Vol 2, No 1-2 (1995)

The treatment efficiency in elderly and senile patients with proximal femur fractures directly depends on timely hospitalization and the performance of primary osteosynthesis during the first 3 days after trauma. One hundred thirty patients with femoral neck fractures were operated on using three-paddles nails including diaphyseal plate (95), angular plates and dynamic compressive screw with diaphyseal strap (25), Seppo fixative (10). Postoperative lethality was 3,08%. Good long term functional result was achieved in 80% of cases. The trochanteric and subtrochanteric fractures (182) were operated on using elastic curved nails (90), Bakicharov fixatives (32), three-paddles nails with diaphyseal straps and dynamic compressive screws (40), Kuncher joint-pins (15), Sivash screw-pins (5). Postoperative lethality was 7,14%. Positive long term results were observed in 85% of cases. The emergent primary osteosynthesis in elderly and senile patients with proximal femur fractures is the life-saving procedure aimed at the prevention of hypostatic complications, restoration of limb function and social rehabilitation.

The paper presents the results of pulse electric current therapy used in 146 children aged 3 to 14 years who had intra-articular fractures in the acute period, long- bone fractures, dystrophic (Osgood—Schlatter and Legg— Calve—Perthes diseases, juvenile epiphysiolysis of the head of the femur) and dysplastic (polyosteal fibrous dysplasia) diseases of the bone. It also describes a procedure for intraosteal electrostimulation and gives indications for its use. The proposed procedure allows bone tissue to be prevented, promotes the recovery of the bone structure and the reduction of treatment duration, decreases the number of complications and poor results.

Biopsy specimens from the wing of the ilium were examined in 16 liquidators of the Chernobyl Atomic Power Station accident. A test for clonogenic stromal cells was performed long with quantitative analysis of osseous tissue parameters and the histomorphometric assessment of remodelling processes (resorption and osteogenesis). There was strong evidence for the fact that small dose ionizing radiation might lead to the development of at least 3 types of osseous tissue metabolic disturbances: osteoporosis of the cortical bone; that of the cortical and spongy bones (the mixed type) and abnormalities arbitrarily defined as osteosclerosis. It was found that resorption was simultaneously or even before suppressed in osteoporosis in the liquidators, whereas in other forms of osteoporosis, inhibited ostepgenesis triggerred rarefaction of the bones. The negative effect of ionizing radiation on stromal cells of the bone marrow was evident by the studies of the efficiency of cloning of osteoblast precursors. No dependence of the revealed changes on the dosage of ionizing radiation and the various pattern of metabolic disturbances in the osseous tissue under the action of the same dosages suggest that a premorbid background is of definite value in the development of abnormalities.

The authors suggest the original conception of the development of so-called tibial syndrome that is the typical one for patients with infantile cerebral paralysis. The significance of tibial synkinesis being pathognomonic for pyramidal lesions in the formation of a peculiar severe locomotor pathology is detected. This severe locomotor pathology is a tibial syndrome. The authors emphasize that tibial syndrome is often a failured outcome of surgical intervention for foot equinus in young children. New surgical technique that eliminates the main pathologic components of tibial syndrome: flexion contracture of the knee joint, crus anterversion, redundant dorsal foot flexion, and improves the posture and gait is suggested.

The treatment results of 184 children under school age with infantile cerebral paralysis and equinus deformity were analysed. There were 268 feet with equinus deformity. Out of 312 operations 137 (44%) Str operations, 63 (20,3%) aponeurotic elongation of gastrocnemical muscle, 56 (18,1%) Z-shape elongation of gastrocnemical muscle and 14 (4,5%) achilloplasty by Hoke-method were performed. The indications to apply the surgical management depending on the orthopedic and neurologic status as well as the methods of aponeurotic elongation of gastrocnemical muscle are presented. Excellent and good results were achieved in 86% of cases, recurrence of deformity was observed in 8% of cases. Minimum trauma, high efficiency, organ-sparing pattern of aponeurotic elongation of gastrocnemical muscle makes this procedure the method of choice in children under school age.

Dynamics of activity of glutathione: dehydroascorbate oxyreductase, glutathione peroxydase, glutathione reductase was studied in bone marrow of rats with closed bone fractures during different terms after injury infliction. On day 30 of traumatic disease the activity of glutathione: dehydroascorbate oxyreductuse, calculated jn 1 mg DNA, decreased on 27% that increased the sensitiveness of bone marrow cells to the deficit of ascorbinic acid. The detected stability of glutathione reductase showed the possibility of glutathione application in pharmcotherapy of traumatic disease.

In the past 30 years, of all surgical specialties, orthopedics has shown the largest increase in the number of surgeons and the number of operations performed. It has significantly contributed to the improvement of the quality of life, and this becomes its main task. During this period, not only were more orthopedic operations performed, but the type of surgical intervention itself changed. In the 1960s, internal fixation of fractures and arthroplasty took the first place, in the 1970s there was a revolution in diagnostic arthroscopy and reconstructive surgery of ligaments, especially the knee joint, in the 1980s, operative arthroscopy, spinal surgery and microsurgery were mainly developed.

Chronic transdental dislocations of the atlas are among the most severe spinal injuries. In this area, the vertebral arteries, spinal cord, cranial nerves are in close contact. According to the literature [3], severe neurological symptoms develop in 25% of cases with fractures of the C2 odontoid process.

Early detection and treatment of congenital hip dislocation is one of the most urgent problems of modern orthopedics. If a child is born with a stretched capsule of the hip joint and he has a dislocation and subsequent slight reduction of the head into the acetabulum (a symptom of "slipping"), then we interpret this condition as a pre-dislocation of the hip.

With a perseverance worthy of a better application, humanity throughout its history has been creating means of defeating its own kind. The stone ax and club were replaced by such tools as a knife, an arrow, a dart, a battle ax, a saber, a sword, etc. With the invention of gunpowder, the era of firearms began, which began to improve rapidly and over a relatively short period of time - about 200 years, has undergone dramatic changes. However, no matter how condescendingly today we look at the guns of the era of Peter the Great, a qualitative leap in the development of means of destruction of manpower occurred precisely when the first shot from a primitive gun sounded.

From 2 to 7 July 1995 in Munich, under the auspices of the European Federation of National Associations of Orthopedic Traumatologists (EFORT), a major forum of traumatologists and orthopedists of Europe was held. 30 national associations of orthopedic traumatologists, 17 specialized European societies took part in its work. For 7 days, more than 1.5 thousand participants were able to exchange scientific and practical experience, having listened to a total of 505 messages, familiarized themselves with 482 poster presentations, 57 video demonstrations.

50 years have passed since the Victory of the Soviet people in the Great Patriotic War of 1941-1945, but the memory reliably preserves the events of that time... The war was hard, painful and bloody, the victory over the formidable, strong, insidious enemy went to our people at the cost of enormous efforts , suffering and sacrifice. Physicians, including surgeons, were no exception, and they faced enormous difficulties, and the war demanded many sacrifices from them. We remember our friends and comrades and pay tribute to their memory.