Vol 1, No 1 (1994)

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 "

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)

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

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

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

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

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

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

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

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

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

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"

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

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