Saratov JOURNAL of Medical and Scientific Research

Barabash A.P.

Saratov Science Research Institute of Traumatology and Orthopedics, Department of New Technologies in Orthopedics, Professor, Doctor of Medical Science

Justification of intramedullary fixation devices modification and first clinical experience of application of the SarNIITO nails for femur shaft osteosynthesis

Year: 2019, volume 15 Issue: №1 Pages: 52-57
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Barabash А.Р., Norkin I.A., Barabash Yu.A., Ivanov D.V., Zuev P.P., Shpinyak S.P.
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Summary:

Objective: to estimate the changes of effective stresses (by Mises) at three types of loads (axial, lateral and twisting) for various types of intramedullary nails synthesizing modeled fractures of A1; A3; B2 types at the level of femur bone middle third. Material and Methods. To solve the preclinical tasks computer simulation of biomechanical systems bone-fixing pin and method of finite elements were employed. Results. The nails developed by SarNIITO excel ChM and Fixion rods in stress-deformed condition, fatigue strength and stability of fixation of the examined types of fractures parameters of 12- 23%. Conclusion. The mechanical characteristics of SarNIITO nails proved to be of clinical use and may be recommended for patients with femur bone diaphysis fractures.

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Comparative analysis of external osteosyn-thesis in the treatment of patients with extraarticular fractures of proximal femur

Year: 2018, volume 14 Issue: №3 Pages: 552-557
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Kauts О.А., Barabash Yu.A., Barabash А.Р., Grazhdanov К.А., Shpinyak S.P.
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Aim: to perform comparative analysis of surgical outcomes of patients with extraarticular fractures of proximal femur with the use of various types of external osteosynthesis. Material and Methods. 169 patients with extaarticular fractures of proximal femur who underwent surgical interventions with various kinds of external osteosynthesis were the subject of the study. Results. Extra-cortical osteosynthesis with DHS-construction provided the restoration of anatomic and functional characteristics by 90.3±0.6% of normal values in the short-term and by 95.2±0.4% in the long-term postoperative period. The implantation of intramedullary constructs resulted in high percentage of positive short-term (92.1±0.6%) and long-term (96.7±0.75%) treatment outcomes. Conclusion. The use of intramedullary osteosynthesis

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Intramedullary osteosynthesis in the treatment of humerus fracture consequences

Year: 2018, volume 14 Issue: №3 Pages: 523-529
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Grazhdanov К.А., Barabash А.Р., Barabash Yu.A., Kauts О.А.
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Aim: retrospective analysis of surgical treatment results of patients with the consequences of humerus fractures by locking intramedullary constructions. Material and Methods. 69 patients with ununited fractures and false joints of humerus diaphysis (39 females, 56.7±11.5 yrs (56.5%) and 30 males, 52.3±9.8 yrs (43.5%)) comprised observation group. In the course of surgical intervention they were treated by locking intramedullary rods to perform fragment anchorage, this including 12 patients (17%) with ununited humerus diaphysis fractures after conservative treatment, and 57 (83%) with false humerus joints. Clinical (limb functional restoration) and X-ray (integrity signs) methods were applied for the diagnostics and control of integrity restoration in bone structures; for the assessment of treatment outcomes we used standardized system of outcomes of locomotor fractures and their consequences (SOI-1). Results. Consolidation of the fracture up to 6 months postoperatively was observed in all patients with ununited humerus fractures, treatment outcomes by SOI were 85-94% of anatomic and physiological norm. The consolidation of humerus bone occurred in 50 patients with false joints with

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The dynamics of patients' life quality indices under the conditions of two-stage knee joint replacement

Year: 2017, volume 13 Issue: №3 Pages: 768-772
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shpinyak S.P., Fedonnikov A.S., Barabash А.Р., Barabash Ju.A.
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 The aim: to analyze the changes in the life quality indices of the patients with deep periprosthetic joint infection of the knee under the two-stage surgical treatment. Material and Methods. 57 patients who underwent two-stage revision-ary treatment in Research Institute of Traumatology, Orthopedics and Neurosurgery were interviewed with life quality questionnaire Short Form Medical Outcomes Study (SF 36 v.1). Interview results were compared with standardized population indices of SF-36 scales for males and females. Results. In all groups regardless of sex there was a general tendency for an increase in physical and psychological health component up to mean population values after the first stage of surgery and further growth after the second stage. Rehabilitation potential of psychomotor health was higher in women than in men. The ability to handle stress was lower in direct ratio with the patients' age. Conclusion. Two-stage reendoprosthetic treatment with articulating antimicrobial spacer implantation having high grade of fixation is an effective treatment method for deep periprosthetic infection which increases physical health and improves social functioning of patients.

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Treatment of bone defects of tibia edge during external anchorage of fragments

Year: 2017, volume 13 Issue: №3 Pages: 727-731
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Grazhdanov К.А., Barabash А.Р., Barabash Yu.A., Rusanov A.G., Kauts O.A.
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The aim: to identify the efficiency of the improved technology of treatment of tibia marginal defects with the use of granular composite osteoplastic materials during external fixation of fragments. Material and Methods. The observation group was made up of 12 patients with the consequences of lower extremity traumas who had undergone osteosyn-thesis of fractures by an external fixation device with defect alloplasty We used clinical and ray-tracing testing methods and also standardized system of assessment of outcomes of bone fractures and their consequences to control the processes of restoration of bone structure integrity. Results. According to the standardized system of assessment of outcomes in 12-18 months in the course of the rehabilitation measures degree of restoration of anatomic functional indices was 92±5%. Bone density made up 91,3±0,54 HU (p<0,05) before surgery according to the Hounsfield scale, increase in the given parameter was observed in a month and a half after surgery up to 153,1 ±0,97 HU and in 3 months up to 162,7±0,78 HU. Conclusion. Application of granular composite osteoplastic materials for plastic surgery of tibia marginal defects during external fixation of fragments allow us to carry out anatomic reconstruction of the bone reducing surgery injury rate based on the absence of necessity of taking autogenous tissues from the other zones.

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Changes in internal architectonics of proximal femur in children with hip dysplasia development

Year: 2014, volume 10 Issue: №4 Pages: 635-638
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Dokhov M.M., Barabash A.P.
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The aim of the research is to identify common patterns of compensatory changes in internal architectonics of the proximal femur with valgus and varus deformity. Material and Methods. The parameters of the proximal femur were determined on the basis of 78 roentgenograms of children with hip dysplasia (1-4 years, 4-7 years, 7-16 years) before and after surgical treatment (after 6 months). Results. The degree of change in internal architectonics of the bone substance has been determined after changing of the femoral neck-shaft angle achieved with the help of correcting osteotomy in different age groups. Conclusion. Maximum recovery of internal architectonics of the bone substance is observed in the groups aged 4-7 years.

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Organization and development of surgical rehabilitation of patients with traumas and their effects

Year: 2012, volume 8 Issue: №2 Pages: 313-317
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Norkin I.A., Chernyshov V.V., Barabash А.P.
Organization: Saratov Scientific Research Institute of Traumatology and Orthopedics
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Objective: To improve the efficiency of surgical rehabilitation of patients with traumas, their effects. Materials and methods: Short-term and follow-up results of the surgical treatment of patients with traumas and their effects have been analyzed. Statistical research methods have been used. Results: the efficiency of medical technologies during the early rehabilitation of patients has been demonstrated. Conclusion: Adoption of the most efficient medical technologies of general surgical treatment and postoperative rehabilitation of patients with traumas and their effects in daily practice provides high-grade restoration of the extremity's function, shortening of treatment period, decrease in number of complications and invalidism

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Bone tissue density modification in treatment of shin pseudoarthrosis by transosseous compressive osteosynthesis

Year: 2011, volume 7 Issue: №4 Pages: 933-936
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Balayan V.D., Barabash А.P., Barabash Ju.A., Puchinyan D.M., Grazhdanov K.A., Tishkov N.V.
Organization: Siberian Research Centre of Reconstructive Surgery, Saratov State Medical University, Saratov Scientific Research Institute of Traumatology and Orthopedics
Summary:

Objective is to detect bone mineral density along the shin according to «Esperanto» levels by Hounsfield's scale. Materials and methods. The analysis of density modification in 25 patients with pseudoarthrosis of tibia with predominant localization in a lower one-third of bone has been carried out. Results. By means of computed tomography it has been revealed that the bone tissue density of the tibia in the process of false joint union when using the compressive variant of combined transosseous osteosynthesis has changed according to the regularity reproducing phase character of the accumulation of mineral substances in the bone. Conclution. The growth of mineral density of the bone tissue during treatment spreads in the directions from proximal and distal metaepiphyses to the zone of pseudoarthrosis knitting

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Theoretical and practical contribution of SarNIITO researchers to transosseous osteosynthesis technique (Review)

Year: 2011, volume 7 Issue: №2 Pages: 502-505
Heading: Traumatology and Orthopedics Article type: Review
Authors: Barabash А.P.
Organization: Saratov Scientific Research Institute of Traumatology and Orthopedics
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The article deals with the history of transosseous osteosynthesis introduction in SarNIITO clinics. The contribution of doctors and scientists to development of this technique is reproduced in the chronological order. Prospects and place of hardware-based technique of treatment of injuries and diseases of musculoskeletal system are contemplated

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Treatment technique of diaphyseal fractures of shin bones according to biomechanical influence on reparative osteogenesis phases

Year: 2010, volume 6 Issue: №4 Pages: 829-834
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Barabash А.Р., Rusanov A.G., Barabash Yu.A., Alfimov R.A.
Organization: Saratov State Medical University, Saratov Scientific Research Institute of Traumatology and Orthopedics, Central Municipal Hospital of Pyatigorsk
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The article deals with new treatment technique in fractures of shin bones. It combines ideal reduction of damaged bone with reposition device without transition of transosseous elements through muscular masses, adequate fixation of bone fragments and change of biomechanical efforts in apparatus according to reparative osteogenesis phases. It is performed due to application of external fixation apparatus

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