losartan prevented the decrease of microcirculation level in bone tissue that promoted slowing-down of osseous trabecula thinning, prevented microfractures and increased the healing rate of experimental fractures.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):47-51
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Some Aspects of Reparative Osteogenesis Optimization in Long Bone Fractures
Maslennikov E.Y., Taranov I.I., Al'-Naddzhar T.M., Vovchenko I.B., Maclennikov E.Y., Taranov I.I., Al-Naddzhar T.M., Vovchenko I.B.
Abstract
The aim of the examination was to study the influence of some proteolytic enzymes (cathepcin-D, neutral proteinaze of serine group) upon formation of bone regenerate in fractures. There were 138 patients with bone fractures: 80 fractures were fresh, 38 - nonunited, 20 - nonconsolidated. Periosteal and transfragmental tissues were studied. Those materials were obtained during osteosynthesis that was performed at different terms after trauma. Results obtained allowed to make a suggestion that acid and neutral peptide-hydrolases influence the osteosynthesis and degradation of macromolecular components of bone organic matrix during reparative osteogenesis. That allowed detecting the new ways for optimization of reparative processes in fractures.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):51-54
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Treatment Tactics for Sequelae of Lower Extremity Bones Fractures
Eldzarov P.E., Zelyanin A.S., Nikitin S.E., Eldzarov P.E., Zelyanin A.S., Nikitin S.E.
Abstract
Experience in treatment of 104 patients aged from 18 to 74 years with sequelae of femur and shin fractures (47 patients with ununited and improperly united fractures and 57 patients with noninfected pseudarthroses and bone defects) was presented. Analysis of the results showed that the main reasons for unfavorable consequences of fracture were osteosynthesis failure, inadequate appraisal of fracture pattern and localization, inadequate treatment-tactic measures (inobservance of optimum treatment terms, early abolition of external immobilization or groundless refusal of its application, discrepancy between osteosynthesis stability and early functional loads). Treatment outcome (assessment by N.A. Lyuboshits - E.R. Mattis and I.L. Shvarzberg systems) was recognized as good in 49%, satisfactory - in 42.3% and poor - in 8.7% of cases.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):55-59
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Influence of Intravenous Photohemotherapy on Tissue Microcirculation in Patients with Chronic Posttraumatic Osteomyelitis
Izumrudov M.R., Krupatkin A.I., Levin G.Y., Mitrofanov V.N., Sidorov V.V., Izumrudov M.R., Krupatkin A.I., Levin G.Y., Mitropfanov V.N., Sidorov V.V.
Abstract
In patients with chronic posttraumatic octeomyelitis of crus bones the influence of intravenous quantum photohemotherapy of ultraviolet diapason on microcirculation was studied. Efficacy of ultraviolet blood irradiation was assessed by laser Doppler flowmetry with optic tissue oxymetry canal. It was shown that treatment had positive effect on the main indices of microcirculftory bed, promoted activation of blood regulation in microvessels and certain increase of oxygen consumption by tissues. Increase of inflammatory activity was noted in no one out of 19 treated patients.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):60-63
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First Experience in Application of Intraoperative Epidural Morphine Analgesia with Postoperative Ropivacaine Anesthesia in Children with III-IV Degree Scoliotic Deformity
Ukolov K.Y., Ayzenberg V.L., Arzhakova N.I., Ukolov K.Y., Aizenberg V.L., Arzhakova N.I.
Abstract
First experience in aplication of intraoperative epidural morphine analgesia with postoperative ropivacaine anesthesia at correction of III-IV degree scoliotic deformity in children (25 patients) is presented. It is shown that epidural morphine analgesia on lumbar level as a component of combined anesthesia provides an adequate analgesia in during operation and creates an analgesic background for postoperative anesthesia with local anesthetics. Intraoperative high catheterization of epidural space by the proposed technique enables to avoid neurologic complications and provides the possibility of effective postoperative anesthesia with ropivacaine infusion within 3 days on the background of prolonged action of epidurally injected morphine. First xperience in application of the suggested technique shows that it is effective enough and helps this group of patients to endure an invasive operation with greater comfort.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):63-67
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Diagnosis of Mobility Disorders in Fingers Joints of Hand
Tsarev V.N., Zubikov V.S., Voloshin V.P., Dorozhko I.G., Martynenko D.V., Tsaryov V.N., Zubikov V.S., Voloshin V.P., Dorozhko I.G., Martynenko D.V.
Abstract
Algorithm to assess the limitation of functional mobility of hand fingers' joints using elaborated symbols is presented. That algorithm was applied to analyze the possibility of pinches and different types of power grips including ball, cylinder. A description of functional zero position is given. This position is used as starting point for the evaluation of motion restriction in joints and as a reference point for arthrodesis performance. Concept of remoteness of mobility sector in joint from functional zero position is introduced. Clinical cases demonstrate the possibility to apply algorithm for the evaluation of motion restriction and detection of indications for both conservative and surgical treatment.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):68-73
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Radiologic Diagnosis of Shoulder Joint Deforming Arthrosis
Zorya V.I., Zarayskiy A.S., Zorya V.I., Zaraiskiy A.S.
Abstract
The basis of the lecture is complex analysis and systematization of various forms of degenerative-dystrophic lesions of shoulder joint. With regard for the principles of modern clinical and roentgenologic diagnosis six etiologic and morphofunctional groups of shoulder deforming arthrosis are distinguished and characterized. Accurate diagnosis of clinical-roentgenologic type of the pathology will enable a physician to choose a maximum effective treatment technique.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):74-81
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Aseptic Loosening of Total Hip Implant: Mechanisms of Osteolysis and Potential Therapy
Berglezov M.A., Andreeva T.M., Berglezov M.A., Andreeva T.M.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):82-88
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Report on the Work of IV All-Russian Symposium with International Participation «Actual Questions of Tissue and Cell Transplantology»
Lekishvili M.V., Ochkurenko A.A., Lekishvili M.V., Ochkurenko A.A.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):89-90
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Commemorating the 110th Anniversary of Fyodor R. Bogdanov
Knopov M.S., Taranukha V.K., Knopov M.S., Taranukha V.K.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):91-92
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O.V. Oganesyan
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N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):93-93
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M.Zh. Azizov
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N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(3):94-94
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