Vol 10, No 2 (2003)

Original study articles

Features of hip arthroplasty for fractures of the femoral neck

Lazarev A.F., Ragozin A.O., Solod E.I., Kakabadze M.G.


Biomechanic conception of implant choice for primary total hip replacement in osteoporotic femur neck fractures is presented. Criterion for the choice is a localization of load-bearing surface of dense structure in acetabulum roof zone, i.e. sursile. Absolute indications to total hip replacement, use of bipolar and unipolar hemiprostheses are determined depending on the direction and deviation degree of sursile from horizontal axis of pelvis. Based on suggested conception the retrospective analysis of joint replacement results in 58 patients has been performed. The causes of protrusion and loosing of implants were studied.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):3-8
pages 3-8 views

Clinical and morphological features of coxarthrosis with cystic rearrangement and the quality of secondary fixation of cementless total endoprostheses

Nuzhdin V.I., Berchenko G.N., Kudinov O.A.


Clinical and roentgenologic as well as pathomorphologic peculiarities of III—IV stage of coxarthrosis were studied in 254 patients who underwent surgery at the CITO department of joint replacement. Coxarthrosis with cystic alteration of the articular bone structure has been diagnosed in 56% of patients. Cystic alteration was more often detected in middle (II), the most common degree of articular dysplasia. In the absence of dysplasia or in its marginal degrees the noncystic type of coxarthrosis prevailed. It was shown that in patients with cystic coxarthrosis the progress of pathologic process was faster and such patients more often had concomitant diseases characterized by microcirculatory disturbance. Pathomorphologic examination also showed more marked changes of microcirculatory channel in cystic coxarthrosis bone structure. In 47 patients the comparison of roentgenologic indices of the quality of secondary implant fixation and peculiarities of coxarthrosis ( either with or without cystic alteration) performed 3 to 4 years after uncemented total hip replacement by ESI implant demonstrated reliably better quality and longer fixation of bone tissue to the structured surface of the implant in noncystic type of coxarthrosis.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):9-14
pages 9-14 views

Arthroscopic diagnosis and treatment of cartilage injuries of the knee joint in children

Merkulov V.N., Karam E.A., Sokolov O.G., Yeltsin A.G.


Experience in knee arthroscopy in children with acute knee trauma and sequelae of knee injuries is presented. There were 417 patients, aged 4—18, who were under treatment at the clinic in the period from 1994 to 2002. One hundred forty four patients (34.5%) had injury of articular cartilage. In 12 cases diagnostic and in 132 cases diagnostic and curative arthroscopy was performed. Evident advantages of arthroscopy in diagnosis of intraarticular knee structures injuries, especially cartilagenous tissue were emphasized. Protocol of diagnostic examination including clinical, roentgenologic, ultrasonographic methods as well as CT and MRT (as indicated) is suggested. Indications to knee arthroscopy in children and adolescents are determined. Clinical-arthroscopic classification of knee articular cartilage injuries is given. Due to exact diagnosis and adequate curative tactics total restoration of knee function was achieved in 75% of patients with articular cartilage injuries.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):74-78
pages 74-78 views

Organization of medical and psychological care for patients with traumatic disease

Kotelnikov G.P., Sukhobrus E.L.


Results of psychological examination of 117 patients with traumatic disease are presented. Psychological examination was performed using 16-points questionnaire by Cattel, personal questionnaire «Type of relation to disease», scale of alarm by Spielberger, techniques «Type of psychological protection» by Plutchek and «Copping-questionnaire» as well as drawing test by Rosenzweig by 1—7, 14, 30, 90 and 180 day after trauma. Three periods of psychological reactions were determined: 1st period — acute (shock) reactions (1—14 day); 2nd period — interpersonal reactions (14—90 day); 3rd period — social disadaptation (90—180 day). The program of psychological correction was composed and tested on the base of the revealed peculiarities. When program was completed all patients had control testing. Results showed a high efficacy of psychological correction. The problems of the organization of the psychological care for patients with traumatic disease are considered.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):56-61
pages 56-61 views

The frequency of fractures of the proximal femur in urban residents of the Middle Volga region

Tseytlin O.Y.


The aim of the study was to assess the rate of proximal femur fractures in citizens, aged 50 years and over, from two towns of Samara region (Zhigulevsk and Novokujbyshevsk). In Novokujbyshevsk mean rate of proximal femur fractures for males and females was equal to 67.9 and for 72.7 per 100 000, respectively. In Zhigulevsk the same index for males and females was 93.4 and 104.5 per 100 000, respectively. The difference between rate of proximal femur fractures in female relative to male was insignificant. Increase of incidence of proximal femur fractures was detected in women over 65 years and in men over 70 years.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):62-63
pages 62-63 views

The first experience of reconstructive microsurgical operations in patients with traumatic spinal cord disease

Mironov S.P., Stepanov G.A., Grishin I.G., Golubev V.G., Natsvlishvili Z.G., Russkikh S.V., Karpov I.N., Khokhrikov G.I., Kapyrina M.V., Eskin N.A.


The results of microsurgical operation on revascularization and reinnervation of spinal cord performed in 17 patients with traumatic spinal cord disease are presented. Surgical technique was elaborated at CITO. Examination methods are described. Complex program of preoperative management, intraoperative anesthesiologic provision, infusion-transfusion support and postoperative management of patients has been elaborated. This program promotes the homeostasis and optimum functioning of microanastomoses.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):15-19
pages 15-19 views

Evaluation of the results of treatment of injuries of the flexor tendons of the fingers

Fedoseev A.V., Lapin V.V., Lobanov D.S.


The system of evaluation of treatment outcomes of finger flexor tendons are presented. The system is based on the restoration of total range of active movement only in intrafalangeous joints taking into account the contractures in functionally disadvantageous position. Using this system it is possible to evaluate the treatment outcomes in case of simultaneous injury of superficial and deep flexor tendons, isolated injury of deep flexor tendons of II— V fingers as well as long flexor tendon of the thumb.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):64-66
pages 64-66 views

A method for documenting the results of a tendon suture and the problem of assessing treatment outcomes

Zolotov A.S.


Absence of single generally accepted method for the assessment of the results of tendon suture of fingers flexors considerably hampers and even occasionally makes impossible the comparison of data presented by several authors. Under such conditions the registration of tendon suturing results is of great importance. For this purpose a simple and reliable procedure is suggested, i.e. configuration of fingers, that allows to assess the results by different techniques as well as to analyze and compare the assessment techniques.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):67-70
pages 67-70 views

Radionuclide scintigraphy in monitoring reparative processes in irradiated bone replants

Kurilchik A.A., Bizer V.A., Perekhrest M.A., Kudryavtseva G.T.


The remodeling of irradiated bone re-implant placed into simultaneously irradiated bed was studied by scintigraphy method using 99Tc-labeled drug (TcLD) (perfoteh). The data obtained were compared with data of radiologic control. The study included 11 patients with osteogenic sarcoma who were operated on after chemo-radiotherapy course. The peculiarities of operation were as follows. Resected bone with tumor was irradiated by single 60 G dose, after that the bone was re-implanted. It was revealed that 1 month postoperatively TcLD retention in contact zone of bone fragments was 2—2.5 times higher as compared with the symmetric zone of healthy bone. Remodeling peak was observed 1.5—2 months after operation. Over that interval TcLD retention decreased gradually and by 18 months the contact zone was not detected on scintigrams. According to the data of radiologic control the peak of remodeling took place at 6—8 months after operation. The study showed that irradiated re-implant preserved mechanical stiffness and worked as a biologic prosthesis while substituting the newly formed bone. Scintigraphy is an additional method the earlier assessment of reparative processes in extracorporal irradiated reimplant as compared to the assessment of radiologic control.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):71-73
pages 71-73 views

Clinic, diagnosis and treatment of congenital arthrogryposis in children

Malakhov O.L., Kosov I.S., But-Gusaim I.A., Mikhaylova S.A.


Experience in treatment of limb contractures and deformities in children with congenital arthrogryposis is presented. The main principles of treatment were detected. Complex of diagnostic and curative measures including conservative treatment of patients stating from birth is described in details. Conservative treatment consists of therapeutic exercises, massage, physiotherapy, special braces and plaster bandages. Surgical treatment method using external fixation devices is presented. The method of biocontrol disturbance detection is given and the use of functional biocontrol (FBC) method for the treatment of this pathology is well grounded. Early results of FBC use are evaluated as positive ones that confirms the expedience of further use of FBC for the treatment of patients with congenital arthrogryposis.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):79-85
pages 79-85 views

Conceptual model of the pathogenesis of osteochondropathy of the spine

Korzh N.A., Prodan A.M., Kolesnichenko V.A.


The new direction in study of spine osteochondropathy pathogenesis was worked out from the point of systemic approach. The disease is considered as continuous dysplastic-dystrophic process. The base of this process is a structural anomaly of the end-plates of vertebral body that changes morphogenesis of the vertebral segment. Subsequent clinical course is determined by anatomic-biomechanic characteristics of the affected zone, peculiarities of spine configuration in the saggital plane as well as by the variants of disorders in vertebral body shape formation.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):20-28
pages 20-28 views

Lumbar pain in athletes and ballet dancers: pathology of the intervertebral joints (facet syndrome)

Mironov S.P., Vurmakova G.M., Krupatkin A.I.


The experience in examination and treatment of 92 patients (athletes and ballet dancers) with lumbar pain syndrome caused by pathology of intravertebral joints, so-called «faset syndrome» is presented. Curative diagnostic blockade of a joint has an important significance for exact diagnosis side by side with clinical and roentgenologic examination. Treatment included analgetic blockade and transcutaneous radiofrequency destruction of facet nerves. Comparative analysis of conservative and operative methods of treatment of athletes and ballet dancers with facet syndrome was carried out.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):29-36
pages 29-36 views

Maximum moments of lower limb muscle strength in patients with lumbar intervertebral disc herniation

Shchurova E.N.


In 52 patients with lumbar intravertebral disk hernia the examination of muscle lower extremity force was performed. Maximum force moment of crus flexor and extensor as well as plantar and dorsal foot flexors was registered using dynamometry. It was shown that patients with lumbar intravertebral disk hernia had a decrease of maximum force moment not only in the indicator group but other muscles on both affected and contralateral extremity as well. It was detected that maximum level of contractive ability of indicator muscles was expressively influenced by the severity of pain syndrome and microcirculation of compressed spinal radices.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):37-40
pages 37-40 views

The use of artificial correction of movements and orthotics in the complex conservative treatment of patients with osteochondrosis of the lumbosacral spine

Skoblin A.A.


Examination and treatment results of 925 patients with lumbar-sacral ostechondrosis are analyzed. Two groups of patients were defined: patients with mainly chronic recurrent radiculitis and patients with radiculoneuritis. Complex approach to the treatment included pain relief, orthotics and artificial movement correction using muscular electrostimulation at walking. Studies using biomechanic and electrophysiologic methods showed high efficacy of that medical rehabilitation complex. Orthotics provided fixation and unloading of the spine, promoted elimination of pain syndrome. Use of corset and artificial movement correction resulted in pain relief, normalization of biomechanic and innervative gait structure, achievement of firm long remission.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):41-47
pages 41-47 views

Supporting neoarthrosis as an alternative to re-endoprosthetics and arthrodesis in case of purulent processes in the hip joint area

Malovichko V.V., Urazgildeev Z.I., Tsykunov M.B.


The experience in treatment and rehabilitation of 100 patients with suppuration following total hip replacement and 60 patients with chronic osteomyelitis of proximal femur and acetabulum is presented. Patients’ age ranged from 10 to 84 years. Removal of unstable metallic constructions (implant or fixator) and radical resection fistulosequestrnecrectomia by Girdlestone were performed in all patients. In postoperative period the complex program for the elimination of purulent process and rehabilitation measures were carried out. That program foresaw active and expedient control for compensation of the affected joint function. In all patients purulent inflammatory process was eliminated, weight-bearing hip joint neoarthosis with satisfactory function was formed. According to authors’ opinion the formation of weight-bearing neoarthrosis is an adequate alternative to both revision joint replacement and arthrodesis in purulent process in proximal femur and acetabulum.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):48-55
pages 48-55 views

Short communications

Features of the course of an active aneurysmal bone cyst in childhood (case report)

Snetkov A.I., Natsvlishvili Z.G., Morozov A.K., Berchenko T.N., Frantov A.R., Khokhrikov G.I.


Aneurysmal bone cyst refers to tumor-like lesions with an etiology not fully elucidated [10, 13, 14]. Until recently, bone cysts in children were classified as tumor processes [4]. A.P. Berezhny [1], based on a clinical and radiological study and analysis of a large number of observations, came to the conclusion that primary cysts in children, including aneurysmal ones, are a dystrophic process, usually affecting one bone without damaging the growth zone and adjacent bones. The same opinion is shared by some foreign authors [6]. However, at present, the point of view is more widespread, according to which an aneurysmal bone cyst is a reactive process that develops in response to bone damage [3, 5, 9, 10, 14].

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):86-89
pages 86-89 views


I am 90 years old. Zoya Sergeevna Mironova


Among the readers of the magazine, there is hardly anyone who would not be familiar with the name of Zoya Sergeevna Mironova - the most famous specialist in the field of sports traumatology, a person who enjoys unquestioned authority both among colleagues and patients - athletes, ballet dancers and circus. She, like no one else, understands, "feels" her patients, knows how to find a common language with each of them. Probably, Zoya Sergeevna's sports past is of no small importance here - she is an honored master of sports, a two-time champion of the USSR in speed skating. But the main thing is her highest professionalism. Zoya Sergeevna has a great merit in the formation and development of domestic sports traumatology, in the creation of her favorite brainchild - the unique department of sports and ballet trauma CITO. Honored Worker of Science of Russia, Professor Z.S. Mironova was awarded the Order of Lenin, two Orders of the Badge of Honor, the medal "For Valiant Labor", and two Olympic Orders. In the days of the anniversary, the list of her awards was replenished with the Order of Merit for the Fatherland, IV degree, and the Church Order of St. Sergius of Radonezh. The editors turned to Zoya Sergeevna with a request to tell readers about her life. She got a story not so much about herself, but about those who worked next to her. As for the title of the article (you must agree, not every woman, and not every man would dare to put such a “round” date in the title of the publication), here one can only quote A.S. Griboyedova: "... everyone lies calendars!" - Zoya Sergeevna's energy, optimism, efficiency would be envied by many young people.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):90-92
pages 90-92 views

Congratulations to the hero of the day! Hovhannes Vardanovich Hovhannisyan


June 3, 2003 marked the 70th anniversary of O.V. Oganesyan - laureate of the State Prizes of the USSR, the Russian Federation, the Government of the Russian Federation, Corresponding Member of the Russian Academy of Medical Sciences, Honored Scientist of the RSFSR, Honored Inventor of the RSFSR, Head of the Clinic for Orthopedic Surgery for Adults, CITO named after I. N.N. Priorov, professor of the Moscow Medical Academy. THEM. Sechenov.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):93-93
pages 93-93 views

Reviews, literature review

A.I. Krupatkin. Clinical neuroangiophysiology of the extremities (perivascular innervation and nervous trophism). Nauchny Mir Publishing House, Moscow, 2003. 328 p.

Aleksandrov N.P.


In recent years, the activity of conducting clinical and fundamental research has noticeably decreased, including in the field of autonomic regulation and microcirculation disorders of the tissues of the musculoskeletal system. Therefore, the publication of a monograph, which for the first time summarizes modern aspects of the clinical physiology of perivascular innervation and neurovascular interconnections of the extremities, should be welcomed in every possible way.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):94-94
pages 94-94 views


Israel Isakovich Cohn


On November 20, 2002 Professor I.I. Con. He died in Italy, in the city of his youth, Bologna. But his homeland was and always has been Russia. Here he spent his entire working life. Here remains the work of his life.

N.N. Priorov Journal of Traumatology and Orthopedics. 2003;10(2):95-95
pages 95-95 views

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