Saratov JOURNAL of Medical and Scientific Research

Traumatology and Orthopedics

Characteristics of clinical findings and diagnostics of acute cerebral venous circulation disorder in immediate period following neurosurgical intervention for peripheral lung cancer metastasis into brain

Year: 2019, volume 15 Issue: №1 Pages: 67-71
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Bazhanov S.P., Ulyanov V.Yu., Matveeva O.V., Tolkachev V.S., Shuvalov S.D.
Organization: Saratov State Medical University
Summary:

A rare case of cerebral venous circulation disorder in a female patient with peripheral cancer metastasis of the right lung upper lobe to the area of precentral and postcentral gyri of the left cerebrum hemisphere in the immediate post- surgical period is present. It has been shown that the diagnostics of impaired circulation throuth the superficial cerebral veins is rather complicated due to the lack of clinical symptoms specificity and poor sensitivity of neurovisualization methods.

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Variability and connections of parameters characterizing hip dysplasia in 4-7-year-old children

Year: 2019, volume 15 Issue: №1 Pages: 61-66
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Zotkin V.V., Anisimova Е.А., Bakhteeva N.Kh., Anisimov D.l.
Organization: Saratov State Medical University
Summary:

Objective: to identify the variability and contingency of parameters characterizing the structure of the hip joint in children 4-7 years of age, among themselves and with the severity of dysplastic changes in the bone and soft tissue structures of the hip joint. Material and Methods. 132 children aged 4-7 years with dysplasia TBS with different degrees of severity of dysplastic changes (177 joints) were examined. The following characteristics of dysplasia joint were under the study: angular radiological parameters, cartilage defect, electroneuromyographic signs, indicators of the biomechanics of gait. The degree of dysplasia (mild, moderate, severe) was assessed by the method developed by the authors to determine the severity of hip dysplastic changes in points. Results. Light changes in the hip joint were diagnosed in 9 patients aged 4-7 years (15 joints); moderate dysplastic disorders were found in 74 patients (96 joints); pronounced signs of dysplasia were found in 49 patients (66 joints). The coefficient of variation of signs characterizing TDS dysplasia varies from 2.8 to 18.8%. The module of correlation coefficients characterizing the binding force of the studied features is in the range from 0.7 to 0.9. Conclusion. The angular radiological parameters, cartilage defect, electroneuromyographic signs, indicators of the biomechanics of gait characterized by considerable variability and are correlated with strong and close power among themselves and with the degree of dysplastic changes of the bone and soft tissue structures of TBS.

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The use of original device for positioning tools during the installation of femoral component of hip joint

Year: 2019, volume 15 Issue: №1 Pages: 57-61
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Varfolomeev D.l., Samoday V.G.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

Objective: to assess the accuracy of the femoral neck resection using the developed "Device for positioning tools for the installation of the femoral component of the hip prosthesis". Material and Methods. On the basis of the Department of traumatology and orthopedics of Voronezh state medical University n.a. N.N. Burdenko conducted experimental studies on 40 models of plastic bones. In the comparison group resection was performed using the proposed device, in the control group — using a standard guide. Results. Experimental studies have demonstrated higher accuracy of femoral neck osteotomy in the comparison group. The average value of the neck filing angle in the frontal plane in the comparison group was 3.2° higher than in the control group (p<0.05), and in the sagittal difference was 3.1°. The average distance from the line of the osteotomy to the apex of the greater trochanter in both groups was not significantly different (p=0.62). Conclusion. The use of the developed device allows to perform osteotomy of the femoral neck with high accuracy, as well as to control the position of the leg endoprosthesis, which helps to reduce the number of complications and improve the quality of life of patients.

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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Dorsal correction of rigid posttraumatic deformities of thoracic spine in spinal cord injury

Year: 2018, volume 14 Issue: №3 Pages: 611-617
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shul'ga А.Е., Zaretskov V.V., Likhachev S.V., Smolkin A.A.
Organization:
Summary:

Aim: the analysis of the outcomes of dorsal remedial operation in patients with rigid posttraumatic deformities in thoracic spine accompanied by spinal cord injury. Material and Methods. We analyzed surgical outcomes of transpe-dicular anchorage of 28 patients aged 34.5±19.5 with rigid posttraumatic deformities of thoracic spine: 12 patients with acute injury (1st group), 16 patients with long-term deformities (2nd group). The results were estimated by the severity of neurological deficit, pain intensity,the grade of deformity correction as well as by the LQ indexes. All interventions were performed from lateral medial approach with transpedicular anchorage. Results. There were no changes of neurological deficit in both patient groups, however we managed to obtain sufficient spine deformity correction. Pain intensity in patients of 1st group was 6 (5.3-7.8), function — 46.5 (42.5-49.8); 12 months postsurgically pain intensity corresponded to the score of 0 (0.0-0.1); function — 82 (79.0-86.0). The intensity of pain syndrome was significantly reduced in 2nd group patients (VAS reduced from 6 (4.0-7.0) to 1 (0.0-2.0), which in turn allowed for earliest rehabilitation of patients in sedentary position, thus increasing their mobility and functional independence (FIM increased from 70 (65.0-76.0) to 92 (89.0-95.0). Conclusion. Single-step dorsal surgical interventions in patients with rigid deformities of thoracic spine allow restoring normal spinal column axis, performing reconstruction of spinal cord column and safely stabilize injured locomotor segments both in acute and in late periods of spinal cord injury.

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The methods of deep periprosthetic infection diagnostics in the area of knee joint

Year: 2018, volume 14 Issue: №3 Pages: 607-610
Heading: Traumatology and Orthopedics Article type: Review
Authors: Shpinyak S.P., Babushkina I.V., Maksyushina T.D., Galashina E.A., Chibrikova Yu.A., Bondarenko A.S., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The data on the methods and promising areas of investigations potent to improve diagnostic tactics in patients with infectious complications after total knee replacement is presented.

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The capacity of the thrombin generation test in the diagnostics of hemostasis system disorders in patients with osteoarthritis

Year: 2018, volume 14 Issue: №3 Pages: 602-606
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shakhmartova S.G., Vorobyova I.S., Puchinyan D.M.
Organization:
Summary:

Aim: to determine the diagnostic significance of thrombin generation test parameters in the diagnostics of hemostatic disorders in patients with osteoarthritis of large joints in preoperative period. Material and Methods. 137 subjects have been investigated, among whom there were 115 hip and knee osteoarthritis patients, submitted for primary arthroplasty (68) and re-prosthetics (47); control group — 22 conventionally healthy blood donors. All subjects underwent plasma hemostasis study and thrombin generation test with two activators — RB (TF 2 pmol/ml) and RC-low (TF 5 pmol/ ml). Osteoarthritis patients were divided into two groups according to the results of thrombin generation test. The 1st group included patients with an adequate response to the stronger activator (t-lagR >t-lag ow, tt-peak^tt-peak^^), the 2nd —with an inversion response (t-lagRBlow). Results. In trie control group and group 1 patients, the thrombin formation process is more pronounced when using an activator with a high TF(RC-low) content than when using an activator with a lowTF (RB) content, which is regarded as an adequate reaction of thrombin formation to the action of a stronger agonist. Patients of the 2nd group inresponse to the action of the activator with a high content of TF was observed inhibition of the reaction of formation of thrombin, which was reflected in the slowdown in the speed of the generation of this enzyme and reduce its quantity. Conclusion. The use of two activators with different concentrations of tissue factor in the test of thrombin generation allows the nature of the response of the hemocoagulation system to initiate the process of thrombin formation to identify patients with adequate and inadequate response.

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The history of the development of national traumatology on the example of medical and scientific activities of Saratov Research Institute of Traumatology and Orthopedics (SarNIITO) (1950-1980)

Year: 2018, volume 14 Issue: №3 Pages: 596-602
Heading: Traumatology and Orthopedics Article type: Short message
Authors: Ulyanov V.Yu., Grishin S.E., Puchinyan D.M., Fedonnikov A.S., Chibrikov G.l., Norkin I.A., Ilyina E.S., Skobelkina A.V.
Organization: Saratov Socio-Economic Institute of G. V. Plekhanov Russian University of Economics
Summary:

We outlined and described basic directions of national traumatology development at the period of 1950-1980 illustrated by the example of Saratov traumatological school, estimated the contribution of SarNIITO traumatologists into this development at the abovementioned period, depicted syna — one of the founders of acute trauma clinics.

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The epidemiology of spine and spinal cord injuries

Year: 2018, volume 14 Issue: №3 Pages: 592-595
Heading: Traumatology and Orthopedics Article type: Review
Authors: Tolkachev V.S., Bazhanov S.P., Ulyanov V.Yu., Fedonnikov A.S., Ninel V.G., Salikhu Kh., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The article contains domestic and foreign data reflecting epidemiological peculiarities of traumatic injuries of spine and spinal cord, their character and incidence among various population groups with respect to gender and age parameters. The study outlines spine and spinal cord injury structure with regard to modern classification schemes, introduces injury incidence data, specifies indexes of lethality in spine and spinal cord injuries.

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