Vol 1, No 2 (1994)

Original study articles

Treatment of children with polyfractures of the pelvis

Keshishyan R.A., Rozanov V.M., Malakhov O.A., Kuznetsov L.E., Strunin E.G., Chogovadze G.L., Tsukanov V.E.

Abstract

Moscow Institute of Pediatrics and Pediatric Surgery, Central Institute of Traumatology and Orthopedics named after V.I. II.II. Priorova, Russian State Medical University, Children's City Clinical Hospital No. 9, Moscow
An analysis of the results of clinical and radiological examination and treatment of 43 children with pelvic polyfracures in the acute and long-term periods of trauma, as well as sectional and experimental studies is presented. Established a high incidence of diagnostic errors and unsatisfactory outcomes in the treatment of children with pelvic polyfractures. The main reasons for the development of complications, depending on the localization and nature of pelvic injuries, were revealed, and the ways of their prevention were substantiated. A technique has been developed for the use of external fixation rod devices in the treatment of children with pelvic polyfractures. The effectiveness of the proposed therapeutic tactics is confirmed by the results of treatment of 12 children.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):3-6
pages 3-6 views

Osteosynthesis with metal plates in operations on bones in children

Nemsadze V.P., Kuznechikhin E.P., Tarasov N.P., Kuznetsov S.M., Isaev A.A.

Abstract

The paper presents the experience of using metal plate osteosynthesis in 158 patients aged 6 to 14 years in the treatment of bone fractures of different localization, improperly fused fractures, as well as in performing corrective osteotomies for orthopedic diseases. Fixation of bone fragments with metal plates made it possible to do without external immobilization in the postoperative period. Stable osteosynthesis provided the possibility of early functional loading of the operated limb, which excluded the development of post-mobilization states (contractures, hypotrophy). The child could use the operated limb long before the onset of complete consolidation of the bone fragments. Depending on the nature of the fracture and the type of osteotomy, straight, T-shaped, apgular and derotational-compression plates were used.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):7-10
pages 7-10 views

Replacement of post-traumatic skin defects in children by tissue stretching with the use of endo-expanders

Merkulov B.H., Sokolov O.G.

Abstract

In the clinic for pediatric trauma, CITO, replacement of post-traumatic skin defects by tissue stretching was performed in 11 patients aged 4 to 14 years. 16 expanders were implanted (5 patients with two expanders). Implantation was performed on the lower leg (5 patients), in the projection of the knee joint (2), on the hand, thigh, scalp and in Filatov's stem (one patient each). The area of ​​the replaced cicatricial defects was 20 cm2 on the hand, up to 135 cm2 on the lower leg, and 160 cm2 on the scalp. Preference will be given to double-expander stretching with expanders located on opposite sides of the cicatricial defect. Among the complications, the formation of pressure ulcers of the skin over the valve tube, violation of the tightness of the balloons were noted. Out of 11 patients, the desired result was obtained in 9. The method of tissue stretching with the help of expanders can be used in children to replace post-traumatic defects of the skin of the limbs and scalp.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):9-13
pages 9-13 views

Fractures of the condyle head of the humerus in children and their treatment

Stuzhin B.T., Dorokhin A.I., Sokolov O.G.

Abstract

The study included 64 children with fractures of the head of the condyle of the humerus. Three groups of patients were identified depending on the ratio of the shoulder condyle head to the radial head. Treatment methods are clearly described for each group. Long-term results tracked in 41 patients indicate the correct choice of treatment methods: the vast majority of children received good and satisfactory results.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):13-14
pages 13-14 views

Comparative assessment of the state of the musculoskeletal system in children with different types of environmental pollution

Andrianov V.L., Dudin M.G., Ovechkina A.V., Kruk V.I., Sadofieva V.I.

Abstract

In areas with three types of environmental pollution, the state of the musculoskeletal system was studied in 22,710 children aged from the first days of life to 17 years. In general, an increase in the incidence of diseases and injuries of the osteoarticular system was noted, which was most pronounced in areas with aluminum production, which indicates a direct dependence of the pathology of the musculoskeletal system on microelement disorders. In the zone of consequences of the Chernobyl accident with a period of radiation contamination calculated from 1986, static skeletal disorders are most frequent, in Kazakhstan, where the mixed type of contamination has been active for 30 years, the frequency of congenital deformities is increased, and in the zone of aluminum complexes, acquired diseases of the skeleton.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):15-17
pages 15-17 views

Features of the clinical course and treatment of osteosarcoma in children

Bizer B.A.

Abstract

The clinical course and treatment of osteosarcoma in 500 patients under the age of 16 are analyzed. The features of the disease at the indicated age include early metastasis and significant local spread of the tumor. The average time to detect metastases was 3.3 months. The epiphyseal cartilage plate is not an obstacle to tumor growth. The defeat of the knee joint was found in 65% of patients. The results of the primary amputation are unsatisfactory. Immediate amputation is indicated only in case of intoxication and the impossibility of carrying out combined treatment. In 52% of children, as a result of irradiation, tumor growth stopped. Radiation treatment at a dose of 60-90 Gy was used only in combination with surgery and chemotherapy, which was used before and after surgery and radiation. In connection with the early dissemination and significant spread of the tumor, a two-stage complex treatment was used.At the first stage, chemotherapy and radiation therapy were performed. In case of refusal of the operation or detection of metastases, such treatment became the main and final one. The second stage is a radical operation performed after 3-6 months in the absence of metastases and stabilization of tumor growth. This tactic facilitates the selection of patients for surgical treatment and avoids mutilation in children with an unfavorable course of the disease.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):17-20
pages 17-20 views

Solitary eosinophilic granuloma of bone in children

Berezhny A.P., Berchenko G.N., Morozov A.K., Kasymov I.A.

Abstract

The work is based on the experience of examination and treatment of 134 children with solitary eosinophilic granuloma of the vertebrae, long and flat bones. When vertebrae are damaged with the formation of a vertebra plana, treatment consists of reclining the spine and fixing it with a plaster brace, and then with a polyvic brace until V3-V2 is restored to the initial height of the vertebral body. A pathological fracture of one of the cervical vertebrae with the formation of an angular deformity is an indication for the imposition of a halo apparatus. With the localization of eosinophilic granulomas in long and flat bones, the method of choice is puncture treatment with the introduction of a steroid hormone into the focus.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):20-23
pages 20-23 views

Langerhans cell histiocytosis: problems of nomenclature, diagnosis and therapy

Minkov M.L., Rumyantsev A.G.

Abstract

An overview of modern views on the problems of diagnosis and treatment of histiocytosis from Langerhans cells is presented. Criteria for verifying the diagnosis and a complex of mandatory clinical and laboratory examination for this disease, established by the International Society of Histiocytologists, are presented. The clinical manifestations of lesions of various organs and systems are described, taking into account the literature data and our own experience. The indications for therapy and approaches to the choice of the method depending on the form of the disease are discussed.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):23-27
pages 23-27 views

Impaired mobility of the upper cervical spine in children and adolescents

Vetrila C.T., Kolesov C.B.

Abstract

The article is based on the analysis of 185 cases of impaired mobility of the upper cervical spine. A classification of instability and hypomobility of the craniovertebral segment according to the etiological characteristic, mechanism, and severity of mobility impairment has been proposed. Clinical manifestations of instability and hypomobility are described. Clear criteria for diagnostics have been developed using functional radiography of the cervical spine and functional computed tomography of the C1 - C2 and CO - C1 segments. The state of blood circulation in the system of vertebral arteries was studied in this pathology. The indications for surgical and conservative treatment have been clarified.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):27-30
pages 27-30 views

Epidural block in the prevention of intra- and postoperative traction myelopathy in the correction of spinal deformity

Ulrich E.V., Andronnikov V.K., Ryzhikov Y.P., Ulrich G.E.

Abstract

To protect the spinal cord from traction myelopathy during surgical correction of spinal deformities, it is proposed to use an extended epidural block. The developed technique was applied in 34 patients. Myelopathy, subsequently arrested with complete restoration of the function of the lower extremities, occurred in one patient one day after the termination of the epidural block. The article presents the results of studying the epidural patterns of the distribution of solutions of water-soluble drugs in the epidural space in children.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):31-32
pages 31-32 views

Endoprosthetics of the hip joint in children of senior school age

Berezhny A.P., Nuzhdin V.I., Kotov V.L.

Abstract

The experience of hip arthroplasty in 22 children (23 joints) treated in the Department of Pediatric Bone Pathology and Adolescent Orthopedics of CITO is presented. The main group of operated were children with stage III coxarthrosis due to osteochondrodysplasia (10) and congenital dislocation of the hip (6). The duration of follow-up is from 1 to 23 years. A good result was obtained in 13 cases, satisfactory - in 7. Unsatisfactory results were associated with suppuration (1) and instability of the endoprosthesis (2). The authors see bilateral arthroplasty as a way to normalize the biomechanics of standing and walking in patients with osteochondrodysplasia.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):41-44
pages 41-44 views

Pathogenetic substantiation of methods for correcting disorders of the neuromuscular apparatus of the lower extremity in children with congenital clubfoot

Volkov C.E., Maximov I.A., Zakharov E.C., Korostelev L.M., Trif V.V.

Abstract

Ensuring effective and stable correction of congenital clubfoot remains an urgent task of modern pediatric orthopedics (1, 4, 6, 9). The high frequency of unsatisfactory treatment results for this deformity, according to many researchers [1, 2, 4 - 6, 9], is due to neuromuscular disorders that persist in the outcome of traditional lower limb correction. Insufficient effectiveness of traditional rehabilitation of the neuromuscular apparatus in congenital clubfoot is associated with insufficient pathogenetic substantiation of treatment [1, 6].

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):44-46
pages 44-46 views

Equinoplovalgus deformity of the foot in patients with infantile cerebral palsy and its surgical treatment

Zhuravlev L.M., Perkhurova I.S., Osipov L.I., Gorchiev B.M.

Abstract

Equinoplansovalgus deformity of the foot, typical for patients with infantile cerebral palsy, is formed due to the simultaneous action of labyrinthine reflexes on the foot and pathological tibial syncytic nezia Strumpel. Osteomyoplasty of the foot root according to A.M. Zhuravlev allows to eliminate all components of the deformity and creates conditions for the irreversibility of the correction. The operation was performed in 97 patients (in 14 - on both sides). The study of long-term results (54 patients) showed a high efficiency of the method: in all cases, an improvement in the shape and function of the foot was achieved.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):47-49
pages 47-49 views

Clonal analysis of bone marrow stromal cells in multiple exostotic chondrodysplasia and systemic osteoporosis: features of cell cloning efficiency

Meerson E.M., Ilyin B.K., Burdygin B.H., Rodionova C.C., Balberkin L.V., Mitin S.I.

Abstract

We studied the clonal features of bone marrow stromal cells obtained by biopsy of the iliac wing of patients with systemic skeletal diseases: multiple exostotic chondrodysplasia (16 patients) and systemic osteoporosis (24 patients). The proliferative potential of cells was investigated, the main indicator of which is the efficiency of cloning. We analyzed the induction-morphogenetic relationship between the efficiency of cloning and biological inducers contained in the autologous and added suspension of bone marrow cells (the so-called feeder). The rapid growth and proliferation of exostoses in multiple exostotic chondrodysplasia is apparently due to both the increased proliferative activity of the cultured cells themselves, and (especially) the increase in the growth-stimulating effect of the autologous "feeder", which distinguishes fast-growing exostoses from the so-called calm ones, in which the proliferative activity itself cells are increased (but to a lesser extent), and no enhancement of the effect of the autofeed is detected. In systemic osteoporosis, a sharp decrease in the efficiency of cloning of the target cells themselves has been established, which is probably associated with a weakening of their colony-forming properties and / or a decrease in their number in the explanted suspension.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):51-54
pages 51-54 views

Restoration of the structure and function of the elbow joint by the method of vibro-friction impact

Shaposhnikov Y.G., Volkov M.B., Elkin A.I., Prokhorova T.A., Oganesyan O.V., Seleznev N.V.

Abstract

For the first time, a method has been developed for arthroplasty of the elbow joint using a hinge-distraction device for external fixation, which allows automatic vibro-frictional action on the articular ends according to a specific algorithm. The complete removal of the degeneratively altered cartilage tissue of the articular ends together with the subchondral plate and the development of movements in the apparatus according to a given algorithm is performed. The method provides restoration of the structure and function of the joint.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):51-54
pages 51-54 views

Why does the patient fall on the injured leg?

Belenky V.E., Kuropatkin G.V.

Abstract

Orthopedist (referring to biomechanics). Help us deal with the patient. This is a young man sent to us from the draft board of the military enlistment office, with complaints of pain in the right hip joint. We do not find anything either clinically or radiographically. Could you help us with the examination of this patient? Is he feigning?

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):55-57
pages 55-57 views

Photoreoplethysmography as a method for studying the regional blood supply to skin wounds

Kosov I.S., Kaveshnikov A.I.

Abstract

In an experiment on pigs, the photoreoplethysmography method adapted for this purpose was used to characterize the blood supply to the granulation tissue of the bottom of skin wounds under various therapeutic effects. It has been shown that the method allows one to graphically record the state of volumetric blood flow in tissues, to carry out a comparative assessment of microcirculation in tissues due to the possibility of simultaneous registration in several places. The resulting photoreoplethysmograms make it possible to quantify the amplitude and time parameters of blood flow.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):57-59
pages 57-59 views

Lectures

Acute blood loss

Nazarenko G.I.

Abstract

Acute blood loss is a pathological process consisting in the loss of a part of the volume of circulating blood (BCC) by the body due to bleeding. Depending on the type of damaged vessel, arterial, venous and capillary bleeding is distinguished. The bleeding can be external or internal.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):60-64
pages 60-64 views

Reviews, literature review

K.P.Schulitz, H. О. Dustmann. Morbus perthes (pertes disease)

Kutsenok J.B.

Abstract

The authors have been studying Perthes disease for many years. Their first publications on this problem appeared back in 1974. Now, based on an analysis of the world literature, their own experimental studies and a large clinical material (with a follow-up period of up to 25 years), they wrote a major monograph (402 p.) - superbly published, illustrated with many drawings , radiographs, diagrams and tables, with an almost exhaustive list of references (which, unfortunately, does not contain sources in Russian).

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):65-66
pages 65-66 views

Search

Kaplan A.V.

Abstract

Putting my archive in order, I came across a thick general notebook, where on the first page it was written in calligraphic handwriting: "Placental blood - search". Leafing through the yellowed pages, I remembered this long story in which I was a participant.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(2):67-70
pages 67-70 views


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