Vol 11, No 3 (2004)


Ultrasound Diagnosis of Tendon and Nerve Pathology

Mironov S.P., Es'kin N.A., Golubev V.G., Nasnikova I.Y., Bogdashevskiy D.R., Pripisnova S.G., Fineshin A.I.


Ultrasoumd image of tendons and peripheral nerves was described. Sonographic criteria of tendon injury and pathology: dislocation, degenerative changes, ruptures including intratendinous, i.e. longitudinal, partial, total as well as inflammation, tumors and postoperative complications was given. Sonographic peculiarities of diagnosis on injury, compression and constriction of nerve in tunnel osteofibrosis of extremity was presented. Presence of that pathology was confirmed by clinical and electophysiological examination and verified intraoperatively. Ultrasonography may be used for diagnosis of congenital abnormalies, nerve injury and neurogenic tumors. Authors emphasize the importance of participation of experi­enced examiner in interpretation of ultrasonograms.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):3
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Dys-plastic Deformities of Intervertebral Joints in Mechanogenesis of Lumbar Intervertebral Disk Ex­trusion

Prodan A.I., Radchenko V.A., Kolesnochenko V.A.


Dysplastic deformities of intervertebral joints (change of size of articular processes and dimen­sional configuration of articular facets, discrepancy of shape and size of the articular facets) alter the geometry of vertebral segment and this process is accompanied by redistribution of loads between joints and intervertebral disk. The elements of a disk are under the influence of additional torsion and shift forces that inevitably result in the development of dystrophic changes in the disk tissues.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):12
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Osteoscintigraphic the Evaluation of Bone Tissue Metabolic Processes in Scoliotic Deformity Formation

Bergaliev A.N., Pozdnikin Y.L., Filippov I.K.


Scintigraphic examination results of 45 patients with I, II, III degree scoliosis (67 curvature arches) were analyzed. In most observations the reduction of bone tissue metabolism in the injured vertebrae was detected. A variant of asymmetric accumulation of radiopharmaceutical in the injured vertebrae, which reflected redistribution of osteogenesis processes, was defined. On those grounds the prognostic sign of dysplastic scoliosis progression was suggested.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):18
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Stability of Injured Spine in Relation to Bending Loads under Conditions of Transpedicular Osteosynthesis (Experimental Study)

Afaunov A.A., Usikov V.D., Afaunov A.I., Dunaev I.M.


Study of T9—L3 spinal segment blocks using anatomic preparations has showed that in instable injury of T12 the rigidity of T11—L1 segments under conditions of transpedicular osteosynthesis with four screws spinal system is on average 25% and 14.7% lower than the normal rigidity of the intact T11—L1 segments in relation to bending kyphotic loads and lateral bending loads, respectively. The rigidity of synthesized spinal segments to lateral bending loads is 1.9 times lower than the rigidity to sagittal bending loads. With use of metalwork the rigidity indices of the synthesized spinal segments are on average 1.2 times higher as compared with the rigidity of the intact spine.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):23
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Mechanism of Craniovertebral Ligamentous System Injuries and Their Effect on Spinal Arteries Blood Flow (Experimental Study)

Kolesov S.V.


In 22 anatomic preparations of the cervical spine block various injuries of the ligamentous system were simulated and the evaluation of their effect upon the spinal arteries blood flow was per­formed. It has been shown that within craniovertebral segment the alar and transverse ligaments play the basic stabilizing role. Bending rotative, straightening rotative and bending mechanisms of injury may cause different volume of ligamentous system injuries. Three types of injuries have been detected: unilateral injury of the alar ligament, unilateral injury of the alar injury in combination with the transverse ligament injury and bilateral injury of the alar ligaments in combination with the transverse ligament injury. Injury of the upper cervical spine ligamentous structures results in the development of spine instability; especially in instability of atlantoaxial junction that causes dynamic compression of spinal arteries at atlantoaxial segment rotation.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):30
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Restoration of Active Extension of Fore­arm in Patients with Cervical Spinal Cord Injury at C5-C6 Level

Golubev V.G., Baskov A.V., Lisitskiy I.Y., Boev M.V., Mershed K.I.


Surgical reconstruction of upper extremity function in patients with high tetraplegia is presented. Five patients with sequelae of cervical spinal cord injury at C5-C6 level were operated on. Seven reconstructive operations were performed. Surgery consists of m. biceps brachii transposition to m. triceps brachii through the medial end of the humerus. First clinical experience is discussed.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):35
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Arterial Embolization in Patients with Tumors and Tumor-Like Diseases of Loco-Motor System

Mironov S.P., Balberkin A.V., Morozov A.K., Natsvlishvili Z.G., Kolondaev A.F., Khokhrikov G.I., Baranetskiy A.L., Buklemishev Y.V.


Reendovascular occlusion of pathologic vessels responsible for the blood supply of highly vascu­larized tumors of the femur, large pelvic bones, spine and tumor-like foci was used in 20 patients. High efficacy of the method was demonstrated. Marked reduction of the pathologic blood flow resulted in the decreased blood loss during organ saving operations for malignant tumors. Improvement of bone tissue structure in aneurismal cyst and pelvic bones hemangioma was accompanied by manifest positive clinical dynamics. At palliative treatment of patients with inoperable and metastatic tumors rapid and significant reduction of pain syndrome was noted.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):40
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Middle Term Results of Native Implant «ESI» Use in Primary Total Hip Ar­throplasty

Kagramanov S.V., Nuzhdin V.I.


Middle term results of 886 primary total hip replacements using «ESI» implants (cementless fixation of components) have been analyzed. In 22 cases (2.48%) revision was required. When implants with «Chyrulen»-like high molecular polyethylene leaner and cobalt-chromium alloy head were used (718 operations) early aseptic loosening (excluding early dislocation, trauma­tic instability, etc.) developed in 1.11% of cases. Total number of unsatisfactory results did not exceed 5%. The causes for revision interventions have been considered in details.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):44
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Hospital Lethality in Concomitant Injury and Possi­bility of Its Reduction

Bondarenko A.B., Peleganchuk V.A., Gerasimova O.A.


Hospital lethality in victims with polytrauma who had been treated at specialized Polytrauma Center (Barnaul City Hospital # 1) during 1997-2002 was analyzed. Total number of patients made up 3878 including 617 (15,9%) lethal cases. It was shown that the level of hospital lethality was dependent upon such factors as age, inner organs and cranio-cerebral injuries, severity of both traumatic shock and cranio-cerebral injury. Authors believe that after emergency specialized care all patients with concomitant injury independently of a dominant injury should be hospitalized to special department of multiple and concomitant injury. In 2000 such de­partment was organized within the structure of Center and that enabled to reduce hospital lethality from 18,2% to 13,4%.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):49
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Treatment for Gunshot Fractures of Upper Extremity Long Bones with Nerve Injuries

Evloev R.Y., Reshetin В.N., Urazgildeev Z.I.


The treatment results of gunshot fractures with nerve trunk injuries of upper extremity bones were summarized for the period from 1995 to 2000. Thirty patients had the injury at the level of humeral segment, 15 patients — at the level of forearm and 4 patients were with injuries of the elbow joint. The debridement and extrafocal osteosynthesis with early, i.e. 4 weeks after trauma, surgical interventions on bone fragments and nerve trunks were performed. In anatomically safe nerve trunk, neurolysis and bone fragment compression using special device were carried out. In nerve injury, resection of bone fragment ends with following stable osteosynthesis and perineural suturing of nerve was performed. In fractures of forearm bones with large defect of nerve trunk the autografting of nerve was done. In early postoperative period complex drug therapy was prescribed. After fracture healing physiotherapy, massage and exercise therapy was started. Long-term results showed that 82% of patients had positive outcomes. Duration of treatment using suggested tactics was shorter in comparison with traditional multy-step method.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):52
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Surgical Treatment of Intraarticular Tibial Condyle Fractures

Pankov I.O.


Fifty patients with intraarticular fractures of tibial condyle were treated by transosseous osteo­synthesis with application of external fixation devices. Peculiarities of transosseous osteosynthe­sis in various types of intraarticular condyle fractures have been described. In 44 patients the follow up period made up 1—12 years. Favorable results have been noted in 43 (97.7%) patients including excellent and good results in 35 (79.5%) patients.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):57
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Adhesive Disease of the Knee Joint

Kozhevnikov E.V.


The study of anatomic specimens showed that in the knee joint synovial fluid moves along morphologically conditioned canals in both horizontal and vertical direction. Injuries and degenerative-dystrophic diseases cause the formation of adhesions in the canals («adhesive disease» of the knee joint). Arthroscopic examination of the knee joint revealed «adhesive disease» in 64 (17.3%) out of 370 examined patients. Arthroscopic resection or dissection of the adhesions resulted in the elimination of blockades, contractures and pain syndrome.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):62
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Anatomic and Functional Characteristics of Muscles at Transosseous Distraction Osteosynthesis (clinics, experiment - facts, hypothesis)

Popkov A.V., Grebenyuk L.A., Filimonova G.N., Popkov D.A.


Analysis of clinical and experimental data related to biomechanical, functional and morpholo­gical changes of skeletal muscles in surgical crus lengthening by transosseous distraction osteo­synthesis was presented. It was electrophysiological proved that muscle activity decreased starting from the first days of lengthening while muscle tonus significantly increased. Sonography showed that muscle bands reoriented parallel to distraction forces. In fixation period local thickening of muscle bands was detected. After device removal muscle structure and muscle conractivity of the lengthened segment restored. Morphological studies showed that during dis­traction the volumetrical density of connective tissue in muscles increased and simultaneously destruction and reparative regeneration of muscle fibers were noticed. It was shown that after single-step compression of bone regenerate, stroma-parenchyma relationship was shifted to parenchyma. Active training of muscles was stipulated because inner tension of the muscles prevented the development of destructive processes, stimulated regeneration of muscles fibers. All those processes made up the base for functional rehabilitation of loco-motor system both in patients with orthopaedic pathology and in healthy subjects at surgical increasing of height with cosmetic purpose.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):67
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Rheovasographic Evaluation of Peripheral Blood Circulation at Lengthe­ning of Lower Extremities in Children

Vinokurova T.S., Garkavenko Y.E.


Rheovasography was applied for the evaluation of blood circulation in the femur and crus before and after restoration of lower extremity length. There were 51 children, aged 5—18, with acquired pathology of proximal (39 patients) and distal (12 patients) metaepiphysis of femur. Positive dynamics in regional blood circulation was noted both in proximal and distal extremity segments at 1—5 years follow up after lengthening
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):73
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Changes of Serum Bioche­mical Indices Under HBO-Therapy Effect in Treat­ment of Closed Diaphysial Crus Fractures Using Tran­sosseous Osteosynthesis

Stogov M.V., Luneva S.N., Erofeeva T.N., Nikolaichuk E.V., Novichkov S.I.


Sixty five patients with closed diaphysial tibia fractures were examined during transosseous osteosynthesis. Postoperatively 52 patients underwent HBO-therapy. Blood serum activity of alkaline and acid phosphatase, lactate dehydrogenase, content of total calcium, inorganic phosphorus, lactic and pyruvic acids were evaluated. HBO-therapy was shown to effect the metabolism of skeletal muscles and reparative process.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):78
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Brown Splint Application for the Treatment of Closed Injuries of the Central Fascicle of Dorsal Aponeurosis of Fingers

Zolotov A.S., Zolotova Y.A.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):82
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Sur­gical Treatment of Clinically Complicated Disse­minated Skeletal Hyperostosis

Meskhi K.T., Blinov V.V., Kheilo A.L., Aganesov A.G.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):85
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Fascial Flaps in Surgery of Extremities

Fedotov E.Y.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):86
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Modern Conceptions About Expediency of Use of Correcting Osteotomy in Knee Joint Deforming Arthrosis

Kornilov N.N., Novosyelov K.A., Kulyaba T.A.
N.N. Priorov Journal of Traumatology and Orthopedics. 2004;11(3):91
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