Vol 28, No 1 (2021)

Articles

Uniting the traumatological and orthopedical service of the country

Mironov S.P., Ochkurenko A.A., Ochkurenko N.V., Perminov V.A.

Abstract

On April 22, 1921, the Moscow Medical and Prosthetic Institute was founded. Nikolay N. Priorov (MD, PhD, professor, academician of the USSR Academy of Medical Sciences) was the founder and permanent leader of the institute for 40 years. In 1930, the facility was renamed into the Moscow Regional Institute of Traumatology, Orthopedics, and Prosthetics. Before World War II, in 1940, the institute became known as the Central Research Institute of Traumatology and Orthopedics, known as CITO as the leading national institution for traumatology and orthopedics. For a century, CITO employees has been conducting clinical, research, educational, and methodological activities providing comprehensive assistance in all regions of the country. In 2018, CITO was the first traumatological and orthopedics centers to be transformed into the Federal State Budgetary Institution “National Medical Research Center of Traumatology and Orthopedics named after N.N. Priorov” of the Ministry of Health of the Russian Federation which significantly increased the role of the institution in traumatology and orthopedics, especially managemental, analytical, educational, and methodological activities. The 15 clinical departments and various laboratories of the center conducted research work and provide specialized medical care, including high-tech traumatological, orthopedic, oncological, and neurosurgical patient care.

N.N. Priorov Journal of Traumatology and Orthopedics. 2021;28(1):7-15
pages 7-15 views

Peculiarities of spinopelvic fixation in deformations and traumatic injuries of the spine

Vetrile M.S., Kuleshov A.A., Makarov S.N., Lisyansky I.N., Kokorev A.I., Aganesov N.A., Zakharin V.R.

Abstract

AIM: to evaluate the effectiveness of spinal pelvic fixation with screws inserted through the S2 vertebra into the ilium (S2AIS technique) and the use of individual pelvic support plates.

METHODS. The analysis of the results of performing spinal-pelvic fixation in 74 patients with various pathologies of spine column and traumatic injuries (66 patients — S2AIS technique, 8 patients — fixation with individually made implants) was carried out.

RESULTS. The long-term follow-up period for the patient averaged 23.5 months (from 6 to 48 months). In the group of patients with fixation using the S2AIS method, the absence of complications, requiring repeated treatment, and stable fixation in the long-term follow-up period was noted in 53 cases (78.7%). The overall incidence of malpositions out of the total number of screws established was 4.3%; only one case (0.7%) required reoperation. Fracture of the metal implant rod at the L5-S1 level (15.2%), fracture of the screws in the ilium (5%) and instability of fixation with resorption of bone tissue around the screws in the S1 vertebra and in the ilium (3%). With fixation using individual support plates, stable fixation of spinopelvic fixation in the long-term period was achieved in 5 cases; in three cases, the implants had to be removed.

CONCLUSION. Installation of iliac screws using the S2AIS technique is the optimal method of spinopelvic fixation, allowing reliable fixation with minimal complications. In cases where traditional methods of spinopelvic fixation are impossible or technically difficult, fixation with customized implants is possible.

N.N. Priorov Journal of Traumatology and Orthopedics. 2021;28(1):17-27
pages 17-27 views

Aspects of surgical treatment in a petient with Isaac’s syndrome

Koryshkov N.A., Mikhailova L.K., Khodzhiev A.S., Litvinov I.I.

Abstract

This article presents a clinical case demonstrating the correction treatment of the lower extremities in a patient with Issac’s syndrome, as well as the results of ankle surgery and successful post-surgery rehabilitation. The high efficiency of surgery as a treatment method was confirmed.

N.N. Priorov Journal of Traumatology and Orthopedics. 2021;28(1):29-34
pages 29-34 views

Influence of femur condylus dysplasia on development of mediopatellar synovial fold hypertrophy

Ochkurenko A.A., Morozov A.K., Kurpyakov A.P., Gorokhvodatsky A.V., Ivanov K.S., Karpov I.N.

Abstract

Among all anatomic folds of the knee joint, mediopatellar synovial fold has the highest rate of pathological changes that also have influence on adjacent anatomical structures. Presence rate of mediopatellar fold is 46–50% according to cadaveric data and 18–80% according to data acquired in an arthroscopic way. In this work, we studied the possible link between femur condylus dysplasia and forming of the mediopatellar fold. The MRI study was done to 116 patients divided into two equal groups (58 patients in each). The main group (group I) included patients with detected femur condylus dysplasia, the control group (group II) — patients without detected femur condylus dysplasia. Our results suggest that in the main group the mediopatellar fold is detected in 53 patients (91,4% of all cases), in the control group — in 4 patients (6,9% of all cases). The results support our hypothesis that while performing the arthroscopic treatment of the patologically thickened mediopatellar synovial fold, the dysplasia of femur condylus must be taken into account.

N.N. Priorov Journal of Traumatology and Orthopedics. 2021;28(1):35-43
pages 35-43 views

Surgical treatment of Jeune syndrome in a child (rare clinical case and review)

Komolkin I.A., Mushkin A.Y., Agranovich O.E., Afanasiev A.P.

Abstract

Objective: possibility of surgical treatment of chest deformity in children with Jeune syndrome (analysis of the clinical case), review of literature on Jeune syndrome in children.

Methods: clinical, radiological, laboratory, instrumental, statistical.

Results: Positive outcome of surgical treatment of a 3-year-old patient with severe chest deformity and severe respiratory failure.

Conclusions: Jeune syndrome is a severe disease with a high mortality rate. A multidisciplinary approach is required in the treatment of patients with this pathology. Surgical intervention aimed at reducing the compression of the chest organs and increasing its volume, even in conditions of decompensation, allows you to stop the phenomenon of respiratory failure.

N.N. Priorov Journal of Traumatology and Orthopedics. 2021;28(1):45-52
pages 45-52 views

Validation and cultural adaptation of Russian version of KOOS-Child questionnaire

Ivanov Y.A., Yeltsin A.G., Mininkov D.S.

Abstract

Introduction. In our research 100 patients (51 male and 49 female) aged below 18 were assessed with the following knee problems: meniscal, anterior cruciate ligament, posterior cruciate ligament tears, mediopatellar plica syndrome, osteochondritis dissecans.

Aim: validation and cultural adaptation English version of KOOS-Child questionnaire for Russian language children and adolescent patients. Also, for using in N.N. Priorov National Medical Research Center of Traumatology and Orthopedics and other medical hospitals of Russian Federation.

Materials and methods. KOOS-Child has been translated in Russian language by orthopedist who is advanced in English and by professional medical translator. For control group we used Lysholm knee score. After all procedures statistical analysis was used. It consists of 3 stages: general data analysis, validation checking of questionnaire, checking objectivity and relevance of results.

Conclusions. Cronbach’s alpha test score shows up very high-level consistency of the questions (0,959). Questions have high discriminatory power and results of assessment are objective and adequate. Methods of statistical analysis showed up that questionnaire can be use in practice by orthopedist.

N.N. Priorov Journal of Traumatology and Orthopedics. 2021;28(1):53-64
pages 53-64 views

Core decompression of the femoral head. Literature review

Panin M.A., Zagorodniy N.V., Abakirov M.D., Boyko A.V., Ananyin D.A.

Abstract

Avascular necrosis (AVN) of the femoral head is a disease, characterized by the death of osteocytes and bone marrow, leading to collapse of the femoral head and dysfunction of the hip joint. There are many known risk factors for the development of this disease including trauma of the hip joint, hemoglobinopathy, alcoholism, taking corticosteroids, collagenosis, etc. Conservative treatment (drug therapy using vascular drugs, bisphosphonates, chondroprotectors, NSAIDs, physiotherapy, exercise therapy) is shown for any stage of the hip AVN, however, surgical treatment has a higher potential. The key to successful treatment is the detection of AVN at an early (pre-collapse) stage to prevent subsequent collapse by performing organ-sparing surgical interventions that reduce the rate of disease progression and allow delaying of the hip replacement. The literature describes a number of organ-preserving operations performed at an early stage of AVN. Currently, there are three main areas of surgical treatment of this disease: classical decompression of the femoral head, decompression using various types of grafts and combined treatment using various cellular technologies. This literature review is devoted to the consideration of the indications for implementation, as well as the results of treatment of patients using the above techniques.

N.N. Priorov Journal of Traumatology and Orthopedics. 2021;28(1):65-76
pages 65-76 views

Surgery features of aneurysmal bone cysts of the spine in children

Snetkov A.A., Gamayunov R.S., Kuleshov A.A., Kolesov S.V., Akinshina A.D.

Abstract

The article presents the long-term experience of stepwise surgical treatment of pediatric patients with aneurysmal cysts of the spine. The considered material is based on the data of long-term results and various approaches to the resection technique of pathological neoplasm; each approach takes into account the localization, lesion volume, spine growth potential, neurological status, secondary spinal deformity.

N.N. Priorov Journal of Traumatology and Orthopedics. 2021;28(1):77-88
pages 77-88 views

Anterior cruciate ligament injuries in the prepubescent and adolescent. Modern trends and researches

Ivanov Y.A., Yeltsin A.G., Mininkov D.S.

Abstract

The article represents a literature review of research on diagnostics and treatment of ACL tears and intercondylar eminence fractures in children and adolescence published between 2015 and 2020. We scrolled the following databases: Google scholar, Pubmed, and eLilbrary. Today knee injury with isolated ACL tears in young patients is growing more frequent due to their enhanced participation in extreme sports and other organized leisure activities where the risk of injury perceives. The injury with isolated ACL tears represents 1/4 of all knee injuries. Apart from extreme activities there is another risk factor that causes ACL tears — late surgical involvement. Partial ACL tears and surgical techniques of skeletal immature patients (extraphyseal and all-ephyseal) were analysed in this study too. This work also includes the subject of re-fixation of fresh ACL rupture. Perspectives of return to sports of young athletes were also analysed. The most common predictive factor of returning to sports is a patient’s age. Young children return to their usual physical activities more promptly. Questions of proprioceptive impact on bio-mechanics and graft re-innervation also raised. The problem of ACL tears in children and adolescent patient are relevant. It needs more researches and improvements of surgery techniques.

N.N. Priorov Journal of Traumatology and Orthopedics. 2021;28(1):89-107
pages 89-107 views

Development of approaches to treatment of knee instability. Review

Orletskii A.K., Timchenko D.O., Gordeev N.A.

Abstract

Over the past 20 years, interest in the treatment of patellar instability has increased significantly, many actual surgical techniques have been presented in the publications. The article discusses the development of approaches, issues on the treatment of patellar instability, indications and contraindications for different interventions.

N.N. Priorov Journal of Traumatology and Orthopedics. 2021;28(1):109-120
pages 109-120 views


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