Vol 7, No 1 (2000)

Original study articles

Pathophysiological mechanisms of formation of joint contractures during limb lengthening and their correction by functional biofeedback

Mironov S.P., Kosov I.S., Malakhov O.A., Samkov A.S., Kozhevnikov O.V.


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.

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):3-8
pages 3-8 views

Design of navigation technologies for traumatology and orthopedics: state of the problem and prospects

Nazarenko G.I., Cherkashov A.M., Nazarenko A.G.


The basis of the projection of navigation technologies in traumatology and orthopaedics are presented. The stages for the application of navigation technologies for the planning and performance complex surgical interventions which have traditionally rather high rate complications are described in details. Application of navigation program methods allows to achieve the main aim of modern surgery, i.e. treatment quality and provision of patient’s safety. The organization of region surgical centers for navigation planning is substantiated.

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):8-15
pages 8-15 views

Method of treatment of cervical osteochondrosis by intradiscal administration of small doses of papain: morphological substantiation and clinical application

Vetrila S.T., Pogozheva T.I., Styablin N.I.


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.

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):16-22
pages 16-22 views

Decompressive and stabilizing operations in the treatment of patients with tumors of the vertebral bodies

Protsenko A.I., Aliyev M.D., Tomsky M.I., Kallistov V.E.


Results of surgical treatment of 105 patients with vertebral body tumors are presented. Depending on the tumor type, manifestation of spinal disorders and patient’s general condition different decompression and stabilizing operations were performed. Forty seven patients underwent decompressive laminectomy. The choice of that surgical intervention was stipulated by the severity of patient’s condition and impossibility to perform more radical operation. The outcome of that operation was determined to be of short duration and did not prevent the spinal complications. In 58 patients decompressive-stabilizing operations were performed. In 31 out of those patients the anterior approach was used. Results showed the advantages of the later operations not only in benign tumors, but in malignant ones or metastatic vertebral body lesions. Operations by anterior approach with spine stabilization using carbon implants are the most perspective for the treatment of patients with metastatic lesions.

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):22-25
pages 22-25 views

Dysplastic deformities of the vertebral segments in osteochondropathy

Gruntovsky G.H., Kolesnichenko V.A.


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.

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):26-30
pages 26-30 views

Postoperative dislocation of the head of the hip endoprosthesis and ways to prevent it

Rybachuk O.I., Besedinsky S.N.


428 primary and 20 revision hip arthroplasties (384 patients) were performed during 1992-1998 at Republic Center of Arthroplasty. Hip dislocation was observed in 10 patients. Seven of those hips dislocated during the second postoperative week. Two cases of the recurrent and one case of old dislocation are described. It is shown that the incorrect orientation of acetabular component contributes to hip dislocation. Reduction should be performed under anesthesia with musculature relaxation. In case of recurrent or old dislocations open reduction is indicated. Prevention of hip dislocation must be performed both during intra- and postoperative period.

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):31-35
pages 31-35 views

Changes in the bioelectrical activity of the brain in total hip arthroplasty

Barabash I.V., Barabash A.P., Arsentiev N.I.


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.

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):36-41
pages 36-41 views

Surgical treatment of fresh closed patellar ligament injuries

Girshin S.G., Lazishvili G.D., Lishansky A.D.


The study was performed on the basis of surgical treatment results of 69 patients with acute patellar ligament injury. Classification of patellar ligament injuries was considered. Procedures of restoration operations elaborated by authors and their advantages of this technique are shown. Recommendations for postoperative and rehabilitation management are given. Complications have been analysed as well as technical errors. High rate of good long-term results (81,2%) allows to recommend these procedures for the clinical practice.

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):42-46
pages 42-46 views

Pseudo-malignant heterotopic ossification in children

Berezhny A.P., Morozov A.K., Snetkov A.I., Berchenko G.N., Frantov A.R.


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.

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):47-55
pages 47-55 views

Surgical treatment of transverse flat feet, hallux valgus

Istomina I.S., Kuzmin V.I., Levin A.N.


In 766 patients with transverse flatfoot, hallux valgus (1454 feet) the reconstructive operations by CITO technique were performed. The procedure is aimed at the elimination of all components of the deformity and consists in the removal of bone-cartilagenous vegetations along the medial margin of the head of the first metatarsal bone, resection of the base of the proximal phalanx of the great toe (Keller’s operation), transverse subperiosteal osteotomy near the base of the proximal phalanx of the great toe with preservation and bent fracture of external cortex and insertion of the wedge into osteotomy zone. Strengthening of the transverse ligament was performed by passing the lavsan band around the first and fifth metatarsal bone and between metatarsal bones and soft tissues on the plantar side in figure-of-eight. In 337 operations long term results were evaluated in terms from 1 to 23 years. Good results were achieved on 1094 feet (81,8%), satisfactory results - on 211 feet (15,8%) and unsatisfactory results - on 32 feet (2,4%).

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):55-60
pages 55-60 views

Morphological characteristics of the early stages of the reparative process during the replacement of skull bone defects by the method of dosed distraction (communication II)

Shevtsov V.I., Chirkova A.M., Dyachkov A.N.


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.

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):61-66
pages 61-66 views

Functional Studies of Peripheral Circulation and Tissue Microcirculation in Traumatology and Orthopedics: Opportunities and Perspectives

Krupatkin A.I.


Based on the long-term experience the necessity of angiologic investigations in traumatology and orthopedics is defined. Classification of the modern instrumental methods for the examination of peripheric blood circulation and tissular microcirculation of locomotor system is suggested. The main perspective directions of the investigations are defined. They include the study of angiologic peculiarities in injuries and orthopedic diseases, diagnosis of pre- and postoperative vascular disturbances, their prevention and treatment.

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):66-69
pages 66-69 views

From Practical Experience

Changes that develop after damage to the menisci of the knee joint in a symmetrical joint

Chantsev A.V., Raspopova E.A., Kuznetsov G.L., Kravchukov I.V.


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].

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):70-71
pages 70-71 views

Rare toe injury

Zolotov A.S.


Dislocations in the interphalangeal joints of the toes are rare. In this case, as a rule, the first finger is damaged. Dislocations in the interphalangeal joints of the remaining fingers are extremely rare. If the plantar fibrous plate is infringed in the joint cavity, the dislocation becomes irreducible and requires surgical treatment [1].

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):72-73
pages 72-73 views


Report on the All-Russian Conference with international participation "The problem of osteoporosis in traumatology and orthopedics"

Rodionova S.S., Kolondaev A.F.


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).

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):73-74
pages 73-74 views


Galina Ivanovna Lavrischeva


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

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):75-75
pages 75-75 views

Otar Shalvovich Buachidze


O.Sh. is 75 years old. Buachidze, Head of the Department of Traumatology and Orthopedics of the Moscow Regional Research Clinical Institute, Chief Traumatologist and Orthopedist of the Moscow Region, laureate of the Prize of the Government of the Russian Federation, Honored Doctor of Russia, full member of the Academy of Medical and Technical Sciences, Professor, Doctor of Medical Sciences.

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):76-76
pages 76-76 views


To the memory of Elena Gavrilovna Lokshina


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

N.N. Priorov Journal of Traumatology and Orthopedics. 2000;7(1):79-79
pages 79-79 views

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