Vol 17, No 4 (2010)

Articles
IX Russian Congress of Trauma-and Orthopaedic Surgeons
Ochkurenko A.A., Solov'eva K.S., Puchin'yan D.M., Bakhteeva N.K., Ochkurenko A.A., Solov'yova K.S., Puchin'yan D.M., Bakhteeva N.K.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):3-9
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Traumatism and Orthopaedic Morbidity in Children of Russian Federation. Organization of Specialized Care and Perspectives for Its Perfection
Baindurashvili A.G., Norkin I.A., Solov'eva K.S., Baindurashvili A.G., Norkin I.A., Solov'yova K.S.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):13-17
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Innovation in Treatment Theory and Practice for Wounded in Extremities
Shapovalov V.M., Shapovalov V.M.
Abstract
Actual problems and modern approaches to the treatment of wounded with injuries of loco-motor system were reflected. Principal data obtained during long-term investigation of terminal ballistics and pathologic anatomy of gunshot fractures, pathologic physiology of wound process as well as peculiarities of reparative osseous regeneration were presented. Attitude to the treatment of wounded using modern medical technologies was stated; efficacy of practical use of modern technologies was analyzed.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):18-22
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Efficacy of Robotic Assistance Method for Stabilization of Lumbar-Sacral Spine
Konovalov N.A., Shevelev I.N., Kornienko V.N., Nazarenko A.G., Isaev K.A., Asyutin D.S., Konovalov N.A., Shevelev I.N., Kornienko V.N., Nazarenko A.G., Isaev K.A., Asyutin D.S.
Abstract
First experience in performance of spinal segments' stabilization using robotic assistance (SpineAssist, MAZOR Surgical Technologies, Caesarea, Israel) in Russia is presented. Between August 2009 and August 2010 twenty six surgical interventions using that technique were performed at Spinal Department of RAMS Institute of Neurosurgery named after N.N. Burdenko. Preoperative neuro-visualization included spondylography, MRI, CT with sections <1 mm that was essential for preoperative planning using computed work station SpineAssist. The robot was used for automated navigation of instruments in operative wound according to preoperatively planned path. New system of transcorporal stabilization of spinal segments Go-Lif required only two screws for fixation was compatible with fusion technique and was of special interest. Robotic assistance enabled to obtain optimum location of implants in all cases even in presence of anatomical peculiarities of the operated segments (thin vertebral arch roots, rotative deformity of vertebrae. Basing on the results of control CT examination and comparison of obtained CT data with preoperative planning data it was shown that with robotic assistance clinical accuracy of implant location was within 1 mm). No complications related to implant insertion were observed.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):23-29
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Determination of Indications to Surgical Treatment and Choice of Surgical Approaches in Complicated Complex Acetabular Fractures
Beletskiy A.V., Voronovich A.I., Murzich A.E., Beletskiy A.V., Voronovich A.I., Murzich A.E.
Abstract
Experience in surgical treatment of 65 patients with complex fractures of the acetabulum is presented. All patients underwent open reposition with internal fixation of fragments by reconstructive plates. Basic moments of the performance of portals to acetabulum, steps of reposition and fixation in multi-segment comminuted fractures are described. Algorithm for determination of indications to surgical treatment of complex acetabular fractures was determined. Clinical and roentgenologic results were studied at terms from 1 to 9 years. Excellent results were established in 39.5%, good and satisfactory in 34.9%, poor in 25.6% of patients. It was shown that in complex bi-columned fractures the technique of open osteosynthesis was the most effective when used within the first 3 weeks after injury. Simultaneous use of anterior and posterior accesses considerably facilitated the performance of reposition and stabilization of multi-segment comminuted fractures and enabled to achieve favorable treatment results.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):30-37
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Experimental Evaluation of Osteoinduction of Recombinant Bone Morphogenic Protein (rhBMP-2) of Native Production Fixative on Biocomposite or Bone Matrix
Mironov S.P., Gintsburg A.L., Es'kin N.A., Lunin V.G., Gavryushenko N.S., Karyagina A.S., Zaytsev V.V., Mironov S.P., Gintsburg A.L., Es'kin N.A., Lunin V.G., Gavryushenko N.S., Karyagina A.S., Zaytsev V.V.
Abstract
Data on experimental evaluation of osteoinduction of recombinant bone morphogenic protein of native production fixative on xenogenic demineralizated bone matrix or collagen-calcium-phosphate biocomposite material. Evaluation was performed using experimental model of end-to-end osteosynthesis of diaphyseal femur fragments by external fixative device in Wistar rats. Roentgenologic examination, study of autopsy material and evaluation of bone consolidation strength using biomechanical twisting test showed high osteoinduction of rhBMP-2 containing biocomposites.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):38-44
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Role of High-Field Magnetic Resonance Imaging and Ultrasound Examination in Diagnosis of Knee Joint Injuries
Es'kin N.A., Banakov V.V., Tissen B.T., Matveeva N.Y., Es'kin N.A., Banakov V.V., Tissen B.T., Matveeva N.Y.
Abstract
Lecture is devoted to the issues of acute knee joint injury diagnosis. Potentialities of ultrasound method and magnetic resonance imaging in such of injuries are demonstrated. Accuracy and informativeness of each method is evaluated.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):44-48
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Diagnostic Value of Contrast Radiologic Examination for Rational Planning of Surgical Treatment of High Congenital Hip Dislocation in Children
Kozhevnikov O.V., Morozov A.K., Kralina S.E., Ogarev E.V., Negmatov Z.M., Kozhevnikov O.V., Morozov A.K., Kralina S.E., Ogaryov E.V., Negmatov Z.M.
Abstract
Diagnostic value of contrast radiologic examination of hip joint was analyzed in 49 children aged from 1 to 12 years with high congenital hip dislocation. Informativeness of 38 standard hip joint arthrograms was studied for the choice of treatment technique and preoperative planning. It was stated that arthrography did not provide sufficient information on the changes in soft tissue and cartilaginous structures of the joint. Experience in joint pathologic changes diagnosis using contrast computed tomography (11 patients) was presented. Potentialities of that examination technique were determined. It was shown that in high dislocation of femoral head it provided real picture of interrelation of all articular structures. That enabled to take objectively substantiated decision on open or closed correction of dislocation and perform an adequate preoperative planning.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):49-58
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Role of Biomechanical Conception at Treatment of Consequences of Gunshot Fractures of Extremity Bones
Pichkhadze I.M., Daneliya L.M., Kuz'menkov K.A., Pichkhadze I.M., Daneliya L.M., Kuz'menkov K.A.
Abstract
Treatment outcome for 60 patients (1992-2007) with consequences of gunshot fractures of extremity bones (74 segments) have been analyzed. Expediency of use of biomechanical classification and biomechanical conception of fragments fixation for creation of stable osteosynthesis in gunshot fractures has been substantiated. Dynamics of microflora changes in stable osteosynthesis has been presented. An advantage of application of Pichkhadze apparatuses of 1st and 3rd models in gunshot fractures has been noted. Treatment of gunshot fractures with regard for biomechanical conception of fragments fixation enabled to achieve excellent and good results in 93.3% of cases.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):59-64
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Methods of Reconstructive Surgical Treatment for Patients with Defects and Pseudarthroses of Femur
Kopysova V.A., Kaplun V.A., Svetashov A.N., Shashkov V.V., Kopysova V.A., Kaplun V.A., Svetashov A.N., Shashkov V.V.
Abstract
Treatment results of 59 patients with femoral bone defects and diaphyseal pseudarthroses were analyzed. To substitute bone defects of more than 6 cm permeable porous endoprostheses were used. In patients with normotrophic and hypertrophic pseudarthrosis stable osteosynthesis with interfragmental compression of bone fragments by shape-memory-effect tightening bows was performed. In patients with atrophic pseudarthrosis bone plasty with autograft was applied. In all patients the weight-bearing ability of the affected limb was restored. Total restoration of function was achieved in 75.6% of patients.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):65-70
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Surgical Reconstruction of Forefoot with Fallen Arches in Combination with Hallux Valgus
Minasov B.S., Gutov S.P., Bilyalov A.R., Minasov B.S., Gutov S.P., Bilyalov A.R.
Abstract
Tactics of surgical reconstruction of the forefoot with fallen arches in combination with hallux valgus has been described depending on the deformity severity. Original techniques for myotenoplastic reconstruction of the forefoot that enable to restore muscular balance as well as to eliminate forefoot deformity and hallux valgus are proposed. In 235 patients (329 feet) ana-lysis of long term results of surgical correction using radiologic examination and AOFAS criteria showed high efficacy of the proposed technique. Durable preservation of the achieved correction was noted.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):71-74
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Surgical Treatment of Hallux Valgus with Application of External Fixation Device
Bagirov A.B., Alinagiev B.D., Teymurkhanly F.o., Baev V.P., Bagirov A.B., Alinagiev B.D., Teimurkhanly F.A., Baev V.P.
Abstract
The experience in treatment of hallux valgus is presented. There were 90 patients, aged 19-77, 199 feet. Seven patients had first degree of deformity, 24 patients - second degree and 59 patients - third degree. Surgical treatment was performed in the period from 2004 to 2009. Depending on the deformity degree various types of osteotomy were applied followed by biomechanically stipulated fixation of bone fragments with small-sized rod and pin-rod external fixation devices. In all patients stable elimination of valgus deformity was achieved. Excellent long-term results were obtained in 67,5% of cases (112 feet), good results in 29,5% (45 feet) and satisfactory results in 3% (5 feet). Neither long-term failed results nor complications were observed. Advantages of surgical treatment of forefoot deformity with external fixation device are the restoration of foot anatomical shape and function in stable fixation of osteotomic fragments without limitations of active functional load on the operated foot.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):75-79
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Use of Vicrуl Rapide in Hand and Upper Extremity Surgery
Zolotov A.S., Zolotova Y.A., Zolotov A.S., Zolotova Y.A.
Abstract
Quick-Absorbable Suture Vicryl Rapide was used at surgical treatment of 112 patients with various injuries and diseases of the hand and upper extremity for wounds closure. Wounds were closed by intradermal (34 patients) and external (78) sutures. Time of ligatures resorption and loss of strength as well as local response of tissues to suture material were analyzed in post-operative period. Complications that developed in 2 (1.8%) cases were not specific to Vicryl Rapide. External knots of intradermal suture were easily removed in all patients on day 14 after surgery. In 72 patients with external sutures complete loss of ligatures strength was noted during the period from 13th to 21st postoperative day (mean in 15.8±2.3 days). No local tissue reaction was observed. In external sutures the time of ligatures resorption and loss of strength was slightly higher than indicated in instruction. Use of Vicrуl Rapide in hand and upper extremity surgery is effective and safe.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):80-83
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Surgical Treatment of Patients with Radial Distal Metaepiphysis Fractures
Semenkin O.M., Semyonkin O.M.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):84-89
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Nikolay I. Pirogov - Outstanding Representative of Home Surgery (in Commemoration of 200th Аnniversary of Birth)
Knopov M.S., Taranukha V.K., Knopov M.S., Taranukha V.K.
N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):90-92
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A.A. Korzh
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N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):93-93
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Index of Articles Published in 1-4, 2010
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N.N. Priorov Journal of Traumatology and Orthopedics. 2010;17(4):94-95
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