Vol 6, No 2 (1999)

Original study articles

Cotrel-Dubousset instrumentation in surgery for idiopathic scoliosis

Mikhailovsky M.V., Fomichev N.G., Novikov V.V., Vasyura A.S., Kirilov I.A., Bolbas D.V., Lebedev M.N.


From 1996 to 1998 twenty four patients, aged 12.5- 24.5, with idiopathic scoliosis underwent Cotrel-Dubousset instrumentation. Significant correction of all multiplane spine deformities was achieved: scoliosis - by 50.8%, thoracic hypokyphosis - by 8.1-22.5, torsion - by 24.5%. Lumbar lordosis was preserved. Mean follow up was 10.7 months. Only in 5 patients the loss of the correction was observed and it was equal to 7-8°.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):3-7
pages 3-7 views

Harrington instrumentation in combination with Luque method versus Cotrel-Dubousset instrumentation for scoliosis correction

Vetrila S.T., Kuleshov A.A., Shvets V.V.


Results of surgical treatment of 60 patients with scoliosis are presented. In 36 patients Harrington instrumentation in combination with Luque method was used for deformity correction, in 24 patients Cotrel-Dubousset instrumentation was applied. In 8 patients with extremely severe rigid scoliosis the deformity correction was preceded by thoracotomy with multilevel diskectomy for spine mobilization. In frontal plane no differences was observed in obtained correction independent on the type of instrumentation. In horizontal and sagittal planes correction obtained i was more marked if Cotrel-Dubousset instrumentation was applied. In Harrington instrumentation follow up period was 1 year, in Cotrel-dubousset instrumentation follow up ranged from 3 months to 1 year. Scoliotic deformity correction by Cotrel-Dubousset instrumentation is showed to be preferable. However taking into account its high cost the use Harrington instrumentation in combination with Luque method may be recommended as alternative method only.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):7-15
pages 7-15 views

Scheuermann’s disease: yesterday, today, tomorrow

Korzh N.A., Kolesnichenko V.A.


Basing on literature data and personal investigations the authors summarize current concepts regarding etiology and pathogenesis of Scheuermann’s disease. The types of clinical course of the disease are considered depending on its localization and peculiarities of structural changes in spine segments are considered. Further perspective study of spine osteochondropathy is planned.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):15-19
pages 15-19 views

Treatment of lumbar osteochondrosis by intercuteneous laser diskectomy

Mironov S.P., Nazarenko G.I., Cherkashov A.M., Burmakova G.M.


Fifteen patients with lumbar osteochondrosis complicated by L4-L5 and L5-S1 disk protrusion treated by interosseous laser diskectomy are reviewed. Early and long-term results are given. In 14 patients (93%) good results were achieved, 1 patients (7%) had satisfactory outcome. Indications for intercutaneous laser diskectomy are the following: low back pain irradiating to lower extremity, and persistent over 3 months, failed conservative treatment, absence of neurologic complications, such as paresis, disturbance of pelvic organs function as well as disk protrusion (size up to 6 mm) confirmed by CT, MRI. This method does not damage soft tissues and allows to achieve persistent release of pain syndrome.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):19-24
pages 19-24 views

Peculiarities of diagnosis and treatment of transverse lumbar processes neoarthroses in outpatients

Kolesnichenko V.A.


In 17 male patients, aged 18-26 years with L5 transverse processes neoarthroses clinical manifestations and X-ray data were studied. In 12 patients transverse-sacral neoarthroses were diagnosed, in 4 patients transverse-iliac neoarthroses and in 1 patient transverse-transverse neoarthroses were detected. Syndromic pattern of lumbar transverse processes neoarthroses including complaints, clinical manifestations and X-ray data was typical for spondyloartralgia. However unlike lumbar spondyarthralgia neoarthroses spondylartralgia was characterized by prevalence of monoarticular lesion symptoms with strictly local pain in neoathrosis zone at palpation, unilateral localization of painful sense and unilateral muscle tension; recurrence and increase of pain were provoked not as much by extension as by rotatory motions and inclination towards the «aching» side. Prevailing method of treatment of patients with transverse-sacral, transverseiliac as well as transverse-transverse neoarthroses is a conservative one with obligatory intra-articular corticosteroid blocades.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):24-27
pages 24-27 views

Injuries of pelvic blood vessels in pelvic instable fractures and dislocations in patients with combined trauma

Dyatlov M.M.


Retrospective study of medicolegal data and case histories of 20 victims with combined pelvic trauma and blood vessels injuries are presented. In 20 victims 28 vessels were damaged: in 3 cases presacral venous plexus and in 17 cases 25 main blood vessels (14 veins and 11 arteries) were injured. Basing on the analysis of relationship between trauma mechanism, peculiarities of X-ray data and clinical manifestation the author detects a symptom complex named «diagnostic triad» that allows to diagnose the main pelvic vessels damage and perform surgical intervention. Recommendations concerning victim examination, treatment tactics, time for revision intervention on vessels and inner organs are given. This operation should be performed by special surgical team.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):27-33
pages 27-33 views

Restoration of function in interphalangeal finger joints at injury sequelae by modified hinge-distraction device

Zeitlin D.M.


Seventy eight patients with sequelae of interphalangeal finger joint injuries ( long-standing dislocations, fracture-dislocations, peri- and intracapsular fractures, contractures) were treated by modified hinge-distraction devices. In 1-3 years follow up outcomes were evaluated in 71 patients. Good results were achieved in 68 cases (95.8%). Use of our hinge-distraction devices excluded the superfluous mobility, provided the main axis of articular ends motion, volume constancy of the articular split as well as the possibility of active and passive movements that gave adequate conditions for the restoration of osteoarticular structures as well as surrounding soft tissues.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):34-37
pages 34-37 views

Possibilities of condition changing assessment for the patients with hip joint pathology during kinesitherapy loads

Builova T.V., Polyakova A.G., Smirnov G.V., Dorofeeva G.I., Rukina N.N., Maksimova L.P.


Twenty seven patients with hip joint pathology and 10 healthy were examined before and after kinesitherapy loads. Correlation between changes in subjective (pain degree) and objective data (acupuncture testing, dynanometrical and spectrotremor-metry) was analysed. In patients with hip joint pathology the limits of kinesitherapy loads adequacy were determined.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):37-43
pages 37-43 views

Psychologic characteristics of patients with coxarthrosis

Bulyubash I.D., Builova T.V., Gazarov A.A., Kostyunina N.N.


Forty four female patients with degenerative-dystrophic hip diseases were subjected to clinical and psychological examination. Psychological method included Minnesota Multiphasic Personal Inventory test and «Hand» test. It was shown that patients with marked disorders of static-dynamic function, bilateral hip joint pathology accompanied spine osteochondrosis as well as the patients with relatively early stage of the disease and with high level of pain sense were the most disadaptied. These data may be used for the elaboration of the complex rehabilitation program.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):43-47
pages 43-47 views

Preservation of lower extremity function followed by pelvic tumor resection

Filippenko V.A., Istomin A.G.


In 192 operated patients with tumors and tumorlike diseases functional results were analyzed. In 162 patients radical sparing operations were performed according to oncologic demands and with preservation of static-dynamic function of pelvic girdle and lower extremity. High efficacy of those operations was confirmed by clinical and biomechanical data. Long term results showed the necessity to perfect reconstructive surgery on pelvic posterior semi-ring. Elaborated variants of plastic operations for the substitution of acetabular zone allow to restore the hip joint function after resection of pubic, iliac and ischium bones. When the anterior pelvic ring is disturbed bone defects should not be repaired as static-dynamic function is preserved due to compensatory mechanism of sacroiliac ligaments.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):47-54
pages 47-54 views

Peripheric primitive neuroectodermal tumor (Askin)

Makhson A.N., Burlakov A.S., Kuzmin I.V., Pugachev K.K., Popov M.I.


The case of preoperative diagnosis of peripheric primitive neuroectodermal tumor (pPNET) of the chest with damage of body sternum in 21-year-old patient is presented in Native literature for the first time. CT and echography data as well as serum tumor-markers level are given. The detection of tissue-markers and electronic microscopy data are the most reliable diagnostic methods. However clinical and routine morphologic examinations are important as well. Our patient received neoadjuvant chemotherapy followed by chest resection and plasty by osseous-musculocutaneous flap on vascular pedicle. Efficacy of polychemotherapy with vincristine, cyclophosphan, farmorubicin and platidiam is proved. Nine months after operation no tumor relapse and metastasis were observe. In spite of relatively low sensitivity of pPNET to cytostatic drugs, combined treatment with neoadjuvant is the most justified. Original method for the plasty of chest defect with no application of artificial materials provides favourable conditions for wound healing with good and satisfactory cosmetic outcomes.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):54-62
pages 54-62 views

Mechanical characteristics of different osseous alloplastic materials

Kasymov I.A., Gavryushenko N.S.


Comparative study of two plastic materials, i.e. frozen cortical allobone and demineralized perforated allobone («perfoost») was performed. Testing of the samples from the same part of the tibia was carried out using «Zwick 1464» apparatus. It was showed that firmness of «perfoost» was lower than that of the frozen allobone: during compression - by 33%, switching - by 66%, bending - by 46% for metaphyseal sample and by 70% for diaphyseal one. «Perfoost» possesses the rigidity that allows to use this graft in marginal resection as well as in osteotomy as a bone fixator. Advisability of the graft in segmental resection of lower extremity without cortical allograft is doubtful.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):62-65
pages 62-65 views

Modern technique for intraoperative autotransfusion

Zhukov Y.V., Kalnberz V.K., Kalnberza M.V.


Use of autoblood preliminary stored by different preservation method can decrease the risk of posttraumatic complications but not in all cases. In 18 patients who underwent orthopaedic surgery autotransfusion with Cell Saver apparatus was performed that allowed to compensate 1.2-3.2 1 blood loss without additional use of donor blood. Use of electronic apparatus confirms its high efficacy for intraoperative blood reinfusion.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):65-68
pages 65-68 views

Treatment of patients with congenital joints dislocation (Larsen’s syndrome)

Batalov O.A., Bogosyan A.B., Musikhina I.V., Tenilin N.A.


Treatment results of 10 patients with Larsen’s syndrome is presented. Step-by-step treatment regimen including closed reduction of hip joint in functional devices for preparation of tendinous-muscular system of the knee joint, closed reduction of ankle joint with transarticular pin fixation and subsequent plaster immobilization is proposed. If cicatrical degeneration of ankle extensors is confirmed and closed reduction of the ankle dislocation failed the open bilateral reduction with lengthening of anterior femur muscles is indicated. Proposed regimen of operative treatment allowed to achieve early and long-term satisfactory functional and cosmetic results in all patients.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):69-70
pages 69-70 views

From Practical Experience

Setre-Chotzen syndrome in an 8-year-old girl

Kotov V.L., Meyerson E.M., Il'ina V.K., Bruskina V.Y.


Acrocephalosyndactyly (type III), or Saethre-Chotzen syndrome, according to the International Nomenclature of Hereditary Skeletal Diseases, belongs to the group of dysostoses, manifested by deformities of individual bones or their combinations, and is included in the subgroup of dysostoses with a primary lesion of the face and skull. The type of inheritance is autosomal dominant.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):71-72
pages 71-72 views

Rod osteosynthesis in the treatment of diaphyseal fractures of the humerus in children

Khachaturian A.Y., Askarova D.S.


The method of transosseous osteosynthesis is widely used in the treatment of fractures of long bones not only in adults but also in children. At the same time, due to the characteristics of the child's body, the indications for its use in these two categories of patients cannot be considered equivalent.

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):73-74
pages 73-74 views

Reviews, literature review

A.E. Belousov. Practical Reconstructive and Aesthetic Surgery (St. Petersburg, 1998)

Pshenisnov K.P.


At the end of 1998, the publishing house "Hippocrates" published the book "Plastic, Reconstructive and Aesthetic Surgery" under the general editorship of a well-known surgeon, Director General of the Center for Plastic and Reconstructive Surgery (St. Petersburg), laureate of the State Prize Professor A.E. Belousov. This is a joyful and welcome event, especially for those specialists who studied and improved in the field of reconstructive microsurgery according to the previous book by A.E. Belousov, written in collaboration with prof. S.S. Tkachenko, "Microsurgery in traumatology" (L., "Medicine", 1988).

N.N. Priorov Journal of Traumatology and Orthopedics. 1999;6(2):75-75
pages 75-75 views

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