Vol 3, No 3 (1996)


75th Anniversary of the Central Scientific Research Institute of Traumatology and 3 Orthopaedics named after N.N. Priorov

Shaposhnikov Y.G.


The birthday of the N.N. Priorov Central Research Institute of Traumatology and Orthopedics. N.N. Priorov was born on April 22, 1921, when the Medical and Orthopedic Institute was opened in Moscow, house 16, Teply Pereulok. Its main purpose was to render aid to invalids of the First World War and the Civil War. The initiative to create the institute belonged to Prof. V.N. Rozanov, a major general surgeon, and Nikolai Nikolaevich Priorov, a young doctor, a former assistant of V.N. Rozanov, was appointed chief physician.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):3-15
pages 3-15 views

Simultaneous Combined Surgical Interventions with Use of Microsurgical Technique for Treatment of Severe Limb Injury Sequelae

Grishin I.G., Goncharenko I.V., Golubev V.G., Evgrafov A.V., Shiryaeva G.N., Bogdashevskiy M.M., Kroshkin M.M., Polotnyanko V.N.


The authors elaborated new tacktics for simultaneous combined reconstructive operations in patients with severe limb injury sequelae. Experience included 268 patients, aged 13-56, who underwent microsurgical operations for restoration of injuried fragment of the limb. The total number of interventions was 589; altogether 474 tendons (169 patients), 277 nerves (194 patients), 76 arteries (114 patients) were restored. For the correction of secondary neurogenic deformity of fingers and wrist (170 patients) 200 operations were performed. In 50 patients plasty with free vascularized skin-bone grafts was carried out. In 22 patients free skin (18 cases), skin-fascial (2 patients) or skin-tendenous (2 patients) plasty was carried out. In 13 patients total elbow joint replacement using Sivash implant, in 3 patients total replacement of metacarpophalangeal and in 1 patient - matatarsophalangeal joints was performed. In 4 patients transposition of broadest muscle of the back was performed due to sequelae of severe damage of shoulder area or elbow joint. Good and satisfactory results were obtaained in 87.6% of cases.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):16-22
pages 16-22 views

Lengthening of Femur by Bliskunov Device Using Application of Different Types of Osteotomies

Bliskunov A.I., Le’kin M.G., Jumabekov S.A., Shuvaev V.G., Kokurnikov V.N., Kuzenko S.N., Dragan V.V., Plotkin A.V., Andrianov M.V., Zarichniy A.V., Tkach A.V., Shpuntov A.E.


One hundred fifty two patients underwent lengthening of 174 femurs with fully implanted guided device inwhich patient’s muscular energy was used as a source of energy. Dissection of bone from the side of bone marrow canal was carried out by specially eleborated osteotome which provided transverse oblique, oblique transverse, Z-shape strraight and Z-shape oblique osteotomy. Transverse osteotomy was applied in 59 patients (33.9%), oblique - in 70 (40,6%), oblique transverse - in 26 (14.9%) patients. Distraction stage was completed in all patients. In 165 (94.8%) out of 174 cases planned volume lehgethening was achieved. In 150 patients devices were removed. Average rate of distraction was 1.4 ± 0,3 mm/ daily, average duration of distraction was 87 ± 13 days. Good results were achieved in 141 cases (94%), satisfactory - in 7 cases (4.6%), unsatisfactory - in 2 cases (1.4%) out of 150. Complications were observed in 30 (17.2%) out of 174 cases. In 9 cases (5.2%) complications influenced the treatment outcome. Analysis of complications showed that they might be to great extent prevented by accurate observance of the technique of distractor implantation, performance of osteotomy, rate of distraction and rational postoperative management of patient.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):22-30
pages 22-30 views

Application of halo apparatus for injuries and diseases of the cervical spine

Vetrile S.T., Kolesov S.V.


The experience of halo-apparatus application is presented in 36 patients, aged 1,5 - 60 years, with injuries and pathology of the cervical spine. There were 12 patients with fractures of the odontoid process, 6 patients with C2 arch fractures, 2 patients with transligamentous dislocation, 1 patient with epiphysiolysis, 5 patients with rotatory subluxation, 2 patients with Jefferson fracture, 2 patients with eosinophilic granuloma, 4 patients with subluxation in the lower cervical spine and 2 patients with discitis. In all cases halo-apparatus showed its high efficacy as a stabilizing and correcting device. Obtained results allow the authors to recommend more wider application of halo-apparatus in clinical practice.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):31-35
pages 31-35 views

Radiographic Findings for Diagnosis of Primary Tumors 35 and Tumor-Like Diseases of Spine in Children

Morozov A.K., Belyaeva A.A., Kornachev A.L.


Retrospective analysis of radiographic semiotics in tumors and tumor-like diseases of spine was performed in 179 children, aged 3-16. Fourteen nosologic forms were revealed, diagnosis was verified morphologically. Eleven patients had malignant tumors (osteogenic sarcoma, Ewing’s sarcoma, malignant osteoblastoma, chondrosarcoma, malignant neuroblastoma); 67 patients had benign tumors (osteoid-osteoma, osteoblastoma, hemangioma, osteoblastoclastoma, osteochondroma, neurogenic tumors, chondroma); tumor-like diseases were revealed in 101 patients (aneurismal bone cyst, eosinophilic granuloma). The peculiarities of radiographic semiotics were described for every nosologic form, differential diagnostic criteria for the most common tumors and tumor-like diseases have been presented.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):35-40
pages 35-40 views

New in Pathogenesis of Pertes Disease

Nechvolodova O.L., Meerson E.M., Mikhailova L.K., Nikitina G.I., Il’ina V.K., Bruskina V.Y., Mitin S.I.


The thesises detected do not allow to keep the pathogenesis of PD within the framework of the theory of primary vessels occlusion. In children with PD marked anomalies including the retardation of bone growth, increased rate of signs of general dysplasia of the connective tissue (detected also in near ralations - parents and siblings), changes of «nondamaged» contralateral head of the femur and spine, disturbance of glycosaminoglycane metabolism, asymmetric retardation of growth of different segments of the limbs. The authors believe that PD is the damage of femur associated with its overloading or another provocing factors that occur on the background of genetically substantiated defect with the damage of bone development. Further infarcts of the head of the femur develop repeatedly and independantly and thus the cupping of PD could be delayed. By the authors opinion PD could not be considerad as femur pathology in a normal child any more but rather as a local manifestation of the general skeleton dysplasia.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):40-44
pages 40-44 views

Arthroscopically Monitored Dynamic Osteosynthesis in Closed Patella Fractures

Kuzmenko V.V., Girshin S.G., Lazishvili G.D., Dubrov V.E., Grishin S.M.


The study is based on the experience of treatment of 52 patients with closed transverse and oblique-transverse fractures of the patella. The problems of diagnosis and treatment of patella fractures with moderate (not more than 5 mm) displacement of fragments are considered. After X-ray exclusion of the severe injury of soft-tissue component of extensive complex of the knee joint the arthroscopy, joint washing from blood, reposition of fragments by instruments, percutaneous dipped osteosynthesis using pins and tightened wired loop quided subfascially are performed. That method was applied in 14 patients. Long term results are studied in 12 patients: complete early restoration of knee function is observed in all cases.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):44-47
pages 44-47 views

Fractures of the Condyle of the Tibia Complicated by Subluxation or Dislocation of the Crus

Mikhailenko V.V., Lirtsman V.M., Antipin S.K.


Twenty seven patients (9 men and 18 women, aged 16-87 years) with the fractures of the condyle of the tibia complicated by subluxation or dislocation of the crus were observed. The authors believe that the most effective treatment method for such injuries is the reposition with apparatuses on the orthopaedic table and simultaneous fixation of the fragments by specialscrew that allows to eliminate subluxation or dislocation of the crus and to perform compression osteosynthesis with firm fixation of the fragments. In severe displacement of the condyle with its angular rotation, disturbance of spongy bone and crus dislocation, open reposition of the fragments and elimination of crus dislocation with the plasty of spongy bone defect using the autografts from the upper flaring portion of te ilium or biocompatible porous ceramics with the fixation of fragments by a screw is indicated. Permanent skeletal traction is much less effective than the surgical methods of treatment.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):47-50
pages 47-50 views

Lasertherapy in Traumatology and Orthopaedics

Berglezov M.A., Vyal’ko V.V., Ugnivenko V.I.


Results of experimental and clinical laser application are presented. Lowenergetic laser was used for the treatment of patients with loco-motor system diseases and injury sequelae. Management of lasertherapy was elaborated; therapeutic action of laser was studied. Application of different methods of lasertherapy (external irradiation, combined lasertherapy, invasive methods) for the treatment of more than 10000 patients showed their high efficacy.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):51-54
pages 51-54 views

Patho- morphologic Peculiarities of the Stages of Osteitis Deformans Develkopment (Paget’s Disease)

Berchenko G.N., Burdygin V.N., Kolondaev A.F.


Pathomorphologic examinations of the biopsy and operative specimens were performed in 39 patients with osteitis deformans who underwent surgery at the department of Bone Pathology in Adults (CITO) during the period fron 1958 to 1995. On the basis of the personal and literature data the authors underlined three stages of the osteitis deformans development that differed by the pathologic peculiarities and activity of the pathologic process: 1st stage - stage of osteolysis characterizing by marked bone resorption; 2nd stage - stage of remodelling characterizing by the combination of disturbance process and formation of new bone; 3rd stage - stage of the attenuation of pathologic process during which the resorption and new bone formation stopped. Application of drugs that inhibit bone tissue resorption is the most expedient in the 2nd and especially in the 1st stage of the disease.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):54-57
pages 54-57 views

Results of Investigation of Theoretical Problems of Reparative Regeneration of Loco-Motor 58 System

Lavrishcheva G.I.


Results of investigations of the restorative processes in loco-motor system injuries are generalized. These investigations performed at the Department of Pathologic Anatomy of CITO from 1930s to 1980s included about 10000 experimental studies (2000 observations) and joint study with traumatologists, orthopaedic and plastic surgeons. Possibility of organotopic regeneration of limbs for the account of mesenchimal resource - skeletogenous tissue is emphasized. However such an outcome of the reparative regeration is possible only under strictly definite conditions created by the surgeon that are specific for different tissues (cartilage, bone, tendon) and in different types of their injury. Some conditions have been formulated for the first time.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):58-61
pages 58-61 views

Medical and Demographic Features of Traumatism Related to Traffic Accidents

Zhuravlev S.M., Theodoridis K.A., Novikov P.E.


In Russian Federation traumatism due tto traffic accidents as well as its influence upon demographic indices are considered. The work is based on the SAI information about traffic accidents and data on 4486 victims with fatal traffic accidents in Moscow and Moscow region from 1991 to 1993. The study shows that traffic mortality in Russia is significantly higher than in USA and this index constantly increases. Injury features and mortality in different age-groups of road users (drivers, passangers, pedestrians, motorcyclists) are presented. Recommendations concerning improvement of primary medical care organization are determined.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):61-64
pages 61-64 views


S.D. Ternovsky, a major pediatric orthopedic traumatologist (100th anniversary of his birth)

Volkov M.V.


Professor Sergey Dmitrievich Ternovsky is considered to be one of the founders of Russian pediatric surgery. At the same time this versatile surgeon, who created his own clinical school, was a recognized traumatologist. In the last years of his life he was the Chairman of Moscow Scientific Society of Orthopedic Traumatologists. His close friends were N.N. Priorov, V.N. Blokhin, F.R. Bogdanov, N.P. Novachenko, V.D. Chaklin, M.O. Friedland, B.P. Popov, T.S. Zatsepin.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):65-66
pages 65-66 views

A.E. Rauer (on the 125th anniversary of his birth)

Cherkasova G.I.


March 28, 1996 was the 125th anniversary of the birth of Alexander Eduardovich Rauer, a man who operated on the face, restoring an image disfigured by war. A bloody mask instead of a face, a gaping wound instead of a nose, splinters of bones and teeth sticking out instead of jaws, mooing instead of speech - all this was horrifying and repulsive. All this is the face of war. We know from the history of past world wars how terrible the fate of those who were wounded in the face was. The orderlies sometimes left such wounded on the battlefield, considering them doomed to death. Bitter was the fate of those who were brought to hospitals: they could not drink, feed and nurse them. They died not from wounds, but from exhaustion. The survivors were doomed to wear a white mask on their face, hiding the face with the stigma of war under it. There were few surgeons who tried to perform reconstructive surgeries. Plastic surgery as an independent branch of medicine at the beginning of the century were making their first steps Wounded in the face were afraid to leave the walls of hospitals, afraid to appear in human society. The stigma of war deprived them of the joy of being, communication and family.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):67-69
pages 67-69 views

Wounding of Marshal (commemorating the 100th anniversary of K.K. Rokossovskiy)

Kaplan A.V.


On March 8, 1942, during the offensive period of the Battle of Moscow, the famous commander of the 16th Army, Lieutenant General Rokossovsky was sitting with his back to an open window in a small hut, where the army headquarters was temporarily located. At 10:30 p.m. artillery shelling of the small village began. A shell fragment exploded in the street and wounded the commander. A strong blow to his back threw him to the middle of the room. He didn't lose consciousness, complaining of backache. The first aid was given to him by the staff physician, 3rd rank 3. Ibragimov: put aseptic dressing on the wound, administered morphine and tetanus serum.

N.N. Priorov Journal of Traumatology and Orthopedics. 1996;3(3):69-72
pages 69-72 views

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