Vol 1, No 3 (1994)


Articular fractures in children: systemic approach

Volkov M.V., Samoilovich E.F., Shaklychev O.K.


The paper deals with the analysis of the diagnosis and treatment of articular fractures in 1376 children. Despite their site, the articular fractures may be included into a special group of injuries on the basis of anatomical and physiological features and pathogenetic factors. Based on the quantitative assessment of the extent of fragment displacement, a classification of articular fractures has been developed. An algorithm has been proposed for defining the optimum therapeutical policy — conservative, active surgical or operative.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):3-8
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Some theoretical bases of osteosynthesis and their practical applicahon using computer

Pichkhadze I.M.


Biomechanical classification of long bone factures, biomechanical concepts of stable fixation of fragments, devices for treatment of long bone fractures as well as computer system «ORTO» for choice of the most optimal treatment method and individual selection of external fixation device are suggested.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):9-13
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Surgical treatment of acute cervical spine injuries

Protsenko A.I., Kalashnik V.A.


The study presents the analysis of surgical treatment efficiency of 330 patients with cervical spine injuries: 199 patients with dislocations, 89 — with dislocation fractures, 22 — with vertebral body fractures. Worked out treatment tactics with application of modified operative methods from anterior approach (open setting of dislocations and subdislocations followed by spondylodesis, replacement of vertebral body with osseous grafts or implants) enabled to obtain stable positive results in most of the patients as well as to shorten the treatment course duration due to active rehabilitation of patients.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):13-15
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The role of arthroscopy in the diagnosis and treatment of knee joint lesions in children

Zar V.V., Merkulov V.N., Ushakova O.A.


A retrospective review of the first 9 years' experience with arthroscopy at the children's department of the Priorov’s Central Institute for Traumatology and Orthopedics (Moscow) was conducted. One hundred and twenty-eight arthroscopies were perforated in 125 children with knee joint lesions. The patients were followed up from 1 to 117 months. Tire most common arthroscopic finding in adolescent group was chondromalacia patellae followed by anterior cruciate ligament injury, meniscal lesions, patellar dislocations. There were many cases of synovitis and discoid meniscus in the preadolescent group. Arthroscopy proved a safe, accurate and effective tool in the diagnosis and treatment of childhood and adolescent hemarthrosis for meniscus and ACL injury, in septic arthritis, acute patellar dislocations.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):16-18
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Treatment tactics for könig and lawen diseases in children

Nemsadze V.P., Kuznechikhin E.P., Vybornov D.Y., Krestyashin V.M.


We present the results as well as our experience in observation and treatment of 54 patients aged from 7 to 15 years with femoral condyle osteochondrosis dissecans (31) and patella chondromalacia (23). Application of arthroscopic methods in complex diagnosis enabled us to differentiate the stages of the disease with regard for roentgenological and intraarticular (endoscopic) changes. For the stimulation of regeneration in the zone of osteonecrosis both conservative (electromagnetic) and suigical (endoscopic oste- operforation, insertion of bone allopins, etc.) methods were used. Radionucleid method was used for the objective evaluation of the treatment results.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):19-22
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Combined damage to the knee ligaments and the coxofemoral nerve

Sukhonosenko V.M., Міan A.A.


The examination and treatment of 25 patients with chronic combined damage to the knee ligaments and the coxofemoral nerve have led the authors to the conclusion that many patients are not diagnosed as having nerve injury in the early period. Early diagnosis of combined damages makes it possible to perform treatment in time in recovering the ligaments and nerve function and to rule out intricate reconst motive operations in the late period of injury. In chronic combined damages to the ligaments and the nerve, the most justifiable therapeutical method is surgery: plastic recovery of the ligaments and revision of the nerve, which is expedient to make simultaneously, the scope of an operation on the nerve is determined by the nature of a damage. Positive clinical results seen among most patients confirmed the efficiency of the therapeutical method.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):22-25
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Achillotalar syndrome

Mironov S.P., Vasiliev D.O.


The authors have detected and described a syndrome that consisted of pathological functional changes in the posterior segment of the talus coupled with the pathology of the Achilles tendon. That symptomocomplex named as Achillotalar syndrome was diagnosed in 9 patients. All patients were thorouglily examined and treated suigically. As a result, they all reverted to their initial level of professional and physical activity.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):25-26
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Standards of early diagnosis of Perthes disease

Kryuchok V.G.


Sixty-tliree patients with suspected early (preroentgenological) stage of Perthes’ disease were examined, 25 of these developed later a typical picture of osteochondropathy of the neck of the femur with manifest x-ray signs. Application of an improved method of osteoscinligraphy helped correctly diagnose the disease at the early stage in 24 (96%) of these 25 patients, whereas examination with a newly developed method of nonreference roentgenophotodensit- ometry was effective in 18 (72%) patients. A scheme for examination of patients with suspected Perthes disease («examination standard») is offered.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):26-30
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Diagnosis of genetic forms of rickets in children

Snetkov A.I.


Results of examinations of 121 children with genetic forms of rickets were used to develop criteria for the diagnosis and differential diagnosis of vitamin D-resistant and vitamin D-dependent rickets, renal tubilar acidosis, and de Toni—Debre—Fanconi's disease. The severity of genetic forms of rickets was found related to manifestation of metabolic disorders. 'Triggering mechanisms of mineral metabolism disorders in a child's body were revealed, which were related to abnonnal vitamin D metabolism in cases with vitamin D-resistant and negatice rickets and to genetic defects of the proximal and distal renal canaliculi. Roentgenography of skeletal bones helped detect a number of important symptoms characteristic of osteomalacia, osteoporosis, osteosclerosis, and combinations thereof. Roentgenography of the hand with magnification x3—4 demonstrated a high informative value of the method and confirmed the similarity of structural disorders in the bones of the hand and other skeletal zones.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):30-33
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Extremity segment resection as a special type of surgical intervention in patients with malignant tumors

Makhson A.N.


A suigical intervention called extremity resection was developed. It consists in removal of the entire segment of the extremity (including bones, joints, muscles and skin) after preisolation tluoughout its extention of great vessels and nerves wlrich are preserved. With a tumor in the bones forming a knee joint, the operation ends with the application of the exterior fixation apparatus to achieve consolidation of the femur and the tibia. Then osteotomy is perfonned at one or two levels and the extremity is extended in the apparatus. A bone defect may be replaced by an endoprosthesis on the arm where shortening lesser affects the function after resection of an extremity segment with the ulnar joint. Eight patients with various malignant tumors were operated on in accordance with this procedure.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):33-35
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Surgical treatment of posttraumatic defects of the skull in children

Mytnikov A.M., Ivanov L.B., Eshankulov G.S., Zolkin P.I., Korablyov V.V., Schedrinskaya S.Y.


The authors analyze many-year experience gained in the treatment of children with posttraumatic defects and depressed fractures of the bones of cranial vault at Department of Nemotraumatology of the Moscow Research Institute of Pediatrics and Childhood Surgery and the results of various cranioplastic operations in 141 children aged 1 month to 15 years. Autocranioplasty was earned out in 50 children (reposition in 11, replantation in 37, secondary autoplasty with preserved transplant in 2). Cranioplasty with allotransplants was carried out in 77 patients. Polymeric expiants for cranioplasty were used in 4 cases, carbon ones in 10. Ligature method for transplant fixation was resorted to in 52 patients, compression one in 47, reposition and replantation without supplementary fixation in 42 cases. The best remote results were attained after plasty by the compression method with autobone, allotransplants, and carbon expiants.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):35-37
pages 35-37 views

Disturbance of connective tissue metabolism in gunshot injury of lower extremities

Shaposhnikov Y.G., Gerasimov A.M., Bogdanova I.A., Furtseva L.N., Tikhomirov A.G., Arzhakova N.I.


Total urine excretion of glicosaminoglycanes, glicosaminoglycanes spectnun (electrophoresis on acetate cellulose) activity of 3 lysomal enzymes which participated in the breakdown of glicosaminoglycanes and were very sensitive indicators of renal damage as well as oxyproline (marker of collagene breakdown) and creatinine (typical index of muscle breakdown) were studied in 7 patients with gunshot injuries of lower extremities during the early phase of traumatic disease (on 2, 7, 15 days). Increased urine excretion of glicosaminoglycanes, mainly chondroitin sulfate, N- acetyl-ß-glucosaminidase, oxyproline as well as creatinine was detected. Maximum excretion was noted on day 7 after injury infliction. By day 15 most of biochemical parameters, except for creatinine, returned to normal level. Tire results obtained showed that during early phase of traumatic disease gunshot injury caused the breakdown of the intracellular matrix of connective tissue.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):38-40
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What does traumatic disease mean? ( On the article by I.A. Eryukhin)

Tsibin Y.N.


The term "traumatic illness" is of purely domestic origin. The Russian tradition is to call something incomprehensible or not fully understood a disease. Approximately the same history has, for example, "hypertension". And if Frank in the beginning of the XX century, not being able to find out all causes of hypertension, called it essential, i.e. having no easy origin, then on the Russian soil by the 40s it turned into "hypertensive disease", and G.F. Lang consolidated this notion with his excellent monograph, which was called "Hypertensive disease".

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):41-41
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In which hand to take the cane? (Dialogue between an orthopedist and a biomechanic)

Belenky V.E., Kuropatkin G.V.


Orthopedist. In our previous conversation, when we talked about gentle claudication, you said that the patient chooses the optimal walking conditions for himself.
Biomechanic. Yes, it minimizes (as much as possible) the pain that occurs when you load the leg.
О. But by unloading the diseased leg, it overloads the healthy leg. And with a chronic process, the healthy leg will eventually become sore, too. Then what kind of "optimum" are we talking about?
B. That's right. We call optimal the regime that suits the organism the most at a given moment. The patient doesn't know what will happen to him tomorrow, but today he successfully solves the problem - he walks the distance from point "A" to point "B" with minimal pain.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):42-43
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From Practical Experience

On conservative treatment of degenerative-dystrophic diseases of the hip and knee joints in adults

Nazarov E.A.


Out of 360 patients with degenerative-dystrophic diseases of the hip and knee joints who passed through the orthopedic clinic during the five-year period (1984-1988), 175 (48.6%) received conservative treatment. Almost half of the patients had late stages of the pathological process according to the classifications of N.S. Kosinskaya and V.N. Guriev. Their treatment was carried out in accordance with the basic principles developed by Russian scientists. Conservative therapy included unloading of the diseased limb, relief of pain syndrome and improvement of blood circulation in the articular and periarticular tissues.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):44-45
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On conservative treatment of complications of irregularly healed fractures of the distal radial metaepiphysis

Landa V.A., Kachur E.I.


Fractures of the distal radial metaepiphysis are often complicated by forearm and hand dystrophy. One of the most important factors predisposing to its development is unresolved displacement of radial bone fragments. We observed 18 patients with irregularly healed fracture of the distal radial metaepiphysis complicated by posttraumatic neurodystrophic syndrome (phase II, III). There were 17 women and 1 man among them. The average age of the patients was 58.4 years.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):46-47
pages 46-47 views

Gentle method of treatment of closed diaphyseal fractures of the tibia bones in elderly and old people

Semenov A.Y., Rabinovich L.S., Kalashnik A.D., Yakimov L.A.


The Department of Traumatology, Orthopedics, and Military Field Surgery of the Sechenov Moscow Medical Academy. I.M. Sechenov Moscow Medical Academy and its clinical base, Hospital No. 67, have developed and put into practice a method of extrafocal fixation of fragments in closed diaphyseal fractures of the tibia bones in the elderly and elderly; its use in combination with functional treatment techniques during fracture healing makes it possible to minimize postoperative complications and significantly reduce the rehabilitation period of patients.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):47-48
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Splint-boot for the treatment of injuries in the ankle joint

Ott G.H., Lange L.


The multitude of different recommendations aimed at eliminating the same pathology in most cases indicates that none of them fully achieves the expected results. Almost all commercially available ankle fixators have two major shortcomings: they lack an individualized fit for the shape of the foot, joint, and lower leg of the individual patient, and they do not provide sufficiently reliable locking of the foot during supination. In other words, they do not create the conditions necessary for healing when the external ligaments of the ankle joint are injured. To solve this problem, a boot splint (Badgodesberg boot splint) was developed at the Bonn-Bad Godesberg Evangelical Hospital, which has proven to be excellent for treating ankle ligament injuries.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):48-50
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Conservative treatment of osteoarthritis of large joints

Geroeva I.B., Tsykunov M.B.


Patients suffering from degenerative-dystrophic diseases of the joints and spine occupy a significant place among those who seek help from doctors of various specialties. Osteoarthritis (OA) is the most common form of joint pathology. It is characterized by primary damage (dystrophy) of articular cartilage, which subsequently leads to changes in the articular surfaces - the appearance of osteophytes and deformation of the joint.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):51-55
pages 51-55 views


Skeletal dysplasia: classification, early diagnosis and treatment

Mikhailova L.K.


Skeletal anomalies with body disproportions have attracted people's attention since ancient times. Attitudes towards those suffering from these malformations varied in different times and among different peoples - from deification (for example, in Ancient Egypt) to rejection and isolation (in Sparta and medieval Europe). In ancient Egypt, Bez, the patron god of children and pregnant women, was depicted as a dwarf with short arms and legs. History has preserved information that the ancient Greek philosopher and fabulist Aesop suffered from disproportionate dwarfism (probably achondroplasia).

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):56-61
pages 56-61 views

Reviews, literature review

E. Ornstein, A. Voinia. Semiotics and Diagnostics in Traumatology and Orthopedics (Kishinev, "Stiinza", 1992)

Volkov M.V., Kiselev V.P., Rassovsky S.V.


A monograph has been published that summarizes the many years of experience of two well-known specialists, E. Ornstein (Moldova) and A. Voini (Romania). The book consists of 451 pages and consists of a foreword, introduction, 5 chapters, conclusion, list of references and index. The preface, written by A.V. Kaplan, notes the merits of the book and emphasizes its undoubted usefulness for clinicians.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):65-66
pages 65-66 views


II All-Russian Conference on Biomechanics

Kuropatkin G.V.


The II All-Russian Conference on Biomechanics in Memory of N.A. Bernstein was held in Nizhny Novgorod on November 22-25, 1994. The conference was held under the auspices of the Russian Academy of Sciences, the Ministry of Social Security, and the Society of Biomechanics of Russia. Great merit in its organization belonged to the Nizhny Novgorod State Medical Academy, the Nizhny Novgorod Branch of the Interdisciplinary Institute of Medical and Social Rehabilitation, and the Research Center "Radiomechanics and Rehabilitation".

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):67-67
pages 67-67 views


To the 100th anniversary of the birth of T.P. Vinogradova (1894-1994)

Lavrishcheva G.I.


It was 100 years since birthday of the greatest pathologist of our country, the specialist in the field of bone-joint pathology and physiology, the laureate of the State Prize, the honored worker of science of RSFSR professor Tatyana Pavlovna Vinogradova and 70 years since her creation of the pathology department of the Priorov Central Institute of Traumatology and Orthopedics.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):68-69
pages 68-69 views

G.I. Lavrishcheva


The material presented above, dedicated to the 100th anniversary of the birth of T.P. Vinogradova, prepared by her student, closest collaborator, devoted associate and friend, Professor Galina Ivanovna Lavrishcheva. Replacing T.P. Vinogradov as head of the pathological and anatomical department of CITO, G.I. Lavrishcheva led it for about 20 years, carefully preserving its best traditions and continuing the work begun by the teacher, developing the ideas and directions of the school of A.V. Rusakova—T.P. Vinogradova.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):69-69
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O.Sh. Buachidze

Onoprienko G.A.


It was 70 years from the date of his birth and 47 years of scientific and practical and socio-pedagogical activity of one of the leading orthopedic traumatologists of our country, Doctor of Medical Sciences, Professor Otar Shalvovich Buachidze.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):70-70
pages 70-70 views

In memory of Georgy Moiseyevich Ter-Yegiazarov


On September 7, 1994, the RSFSR Honored Scientist, Doctor of Medical Sciences, Professor Georgy Moiseyevich Ter-Yegiazarov died at the age of 71. He devoted all his strength, mind, and talent to his favorite specialty - traumatology and orthopedics.

N.N. Priorov Journal of Traumatology and Orthopedics. 1994;1(3):71-71
pages 71-71 views

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