Saratov JOURNAL of Medical and Scientific Research

Barabash Yu.A.

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n.a. VI. Razumovsky, Department of Innovation Projects in Traumatology and Orthopedics, Chief Research Scientist, 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.
Organization:
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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Comprehensive comparative evaluation of results of surgical management of unstable distal tibia fractures

Year: 2019, volume 15 Issue: №1 Pages: 48-52
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Barabash Yu.A., Mandrov D.V., Balayan V.D.
Organization: Saratov Regional Clinical Hospital, Saratov State Medical University, Tuchkovskaya District Hospital
Summary:

Objective: to evaluate the outcomes of various methods of surgical interventions and functional properties of lower extremities in patients with complicated ankle fractures. Material and Methods. Clinical outcomes of 140 surgically managed patients with unstable bimalleolar and trimalleolar fractures were studied. 80 patients were managed with external fixation devices applied by original method (main group) and 60 patients were managed with submersible structures (comparison group). Results. Compared to submersible structures, the use of transosseous metalosteosynthesis has led to 100% ankle fracture unions. In early postsurgery period the index of average anatomic and functional result reached values of 93.4% corresponding to "good" and 6.6% corresponding to "satisfactory". Conclusion. It has been established with rheovasography data that transosseous osteosynthesis contributed to restoration of blood microcir-culation in the damaged segment of lower extremity in 8 weeks period after surgery and submersible structures in 6 months period.

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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.
Organization:
Summary:

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.
Organization:
Summary:

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.
Organization:
Summary:

 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.
Organization:
Summary:

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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Biomechanical criteria of orthopedic status of patients with dysplastic coxarthrosis (Crowe) IV before and after treatment

Year: 2017, volume 13 Issue: №3 Pages: 520-526
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Yusupov K.S., Barabash Yu.A., Pavlenko N.N., Romakina N.A., Anisimova E.A., Letov A.S., Sertakova A.V., Anisimov D.l.
Organization: Scientific Research Institute of Traumatology Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky
Summary:

The aim: to analyze locomotor function of lower limbs in patients with dysplastic coxarthrosis Crowe IV type before and after single-step hip joint endoprosthesis and femoral bone osteotomy conducted by our own technology. Material and Methods. 42 patients with one-side dysplastic coxarthrosis Crowe IV type were examined and operated. The mean age at the time of admission in men was 47.3±1.2 years, women — 46.1 ±1.1 years. Static and kinematic function of lower limbs was evaluated with the help of stabilometrics and podometry before and one year after the operation. Results. Before treatment, the patients had deviations of static and dynamic function of locomotor system stabilometri-cally seen as instability in upright position and podographically as a compromised gait. One year postsurgically we indicated static balance between the limbs within the normal range, expanded motoring mode, which was supported by significant improvement in the biomechanical characteristics of locomotor function of the patients. Conclusion. Total hip replacement in combination with modifying osteotomy of the hip conducted by a unique technique restores static and kinematic function of lower limbs in patients with high congenital hip dislocation (dysplastic coxarthrosis Crowe type IV) which is proved by stabilographic and podographic indices one year after operation.

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Transosseous osteosynthesis technique in treatment of diaphyseal fractures of shin bones

Year: 2012, volume 8 Issue: №1 Pages: 133-136
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Alfimov R.A., Barabash Yu.A., Simeonov N.S.
Organization: Saratov State Medical University, Central Municipal Hospital of Pyatigorsk
Summary:

Objective: The study of bone tissue repair in different conditions of stability of transosseous fixation (techniques of treatment) of injuries of bones of the shin. Material and methods: Analysis of treatment of 74 patients with unstable diaphyseal fractures of bones of the shin, with the use of different methods of osteosynthesis is carried out. Results: An optimal method of combined transosseous osteosynthesis for treatment of victims with unstable fractures of bones of the shin is offered. Conclusion: A complex approach to the decision of the available problems is offered, consisting in a combination of the use of different types of transosseous elements in the external fixation device which allows to improve results of treatment and to reduce disability period

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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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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
Summary:

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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