Vol 8, No 3 (2001)

The life and health of children is the health of the future of Russia, and therefore the protection of motherhood and childhood, the formation of state policy in this area are a priority area, the cornerstone of the strategic development of health care.

Original method for clinical evaluation of the hip functional state in children and adolescents is presented. This method includes passport data, case history, subjective signs, special functional test and motor tasks, clinical and instrumental examination. Every sign is assessed in points: 5 points — absence of pathological changes and this corresponds to function compensation; 3—4 points — moderately marked changes — subcompensation; less than 3 points — marked changes — decom­pensation. Final evaluation of the hip functional state is the integral index. 107 joints in 83 patients with various hip dysplasias were examined. All patients were on target rehabilitation treatment that resulted in the improvement of the functional state. The repeated postrehabilitation testing showed increase in integral index within 1—2 points. In 30 patients the compensation of function was achieved, 34 patients subcompensation was observed. Decompensation persisted in 19 patients.

The technique for the treatment of crus malformation accompanied by popliteal pterygium is suggested. The method consists of three stages. First stage is the lengthening of m. gastrocnemius and dissection of tape and cord-like bands. In the second stage hinge distraction device is applied and asymmetric distraction is performed, then pterygium popliteal fold is distended and incorrect position of the limb is eliminated. During the third stage the additional foot is resected and ligaments of knee joint are created from the muscular tendon of the additional foot.

The work was grounded on the analysis of the examination data and treatment results of 130 patients with uncomplicated rotator cuff injuries. Clinical manifestation and radiographic find­ings were described for the different types of injuries. Differentiated methods for the treatment were suggested. Forty two patients with partial local cuff injuries were on conservative treatment. In 38 patients that treatment was successful and in 4 patients with degenerative cuff changes the treatment was failed. Ninety two patients were operated on. Good and excellent results were achieved in 90.2%) of cases, satisfactory and poor — in 9.8%. Poor outcomes (4 patients) were resulted from formation of acromion pseudoarthrosis and development of wound infection, satis­factory outcomes (5) were resulted from cuff suture failure and scar development in defect plasty.

Influence of low intensive laser irradiation (LILI) on the healing of the infected osseous and soft tissue wound in experimental open fracture was studied using transmission and electron micros­copy. LILI provided antimicrobic affect on the infected wounds increasing phagocytosis by neutrophiles and accelerating the formation of callus.

The use of «scarf» osteotomy in 9 patients (14 feet) with valgus deformity of great toe was analysed. That technique was showed to provide stable correction of varus deviation of the first metatarsal bone and valgus deformity of the great toe as well as correction of the length of the first metatarsal bone and elimination of its pronator rotation without development of avascular necrosis of the head in postoperative period. Rigid fixation of bone fragments provides the possibility of early activization and rehabilitation of patients.

The monitoring system for the course of deforming gonarthrosis based on the basis of quantitative estimation of the main disease signs is suggested. Significance of a sign is evaluated in scores according to the used clinical classification of deforming osteoarthrosis. There were 23 patients with deforming gonarthrosis. Graphic imaging of course severity of the disease as well as efficacy of the treatment is suggested. Revealing of the characteristic types of disease course allows to control and correct management as well as to detect the indications to operative treatment.

The founders of the method of segmental resection of the limb as an alternative to its amputation are Russian surgeons P.I. Tikhov and N.A. Bogoraz. At the beginning of the 20th century, they put forward the idea - to preserve the unaffected peripheral (functionally most valuable) section of the limb on the main vessels and main nerve trunks in case of tumors of the bones of the limbs, resecting its central section (segment).

Anesthesiological and resuscitation support during surgical interventions in children with systemic skeletal diseases (SDS) presents certain difficulties. This is due to the functional changes in such patients and the insufficiency of various organs and systems, as well as the disproportionate development of the facial part of the skeleton and deformation of the chest, which makes it difficult to intubate the trachea, impaired airway patency with possible subsequent development of respiratory insufficiency. Often used during operations on the extremities, the application of a tourniquet leads to the development of severe tachycardia, hypertension, aggravation of metabolic acidosis and intoxication, which are extremely difficult to stop, especially in this group of children with pneumosclerosis and cardiopathy.

In 2000, the Higher Attestation Commission of Russia in the specialty 14.00.22 (traumatology and orthopedics) reviewed and approved 122 dissertations, including 30 (24.6%) doctoral (in 1999 - 19, or 18.6% ) and 92 (75.4%) candidates (in 1999 - 83, or 81.4%). There were no dissertations rejected. There were no violations of the “Regulations of the Higher Attestation Commission of the Russian Federation” during the defense of dissertations.

In July 2001, Doctor of Medical Sciences, Professor of the Department of Traumatology, Orthopedics and Military Field Surgery of the Moscow State Medical and Dental University, Honored Scientist of the Russian Federation, Honored Inventor of the Russian Federation Aidyn Saparovich Imamaliev turned 75 years old.

July 13, 2001 was the 60th anniversary of the head of the clinic for pediatric orthopedics of the Central Institute of Traumatology and Orthopedics. N.N. Priorov to the Honored Doctor of the Russian Federation, Doctor of Medical Sciences, Professor, Academician of the Academy of Medical and Technical Sciences, Chief Orthopedist of the Moscow Health Committee, Chief Children's Orthopedic Traumatologist M3 of the Russian Federation O.A. Malakhov.

On January 31, 2001, Doctor of Medical Sciences, Professor M.N. Nikitin. The life of a remarkable scientist, teacher and surgeon was cut short.