Saratov JOURNAL of Medical and Scientific Research

Norkin I.A.

Saratov State Medical University n.a. V I. Razumovsky, Director of Scientific and Research Institute of Traumatology, Orthopedics and Neurosurgery, Head of Department of Traumatology and Orthopedics, Professor, Doctor of Medical Science

Peculiarities of microcirculatory reactions after subcutaneous implantation of polycaprolactone matrices mineralized by vaterite

Year: 2018, volume 14 Issue: №1 Pages: 35-41
Heading: Physiology and Pathophysiology Article type: Original article
Authors: Norkin I.A., Ivanov A.N., Kurtukova M.O., Savelyeva M.S., Martyukova A.V., Gorin D.A., Parakhonsky B.V.
Organization: Saratov State Medical University, Saratov state university, Skolkovo Institute of Science and Technology
Summary:

The aim is to assess skin microcirculation changes arising during subcutaneous implantation of polycaprolactone scaffolds mineralized by vaterite. Material and Methods. The experiment was carried out on 30 albino rats divided into two groups: a negative control group and an experimental one. We implanted polycaprolactone scaffold with exhausted foreign protein subcutaneously into rats of the negative control group. We implanted polycaprolactone matrix mineralized by vaterite subcutaneously into the animals of the experimental group. Research methods include laser Doppler flowmetry and morphological examination of the tissues of the matrix implantation area. Results. Changes of skin microcirculation over the matrix allocation area correspond to the morphological pattern of tissue reactions. Biocompat-ibility disorders take the form of inflammation in the scaffold implantation area that is accompanied by stable perfusion rise associated with local bloodstream modulation changes. We did not observe inflammation signs in the surrounding scaffold tissues during implantation of polycaprolactone matrices mineralized by vaterite. Besides local microcircula-tory reactions possess a transient character disappearing completely by the 21st day after the implantation. Conclusion. Complex of the given functional and morphological studies allow us to ascertain high-grade biocompatibility of polycaprolactone matrices mineralized by vaterite thus giving rise to prospect of their use for tissue regeneration stimulation.

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Rehabilitation after hip and knee joints replacement: several results of medical and sociological monitoring

Year: 2017, volume 13 Issue: №4 Pages: 796-799
Heading: Health Service Organization Article type: Original article
Authors: Fedonnikov A.S., Andriyanova Е.А., Erugina M.V, Norkin I.A.
Organization: Saratov State Medical University
Summary:

Aim: research of rehabilitation process problem areas after hip and knee joints replacement. Material and Methods. Program of monitoring and evaluation of medical, organizational, social and psychological components of rehabilitation was developed. Sociological study of 1175 patients who have undergone in 2015-2016 total hip and knee joints replacement was conducted. Results. It was revealed an absence of real interaction between key parties of rehabilitation processes based on significant disproportion between high level (more than 80%) of patients' satisfaction of rehabilitation organizing and low activity of health managers (9.4%). Despite of declared patients' high rehabilitation quality permanent pain noted by 45% of respondents, move freely without additional support is available only for about 50% of patients. Conclusion. Rehabilitation management and its' quality are the key values for locomotor system functional recovery. Provided study has designated main problems of rehabilitation quality evaluation after hip and knee joints replacement.

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Medical and sociological issues of rehabilitation of patients after hip and knee joints replacement

Year: 2017, volume 13 Issue: №3 Pages: 761-764
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Fedonnikov A.S., Erugina M.V., Andriyanova E.A., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The aim: research of medical and social issues of rehabilitation after hip and knee joints replacement. Material and Methods. Sociological study of 1175 patients who have undergone in 2015-2016 total hip and knee joints replacement was conducted. Results. Within the scope of medical surveillance after the surgery 69.8% of patients made regular visits to orthopedic specialists after joint replacement, but only 9.4% of surveyed patients confirm the practice of active monitoring of rehabilitation on the part of health services. There had been determined a high level of declared patients satisfaction (more than 80%) with weak health managers activities argue considerable informational gap between the key parties of rehabilitation. Conclusion. Provided study has designated problem areas of patient and health system communication in rehabilitation after hip and knee joints replacement.

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Coxar-throsis in infancy and adolescence: opportunities of preventive treatment

Year: 2017, volume 13 Issue: №3 Pages: 751-755
Heading: Traumatology and Orthopedics Article type: Review
Authors: Norkin I.A., Sertakova A.V., Rubashkin S.A., Zotkin V.V., Gerasimov V.A., Timaev M.Kh., Chibrikova Yu.A., Kupina E.S.
Organization:
Summary:

The review systematizes scientific data on the major groups of heterogeneous diseases which have infant and adolescence coxarthrosis as their outcome and contains materials on etiology, pathogenesis, diagnostic, treatment and precaution methods of complication (dystrophic changes in hip joints) for each disease.

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Complex stimulation of peripheral nerve regeneration after deferred neurorrhaphy

Year: 2017, volume 13 Issue: №3 Pages: 732-737
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Ivanov A.N., Korshunova G.A., Matveyeva O.V., Ninel V.G., Shutrov I.E., Shchanitsyn I.N., Andronova Т.А., Norkin I.A.
Organization: Saratov Regional Child Clinical Hospital, Saratov State Medical University
Summary:

The aim is to study the complex stimulation effect including skin autotransplantation and electrical stimulation of the sciatic nerve on microcircular, electrophysiological and morphological changes after deferred neurorrhaphy in rats. Material and methods. The experiment was performed in 50 albino rats divided into control, comparative and experimental groups. In the experimental group, on the background of deferred neurorrhaphy, skin autotransplantation and electrical stimulation of the sciatic nerve had been carried out. In the comparative group only deferred neurorrhaphy was performed. Research methods included laser doppler flowmetry, electroneuromyography and morphological analysis of the operated nerve. Results. Complex stimulation including skin autotransplantation and direct action of electrical pulses on the sciatic nerve after its deferred neurorrhaphy causes restoration of bloodstream in the operated limb, promotes intensification of restoration of nerve fibers. Conclusion. Intensification of sciatic nerve regeneration after deferred neurorrhaphy in rats under the influence of complex stimulation including full-thickness skin graft autotransplantation and direct action of electrical pulses substantiates experimentally appropriateness of clinical testing of the given method for treatment of patients with peripheral nerve injuries.

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Comparative retro- and prospective analysis of treatment outcomes in patients with SCI and cervical spine injuries in acute and early periods of traumatic disease

Year: 2017, volume 13 Issue: №3 Pages: 710-715
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Bazhanov S.P., Ulyanov V.Yu., Chibrikova Yu.A., Biryukova A.V., Norkin I.A., Gulyaev D.A., Salihu H.
Organization: Almazov National Medical Research Centre, Saratov State Medical University
Summary:

The aim: to conduct comparative retro- and prospective study of treatment outcomes in patients with cervical spine and SC injuries on the basis of assessment scale analysis. Material and Methods. 217 patients with closed cervical spine and SC injuries commeasurable by age, degree of neurological deficit, acute physiological and chronic state disorders were enrolled into the study. 177 patients comprised the main group (prospective study) and 40 — comparison group (retrospective study). To compare treatment outcomes we used Karnofsky score (Karnofsky, 1949), a quantitative assessment score for general patient status scales, APACHE II, Acute Physiology and Chronic State Evaluations (Knaus — Draper, 1985) and SCIM II, Spinal Cord Independence Measure Scale. Results. Comparative analysis based on the quantitative values of assessment scales, indicates an improvement of short-term treatment outcomes in patients with SC and cervical spine injuries in the main group. Conclusion. Complex approach to differentiated surgical treatment management and unique neuroprotection methods significantly improves short-term treatment outcomes having positive effect on general patient status, severity of acute physiological and chronic state disorders and patients' independence in the post-surgical period.

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Comprehensive approach to the assessment of the functional status of patients with degenerative joint diseases of the lower extremities

Year: 2017, volume 13 Issue: №3 Pages: 510-514
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Romakina N.A., Korshunova G.A., Kireev S.I., Sertakova A.V., Norkin I.A.
Organization: Scientific Research Institute of Traumatology Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky
Summary:

Aim: development of an integrated biomechanical index that reflects the state of kinematic and static function in patients who need replacement of large joints as well as evaluation of the myoneural complex of lower extremities activity of category of patients. Material and Methods. 103 patients with osteoarthrosis of the hip and knee joints. A biomechanical survey included podography, stabilometry and dynamometry. An electrophysiological study of the peripheral nerves of the lower extremities with the determination of the amplitude of the muscle response and late neuronal responses was carried out. The level of activity of the gluteal muscles was determined. Results. The most sensitive indicators reflecting the state of biomechanical status were identified, specialized software for the integral biomechanical index calculation was developed. Conclusion. Methods of clinical biomechanics allow specialists to assess the state of kinematic and static function of the musculoskeletal system, matching of the integral biomechanical index with the data of neurophysiological monitoring makes possible to select individual tactics of treatment.

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A competency-based model for training of specialists in vertebrology at higher medical school

Year: 2016, volume 12 Issue: №2 Pages:
Heading: Pedagogics and Education Article type: Short message
Authors: Norkin I.A., Fedonnikov A.S., Zaretskov V.V., Andriyanova E.A., Levchenko K.K., Zaretskov A.V., Belonogov V.N.
Organization: Saratov State Medical University
Summary:

The field of medicine facing the issues of diagnosis and treatment of spine diseases and injuries requires training of specialists in vertebrology taking into consideration the modern standards of higher professional education and medical care conditions. The article deals with the training of the specialists using a competency-based model

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The use of clinical analysis of movements in evaluation of motor functional status of patients after total hip replacement

Year: 2016, volume 12 Issue: №2 Pages: 185-190
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Romakina N.A., Kireev S.I., Reshetnikov A.N., Frolenkov A.V., Norkin I.A.
Organization: Saratov State Medical University
Summary:

Aim: to estimate functional status of coxarthrosis in patients requiring total hip replacement of the two hip joints. Material and methods. The biomechanical examination of 94 patients with bilateral primary coxarthrosis before and after total hip replacement was performed using clinical stabilometric software complex. The ability to perceive the mechanical load during standing and walking was evaluated at different stages of the treatment. The difference between the samples was estimated with the use of Mann — Whitney U-test. The rank correlation of biomechanical parameters was measured by Spearman coefficient. Results. It was revealed that the most responsive indicators are the transfer period, the first and second periods of double support and the deviation of the center of pressure relative to the average position in the frontal plane. Conclusion. After surgical treatment there was observed some improvement: the-left-and-right-step asymmetry decrease, rhythm rate increase, improved ability to maintain body balance, jog reactions increase.

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Towards the causes of secondary post-traumatic deformations of thoracic and lumbar spine

Year: 2015, volume 11 Issue: №4 Pages: 570-575
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shulga А.Е., Zaretskov V.V., Ostrovsky V.V., Arsenievich V.B., Smolkin A.A., Norkin I.A.
Organization:
Summary:

The purpose of the study is to analyze and systematize main causes of secondary spine deformations forming in patients who had operations due to thoracic and lumbar spine damages. Material and Methods. The analysis of poor surgical results of 155 patients previously operated due to various thoracic and lumbar spine damages has been conducted. All patients had complications associated with secondary spinal column deformations at various time after the intervention. Standard investigation included the analysis of patients' complaints, their previous history, somatic, neurological and orthopedic status. Results. The intensity of spinal column deformation was defined due to the character and level of primary trauma structurally characterized predominantly by unstable damages. However as it has been found in this research the main cause of this complicated pathology lied in the number of tactical and technical pitfalls of primary surgical treatment. Conclusion. Surgical operations due to secondary post-traumatic deformations in most cases are laborious and are accompanied by significant surgical trauma therefore systematization and analysis of the main causes of poor results of primary spine surgery may contribute to the preventive treatment of this type of pathology.

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