Vol 1, No 1 (1994)

Editorial articles

Message from the editor-in-chief

Shaposhnikov Y.G.


On behalf of the editorial board and editorial board, I would like to congratulate my colleagues on the publication of the new journal “Bulletin of Traumatology and Orthopedics named after V.I. N. N. Priorov "

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):3-3
pages 3-3 views

Original study articles

Surgical tactics for multiple and concomitant shock-related injuries of the musculoskeletal system

Grinev M.V., Frolov G.M.


Based on the analysis of the treatment results of 2269 patients with multiple shock and concomitant injuries of the musculoskeletal system, it was shown that a significant increase in surgical activity (from 12 to 38%) did not lead to an increase in mortality and significantly (3.5 times) reduced the rate of disability. The developed objectified treatment tactics allows, based on the prognosis data, to perform the required volume of surgical trauma care in the first 2 days after injury in more than half (61%) of patients with polytrauma and shock. The study of mortality in a group of 1324 victims, depending on the method of treatment, revealed that when using the surgical method in patients with a favorable prognosis, mortality is almost 2 times lower than with conservative treatment (7.7 and 13.3%, respectively)

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):4-9
pages 4-9 views

Principles for evaluating the effectiveness of treatment of patients with polytrauma

Nazarenko G.I.


Approaches to assessing the effectiveness of medical care for victims with polytrauma are considered. Attention is focused on the methods based on the comparison of real and proper treatment results. Specific algorithms used for this purpose are presented. It has been shown that an approach based on the use of data on specific victims is adequate. It allows the system to obtain reliable estimates / avoid the influence on the calculation results of the heterogeneity (ps / severity of the condition) of the contingents of victims treated in various medical institutions. The discussed methods can be used to assess the quality of the work of medical institutions and specific specialists, the effectiveness of treatment methods, to study the epidemiology of injuries, licensing of hospitals, in insurance medicine, etc.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):9-12
pages 9-12 views

Traumatic disease - general pathological concept or nosological category?

Eryukhin I.A.


The concept of "traumatic illness" is related by the author only to severe shockogenic, mainly concomitant trauma. Based on the analysis of 2650 cases of concomitant injury and 978 cases of combat concomitant injuries, it was found that during a severe injury after removing the victim from shock, there are general patterns that are revealed, in particular, when comparing the causes of deaths at different times after injury. The author defines “traumatic illness” as a scientific problem and as a clinical concept that establishes the main patterns of cause-and-effect relationships between the nature of the injury and the features of traumatic shock, on the one hand, and the features of the clinical course after the victim is removed from shock, on the other. Taking into account the revealed patterns, practical recommendations are given for the treatment of the considered contingent of patients

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):12-16
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Treatment of open extensive injuries and destruction of the hand

Korshunov V.F., Germanov V.B., Skopinov V.P., Karazhaev K.S.


Department of Traumatology, Orthopedics and Surgery of Extreme Conditions, Russian State Medical University, Moscow
The work is based on the experience of treating 382 patients with extensive open injuries and 95 patients with destruction of the hand. The main importance is attached to the timely and high-quality primary surgical treatment of the wound and the correct choice of surgical treatment tactics (primary or delayed performance of restorative operations). The use of low-traumatic methods of osteosynthesis during the primary surgical treatment of the wound in case of hand injuries accompanied by impaired blood flow in the main type helps to reduce the frequency of necrotic complications. Long-term results of treatment are known in 357 patients. 40% of them are disabled of the III group, which is due to the severity of the injuries. Of 357 patients, 318 (89%) returned to work

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):22-24
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Treatment of gunshot wounds to the hand

Nikolenko V.K.


Main Military Clinical Hospital named after N. N. Burdenko, Moscow
A working classification of gunshot wounds to the hand is proposed, based on the features of damage caused by different types of ammunition, as well as the direction and localization of the impact of shells and their destructive forces. A comparative analysis of the treatment of gunshot wounds to the hand in two statistically equal groups (676 victims) was carried out. In the 1st group, general surgical methods of treatment were used, in the 2nd group, primary reconstructive-restorative treatment was carried out. The favorable functional results obtained in the 2nd group, a significant decrease in the frequency of purulent complications, and a reduction in the duration of treatment confirmed the possibility and high efficiency of primary restorative and reconstructive interventions on the hand. The features of the treatment of wounds of the hand with combined and multiple injuries (284 wounded), as well as against the background of infectious diseases are shown

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):18-22
pages 18-22 views

New aspects of the pathogenesis of gunshot wounds

Shaposhnikov Y.G., Kesyan G.A., Kondratieva I.E., Zasukhina G.D., Alekhina N.I.


Central Institute of Traumatology and Orthopedics. N.N. Priorova, Institute of General Genetics, Moscow
As a result of studies using the cytogenetic method, it was shown that gunshot injuries can cause violations of the integrity of the chromosomal apparatus, which persist for a long time and aggravate the severity of the wound process

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):17-18
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Syndrome of the sacroiliac joint in fractures of the anterior semi-ring of the pelvis

Yumashev G.S., Chensky A.D., Relin V.E.


The aim of the work is to improve the diagnosis of injuries in the area of ​​the sacroiliac joint against the background of fractures of the anterior pelvic semicircle and to improve the methods of their treatment. A group of 137 patients with fractures of the anterior semi-ring of the pelvis without signs of gross pathology in the region of the sacroiliac joint on radiographs was studied. Clarification of the diagnosis was carried out on the basis of an assessment of radiographs based on bone landmarks, analysis of clinical manifestations, and scintigraphy data. Revealed changes in the sacroiliac joint in the form of a functional block or damage to the ligamentous apparatus. The functional block was removed by manual release. Fractures were treated according to the usual method, taking into account changes in the sacroiliac joint. Good results were obtained in 83.2%, satisfactory - in 16.8% of cases

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):33-36
pages 33-36 views

Patella resection and patellectomy for comminuted fractures

Kuzmenko V.V., Girshin S.G., Litvina E.A.


The work is based on the analysis of the results of surgical treatment of 106 patients with multiple fractures of the patella, of which 92 underwent patella resection and 14 - patelllectomy. The indications for these operations are substantiated, the details of the surgical technique are described. To eliminate tension on the tendon-bone contact line (for resection) and tendon-tendon (for patelllectomy), a locking wire loop was used. Original methods have been developed for replacing extensor defects after resection of the lower third of the patella with autografts from the rectus muscle tendon and from the patellar ligament. Long-term results studied in 76 patients confirm the advantages of the proposed patellar resection and patelllectomy techniques

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):24-28
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Indications for transosseous osteosynthesis and the limits of its use for fractures of long bones in children

Merkulov V.H., Dorokhin A.I., Stuzhina V.T., Sokolov O.G., Arkhipova I.M.


The results of treatment of 3067 children with long bone fractures were analyzed. The method of transosseous osteosynthesis was used in 114 children (116 fractures). The frequency of its use was, depending on the type and location of the fracture, from 0.9 to 21%. On the basis of a comprehensive study involving radiography, scintigraphy, polarography, echoosteometry, thermography, indications for the use of compression-distraction osteosynthesis in children have been developed and substantiated: the method is indicated for fractures of long bones with a complicated course - improperly fused fractures with unacceptable displacements, fractures with circulatory disorders and bone formation in the damaged area, multiple and difficult to reposition fractures. The choice of the type of apparatus was carried out individually

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):36-37
pages 36-37 views

Evaluation of the elemental composition of bone tissue in children with genetically determined forms of rickets during treatment

Berezhny A.P., Snetkov A.I., Zaichik V.E.


Using neutron activation analysis, we determined the absolute values ​​and ratios of the concentrations of calcium, phosphorus, magnesium, sodium, potassium and chlorine in biopsies of the iliac wing in 20 children with genetically determined forms of rickets (GOFR) before and after drug treatment, as well as in 13 conditionally healthy children (control group). It has been shown that in children with GOFR, the content of calcium, phosphorus, sodium and more than 45% content of magnesium is statistically significantly reduced in comparison with the age norm by an average of 25-30%. Also revealed shifts in the ratio of the concentrations of Ca: Mg, Ca: Na and P: Na. Drug treatment in most children with GOFR leads to the normalization of all studied characteristics, with the exception of magnesium, the deficiency of which is manifested both in the absolute value of its content and in the ratio of Ca: Mg concentrations, which may indicate the need to include medicinal preparations containing magnesium

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):38-41
pages 38-41 views

Preoperative examination and surgical treatment using a distraction apparatus for congenital malformations of the hand in children

Malakhov O.A., Belyaeva A.A., Blinov A.V.


Surgical treatment of 66 children with various malformations of the hand was carried out. The importance of serial angiography of the hand and forearm in the preoperative examination of patients is shown. The use of the distraction method using the apparatus developed in the department made it possible to increase the volume of local plastic resources in syndactyly and cicatricial deformities of the hand, and also made it possible to lengthen the underdeveloped bone segments in severe malformations of the hand. The majority of patients received good and satisfactory results

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):41-43
pages 41-43 views

On the classification of spondylometaphyseal dysplasias: spondylophysial-metaphyseal dysplasia

Nechvolodova O.L., Mikhailova L.K.


A clinical and radiological analysis of 107 cases of hereditary systemic diseases of the skeleton with a predominant lesion of the germ (fizar) and metaphyseal zones, which are combined into the group "spondylophysial-metaphyseal dysplasia", was carried out. Changes in the skeleton were traced in dynamics, the age of the observed patients was from 1 to 16 years. Three types of spondylophysial-metaphyseal dysplasia have been identified, depending on the degree of damage to the fizar and metaphyseal zones and its predominant localization: A (with a predominant lesion of the hip joints), B (with a predominant lesion of the spine) and C (with a uniform lesion of the spine and long bones)

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):43-47
pages 43-47 views

Surgical Aspects of Total Vascular Stem Knee Transplant in Dogs

Markov Y.A., Kaveshnikov A.I., Evgrafov A.E., Slesarenko N.A., Kosov I.S.


An experimental model of total knee joint transplantation on a vascular pedicle has been developed, which ensures the restoration of joint function in the postoperative period. It was found that by anastomosing the vessels with the restoration of through blood flow through the popliteal artery, the most adequate blood supply to the graft and all segments of the recipient's limb is achieved. Data on the process of rejection have been obtained, which can be used in studies on joint allotransplantation under the cover of new generation immunosuppressants

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):54-56
pages 54-56 views

Compensated and decompensated vertical posture of a patient with scoliosis

Belenkiy V.E., Popova M.Y.


In 40 patients with thoracic and combined scoliosis of III and IV degrees, the loading of both legs during standing and walking was determined using Kistler dynamometric platforms. The results of the studies and analysis of posture characteristics allowed the authors to distinguish two options for compensating for the imbalance in the body that occurs during the formation of the primary curvature of the spine. A number of provisions are made regarding the pathogenesis of scoliosis, predicting the course of the disease, as well as treatment

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):47-51
pages 47-51 views

Quantitative Analysis of the Interstructural Space of the Compact Substance of Human Bone

Omelyanenko N.P., Butyrin G.M.


Central Institute of Traumatology and Orthopedics. N.N. Priorova, NIIGrafit, Moscow With the help of a methodological complex - electron microscopy, mercury porosimetry, gas adsorption - and subsequent analytical data processing, new quantitative parameters of the interstructural space of the compact substance of human bone were obtained

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):51-54
pages 51-54 views

On the classification of post-traumatic knee instability

Mironov S.P., Orletskiy A.K., Tsykunov M.B.


The classification of post-traumatic instability of the knee joint is proposed. The types of instability are distinguished - simple, complex and combined. For complex instability, types are distinguished (anteromedial, anterolateral, posteromedial and posterolateral), which in turn are divided into degrees (according to the severity of displacement of the articular surfaces). Possible variants of displacements of articular surfaces are given. Clinical criteria for determining the form of instability (decompensated, subcompensated and compensated) are given

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):28-33
pages 28-33 views

From Practical Experience

Operation for harm to well - ikonomov as one of the methods of organ-preserving surgery for bone tumors

Makhson A.N., Burdygin V.N.


Among the various methods of treating patients with tumors of the skin, a special place is occupied by the Vreden-Ikonomov method. It consists in resection of the affected part of the bone, its digestion (boiling) and replantation

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):57-59
pages 57-59 views

Fractures of the posterior condyles of the femur

Mikhailenko V.V., Lirtsman V.M.


Fractures of the posterior femoral condyles are relatively rare. Over the past 20 years, we have observed 15 patients with such injuries - 9 men and 6 women aged 18 to 92 years (average age 54 years). In 7 people, the injury was associated with a collision with a car, 2 fell from a small height on straightened legs, 1 patient fell on the stairs, the remaining 5 patients were injured when falling on a slippery road or at home on a wet floor

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):59-60
pages 59-60 views

Functional method in the treatment of elderly and senile patients with fractures of the proximal femur

L. S. Rabinovich L.S., Zhitenko S.P., Shchukin V.M.


The share of elderly and old people in the age structure of the population is large and constantly growing. At the same time, in industrialized countries, the frequency of fractures characteristic of this age group is increasing

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):60-61
pages 60-61 views


Traumatic shock

Nazarenko G.I.


Traumatic shock is a typical evolutionarily formed, phase-developing pathological process of the acute period of a traumatic illness. It is only one of the pathological processes of the acute period of traumatic illness. There are currently over 100 definitions of shock. This is primarily due to the continuous evolution of ideas about the pathogenesis of shock and its intimate mechanisms. Various definitions of shock also reflect the positions from which they were given (general biological, general pathological, pathophysiological, particular pathological, clinical). According to the just conclusion of VB Lemus (1983), "shock is a multifaceted phenomenon, and it is simply impossible to give it an exhaustive definition"

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):61-66
pages 61-66 views

Reviews, literature review

Non-invasive monitoring of the state of free vascularized graft in microsurgery of the musculoskeletal system

Grishin I.G., Gorbatenko S.A., Krupatkin A.I.


Control of blood circulation of a free vascularized graft is the most important problem in microsurgery of the musculoskeletal system in adults and children. In such transplants, ischemic and reperfusion changes in the microvasculature and cellular elements of tissues occur. The progression of these disorders, for example, due to insufficient anastomoses, can lead to partial necrosis, and in some cases to complete death of the graft, negating the results of a complex, many-hour operation. The failure rate after microvascular autotransplantation is 5–10%, more than half of which are pedicle thrombosis [32]. The development of optimal methods of postoperative monitoring can provide timely correction and prevention of irreversible tissue ischemia, and improve treatment results

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):67-70
pages 67-70 views



Board E.


SI KOT (SICOT - Societe Internationale de Chirurgie Orthopedique et de Traumatologic) The largest international society of orthopedics and traumatology, founded in October 1929 in Paris, currently unites more than 2500 specialists from 81 countries. As stated in the Charter of the society, SICOT sees its goal in its work in orthopedics and traumatology, in support of young orthopedists and traumatologists, in favor of the exchange of experience and establishment of relationships between orthopedists and traumatologists from different countries

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(1):70-71
pages 70-71 views

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