Saratov JOURNAL of Medical and Scientific Research

Traumatology and Orthopedics

Results of electroneuromyographic studies in children with talipes valgus

Year: 2019, volume 15 Issue: №4 Pages: 868-872
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Korshunova G.A., Rubashkin S.A.
Organization: Saratov State Medical University
Summary:

Objective: to estimate the condition of lower extremities neuromuscular apparatus in children with talipes valgus using electroneuromyographic data. Material and Methods. M- and F-responses from foot and lower leg muscles, fibu-lar and tibial nerves in 65 patients aged 7 to 17 у. o. were studies. Results. Decline in M-responses form tibial nerves was detected in 61.8% of cases alongside low activity of spinal cord motor neurons. Significant increase in amplitudes of fibular nerve M- and/or F-responses was detected; this was registered from gastrocnemius muscles in 63.1% of children and was independent of either their age or foot deformity degree. Conclusion. Electroneuromyographic data of the study in children with talipes valgus deformity allowed revealing evidences of segmental and suprasegmental CNS structures as well as lower extremity peripheral nerves involvement into the process.

AttachmentSize
2019_04_868-872.pdf456.41 KB

X-ray morphological features of vertebrae at idiopathic scoliosis of a high risk

Summary:

Aim: to study anatomic and X-ray morphological changes of vertebrae at patients with idiopathic scoliosis of varying severity with method of a multislice computer tomography (MSKT). Material and Methods. At 27 patients with idiopathic scoliosis of varying severity, the MSKT method studied a condition of vertebrae in chest and lumbar department of a backbone within the continuous, retrospective one-center research. Anatomic and X-ray morphological changes of vertebrae depending on expressiveness of deformation are studied. Results. Results of a research showed that, at more expressed deformation the prevalence of frontal diameter over sagittal is 4-5% more, than at deformation less than 90°. At deformation of a backbone 65-80° vertebra height on the convex party is 22.3±1.7% more, than on concave, at deformation more than 90° the difference made 28.9±2.1 %. The median density of bodies of vertebrae on the convex party was 256.6± 44.7, on convex 267.1±36.2 HU. Patients with size have deformations more than 90°, the maximum density of bodies of vertebrae on the concave party was in 1.1 times more, than from convex, minimum in 2.1 times more, and median by 1.04 times. Conclusions. The anatomy, structure and density of the vertebrae in patients with scoliosis depend on the magnitude of the deformities and are characterized by more pronounced changes with deformities of more than 90°. The maximum changes are noted on the concave side of the scoliotic arch and are manifested by an increase in the maximum and median density of the vertebrae and the presence of areas with a lower density than on the convex side.

AttachmentSize
2019_04_861-868.pdf2.49 MB

Shock-wave therapy for combination treatment of plantar fasciitis

Summary:

The objective is enhancing outcomes of plantar fasciitis patients using proprietary shock-wave technique. Material and Methods. There were 65 active plantar fasciitis patients under our care, and we used shock-wave therapy as a part of their combination treatment. The patients were divided into 2 groups depending on the specifics oa shock-wave therapy applied to them. The proprietary technique based on the combination of local cryotherapy and heel area enthe-sises traction during shock-wave sessions was applied for patients of the main group (35 patients) while 30 patients of the control group had conventional shock-wave technique applied to them. Results. Patients of the main group showed better dynamics of pain syndrome reduction (p<0.05), as well as normalization of plantar fascia anatomy parameters on ultrasound evidence. Conclusion. The combined application of local cryotherapy as well as enthesises traction allows enhancing shock-wave therapy efficiency as a component of comprehensive medical rehabilitation of plantar fasciitis patients.

AttachmentSize
2019_04_858-861.pdf288.57 KB

Determination of anterior cruciate ligament attachment with radiographic quadrant method to analyze complications following anterior cruciate ligament reconstruction

Year: 2019, volume 15 Issue: №3 Pages: 653-656
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Sadykov R.Sh., Bogatov M.B.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, Saratov State Medical University
Summary:

Objective: to demonstrate the potential of radiographic quadrant method for defining the correspondence of the administered femoral tunnel to the anatomical anterior cruciate ligament attachment. Material and Methods. We have surveyed 18 patients aged 23 to 36 yo. (mean age 26±2 yo.) who had underwent ACL arthroscopic transtibial plastic reconstruction in 2012-2014, and had post- surgical ACL graft rapture or knee joint instability. All patients had their knee joints X-raid in standard projections. Bernard and Hertel radiographic quadrant method was employed to take lateral view pictures for defining the accuracy of the administered femoral tunnel. Results. In all cases the sites of the administered femoral tunnels did not match ACL anatomic attachments, defined with Bernard and Hertel grid. Conclusion. Radiographic quadrant method of defining ACL anatomic attachments can be used for post-surgery complications analysis.

AttachmentSize
2019_03_653-656.pdf675.54 KB

PRP-therapy efficiency analysis for various shoulder tendinopathies

Year: 2019, volume 15 Issue: №3 Pages: 648-653
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Norkin A.I., Malanin D.A., Tregubov A.S., Demeshchenko M.V., Cherezov L.L., Shormanov A.M., Emkuzhev O.L., Anisimova E.A.
Organization: Saratov State Medical University, Volgograd Medical Scientific Center, Volgograd State Medical University
Summary:

Objective: to perform comparative analysis of PRP-therapy efficiency in patients with various shoulder tendinopathies. Material and Methods. 122 patients with rotator cuff tendinopathies (66%), subacromial impingements and rotator cuff tendinopathies (16%), CLB tendon tendinopathies (18%) participated in the research. The diagnostic scales for estimation of pain syndrome and shoulder joint function, as well as ultrasound and MRT examinations were employed to assess the outcomes in 1 and 6 months after PRP-therapy. Results. Patients of all groups had significant improvements by scales compared to their condition at the beginning of PRP-therapy. The positive response obtained in one month after the treatment still subsisted in 6 months. The most impressive responses to treatment were observed in patients with rotator cuff and CLB tendinopathies (strong middle effect 0.8-0.88). The patients of these groups self-estimated their outcomes relatively high. The scores defining outcomes were somewhat lower in the group of patients with both rotator cuff tendinopathies and subacromial impingements. Both MRT and ultrasound examinations revealed improvements in shoulder joint structures: edema reduction and dissipation, hypoechoic signal areas. Conclusion. PRP-therapy at shoulder tendinopathies may be referred to safe effective biological methods of treatment.

AttachmentSize
2019_03_648-653.pdf337.95 KB

Surgical correction of the first ray deformity using osteotomy biomechanical modeling

Summary:

Objective: to enhance the outcomes of the first ray surgical correction using osteotomy biomechanical modeling of the first metatarsal bone. It allows obtaining quantitative data for the «bone — fixator» system stability as additional criteria for selecting surgery methods and surgery therapeutic approaches. Material and Methods. 97 female patients underwent surgical corrections of static deformities in the anterior parts of the feet. Biomechanical modeling of osteotomies for the first metatarsal bone was used for the main group (50 patients) at the stage of pre-surgery planning. Results. Radiological results showed no significant differences between the groups of patients. The integrated ACFAS index in post- surgery period was statistically significant inpatients of the main group. The detection rate of the restriction of movements, pain syndrome and edema around the first metatarsal bone was higher in the control group. Conclusion. The identified differences in the dynamics of functional and restorative processes proved the efficiency of objective estimation and obtaining stability in «bone — fixator» system. Biomechanical modeling is an efficient tool of the decision making support system for surgical correction of the first ray deformities.

AttachmentSize
2019_03_644-648.pdf290.45 KB

Comparative analysis of surgical outcomes for patients with femoral ununited midshaft fractures

Year: 2019, volume 15 Issue: №3 Pages: 641-643
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Zuev P.P.
Organization: Saratov State Medical University
Summary:

Objective: to perform comparative analysis of surgical outcomes in patients with types A2 and A3 ununited midshaft fractures of the femurs using Oswestry Disability Index (ODI), standardized assessment system for bone fracture outcomes and their consequences (SOI-1) and modified radiographic assessment of fracture healing (mRUS). Material and Methods. 40 patients with ununited midshaft fractures of the femurs including 22 patients with type A fractures (Group I) and 18 patients with type В fractures (Group II) were surveyed. The average follow-up period was 29.5±19.5 months. Results. In Group I the average ODI score made 47±0.9 and SOI-1 scores made 85±1.8% in 12 months. The mRUS fracture union score corresponded to 13.9±0.6. In Group II the average ODI score made 46.2±0.9 and SOI-181.8±1.7% in 12 months. The mRUS fracture union score corresponded to 13.7±0.6. Conclusion. The injured limbs functionality recovered sooner in patients of Group I (type A3 fractures) specifically in 6 months of a surgery proven by the absence of statistical differences in the results of estimation with ODI questionnaire and SOI-1 system observed in 12 months owing to the nature of fractures rather than the degree of their unions or the methods of surgical invasion applied.

AttachmentSize
2019_03_641-643.pdf258.76 KB

Surgical management of humeral shaft comminuted fractures

Year: 2019, volume 15 Issue: №3 Pages: 636-640
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Grazhdanov КА, Barabash АР, Barabash YuA, Chibrikov AG, Kauts OA, Ermolaev PE.
Organization: Saratov State Medical University
Summary:

Objective: based on retrospective outcome review of surgical rehabilitation perform assessment of possible usage for intramedullary locking rod structures meant to treat comminuted fractures of humeral shafts. Material and Methods. The intramedullary cross-locking rods were used to fix the fragments. The structures were inserted into humeral shafts by antegrade or retrograde techniques. In most cases surgical interventions were conducted as fracture closed reductions, at that the length and the axis of the limbs were restored without any additional fixation of separate fragments. Results. The review of outcomes for 33 patients with complicated traumatic destructions of humeral shafts showed high efficiency of intramedullary locking rod structures at managing patients with this type of injuries. Conclusion. Small surgical trauma and solid fixation provide for early functional rehabilitation of injured extremities as well as patients» quick return to everyday routine and activity before the fracture heals completely.

AttachmentSize
2019_03_363-640.pdf635.55 KB

Case study of the first metatarsophalangeal joint total replacement

Year: 2019, volume 15 Issue: №3 Pages: 633-636
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Goryakin M.V., Ulyanov V.Yu., Frolenkov A.V.
Organization: Saratov State Medical University
Summary:

The case report for Hallux rigidus surgical management with endoprosthesis total replacement using zirconia ceramics has been presented.

AttachmentSize
2019_03_633-636.pdf1.56 MB

Complications of transpedicular fixation in the cervical spine (review)

Year: 2019, volume 15 Issue: №3 Pages: 627-632
Heading: Traumatology and Orthopedics Article type: Review
Authors: Borisova О.A., Sergeev K.S., Paskov R.V., Vorobyov D.P.
Organization: Tyumen Regional Clinical Hospital №2, Tyumen State Medical University
Summary:

The analysis of studies on pedicle screw fixation in the cervical spine has been carried out. Mathematical data on the accuracy of freehand placement of cervical pedicle screws, the frequency of screw malposition, the frequency of clinically significant complications are presented. The article describes the causes of perforation of pedicle of vertebra, the causes of complications of this technique, as well as recommendations to increase the accuracy of insertion the screws and reduce postoperative complications.

AttachmentSize
2019_03_627-632.pdf1.31 MB