Vol 7, No 1 (2000)

Analysis of pathologic changes in neuromuscular system developing during distraction osteosynthesis has been performed using biomechanic tests and EMG. The main reflex dysfunctions on the segmental level of biocontrol for periarticular muscles that results in hypertonia and blocking of adjacent joints are determined. The possibility to apply the functional biocontrol with feedback using EMG for contracture correction at limb lengthening is substantiated. Clinical use of this method is presented.

Experiments in 91 rabbits were performed to study the action of proteolytic enzyme - papaine (lekozime, «Lek», Yugoslavia) in small doses (0.5-1.0 mg) and alcohol (in concentrations 24%, 48%, 96%) on the structure of intervertebral disks. 359 intervertebral disks were examined using light and electron microscopy. Morphologic data showed that under papaine effect the gradual substitution of the hydrated tissue of nucleus pulposus by fibrous tissue, decrease of intervertebral space and formation of not mobile block between two displaced vertebral bodies took place. Data obtained during experiments allowed to apply intradisk injection of papaine in small doses for the treatment of cervical intervertebral disk pathology, and gave the possibility to elaborate new method for the treatment of cervical osteochondrosis. That method was used in 89 patients. Follow-up period ranged from 3 months to 9 years. Positive results preserved in 95.2%o of patients. Indications and contraindications for the application of elaboration method were defined on the base of experimental and clinical data, outcomes and treatment efficacy.

Roentgenologic features for diagnosis of thoracic, thoracolumbar and lumbar osteochondropathy were analysed in 250 patients, aged 11-44. The following dysplastic deformities of vertebral motion segments were detected: dysplastic deformities of intervertebral disks and vertebral bodies; dysplasia of vertebral arches; dysplasia of intervertebral joints; dysplastic deformities of transversal processes. Data obtained allow to confirm that spine osteochondropathy (Sheuermann's disease) is a dysplastic process the nature of which is the structural abnormality of the endplates and concomitent disturbance in vertebral body growth plates. Detected dysplastic deformities in vertebral segments may be either of congenital origin or acquired ones resulted from morphogenesis disorder.

The aim of the study was to investigate the EEG changes in patients with coxarthrosis before and after total hip arthroplasty depending on the volume of blood loss during operation as well as to detect the peculiarities of EEG changes at uni- or bilateral total hip replacement. EEG analysis was performed in 71 patients with coxarthrosis of III degree, aged 20-72, who underwent total hip arthroplasty. It was detected that abolition of pathologic focus in hip joint resulted in the improvement brain electric activity by day 30 after operation. Positive dynamics detected by day 30 after operation was more marked in abolition of the second pathologic focus in patients with bilateral coxarthrosis. In unilateral total hip replacement the pathologic focus in the other hip joint supports the brain electric activity similar to those in unilateral coxarthrosis prior to operation. Application of diphenine restores the EEG parameters by day 20 after operation.

Among 26 children with soft tissue ossification 5 patients with pseudomalignant heterotopic ossification were analysed. All patients underwent surgery and were cured. Authors’ presentation emphasizes the importance of the performance of sparing operation after ossification «maturation» as well as local application of steroids, appropriate use of immobilization and accurate rehabilitation.

Substitution of skull defect by transfer of vascularized or free bone grafts within the defect was investigated in 131 dogs. It was shown that distraction regenerate formed in the diastasis from both the side of fragment and the defect margin from which the fragment was transferred. On the day 7 of distraction the bone trabeculae oriented along the fragment transfer were formed. Distraction bone regenerate acquired zone structure in which two bones areas and connective tissue layer -«growth zone»- were distinguished. During 3 weeks observation period the areas of active osteogenesis were noted on the border of the connective layer and bone segment, and structural remodelling of the newly formed bone took place. Similar time-dependent process as well as the regenerate structure were described during distraction osteosynthesis of long bones. Regenerate process was more marked when vascularized bone fragment was transferred within skull defect.

In recent years, in the complex examination of patients with damage to the knee joint, we include a technique for recording sounds that occur in the joint during movements - arthrophonography. Our previous publications have shown the diagnostic capabilities of this method, which makes it possible to qualitatively and quantitatively assess the degree of slip impairment with increased friction in the affected joint [1–4].

The conference took place on February 16-17, 2000 at the Central Institute of Traumatology and Orthopedics named after A.I. N.N. Priorov. In its organization, in addition to CITO and the Ministry of Health of the Russian Federation, the Moscow branch of the Russian Association for Osteoporosis took an active part. Such a large-scale event on the problem of osteoporosis among orthopedists and traumatologists was held for the first time and aroused great interest, as evidenced by its “geography” (most regions of Russia, Ukraine, Belarus, Lithuania were represented) and the number of participants (209 people).

On December 10, 1999 Professor G.I. Lavrishcheva, the country's largest morphologist in the field of regeneration and transplantation of supporting organs.

On October 25, 1999, in the 82nd year, after a long illness, the life of Doctor of Higher Sciences, Professor E.G. Lokshin.