Saratov JOURNAL of Medical and Scientific Research

№3, 2018, volume 14

The peculiarities of morphological differential diagnostics of intradural tumor localized at the level of medullary cone and cauda equina roots

Year: 2018, volume 14 Issue: №3 Pages: 567-570
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Matveeva O.V., Bazhanov S.P., Ponomareva Е.Е., Tolkachev V.S.
Organization: Penza Regional Oncology Centre
Summary:

Aim: to demonstrate the necessity of modern methods of morphological verification in the differential diagnostics of primary and secondary neoplastic lesion of spinal cord. It is shown that histogenesis of tumor cells should be regarded from the viewpoint of comparative assessment of traditional and complementary methods of morphological verification that outlines the necessity of complex differential morphological diagnostics with apparent priority of immunohisto-chemical methods for the verification of final diagnosis of metastatic lesion in a rarely seen localization.

Keywords: differential diagnosis, immunohistochemistry, intradural tumor, pathological anatomy, spinal cord

Biomechanical aspects of circular spondylosynthesis of transitional thoracolumbar spine

Year: 2018, volume 14 Issue: №3 Pages: 560-566
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Likhachev S.V., Zaretskov V.V., Arsenievich V.B., Shul'ga A.E., Shchanitsyn I.N., Skripachenko K.K.
Organization:
Summary:

Aim: to present the potential of biomechanical modeling in individual choice of optimal surgical correction method for transitional thoracolumbar spine injury. Material and Methods. We built solid-base 3-dimensional model of the investigated spine segment in Mimics13 on the basis of CT data of injured thoracolumbar spine. Cage and anchorage models were created in CAE system SolidWorks. Numeric modeling was performed in ANSYS in Workbench medium. We analyzed full movement fields, their maximum values for each model as well as equivalent stress in vertebra and anchorage systems. Results. The analysis of equivalent stress and full movement fields emerging in the models under seven basic types of load revealed the most stable spondylosynthesis model which is circular spine

Keywords: biomechanical modeling of the spine, circular anchorage, transitional thoracolumbar spine

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

Keywords: femur, fracture (extra-articular, trochanteric, intertrochanteric), osteosynthesis (intramedullary, extra-cortical, locked), proximal femur

Historical dynamics of social and role interaction between a doctor and a patient

Year: 2018, volume 14 Issue: №3 Pages: 549-552
Heading: Traumatology and Orthopedics Article type: Review
Authors: Katkova A.V., Andriyanova Е.А., Ulyanov V.Yu.
Organization: Saratov State Medical University
Summary:

The article presents social and role peculiarities of professional interaction in the system "doctor— patient" in the retrospective, various factors influencing the downfall in the social significance of doctor role at the present stage of medicine development from the point of view of a number of theoretical approaches. On the basis of literature review we outlined the necessity of medical sociological investigation for the study of professional practices in medical institutions with various social and role structure and indicated the importance of the development of medical and sociological tools for the assessment of interaction efficiency stipulated by the impact of social and role factor. was performed in the following databases: Web of Science, CyberLeninka, PubMed.

Keywords: doctor, patient, professional interaction, social and role determination

The role of pro- inflammatory cytokines and the enzyme element of antioxidant system in the destruction of hyalin cartilage at the early stages of primary gonarthrosis

Year: 2018, volume 14 Issue: №3 Pages: 545-549
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Karyakina Е.М., Gladkova Е.М., Puchinyan D.M., Romakina N.A., Belova S.V.
Organization:
Summary:

Aim: comparative assessment of the state of joint (hyaline) cartilage, pro-inflammatory component of cytokine profile and enzyme element of blood antioxidant system in healthy individuals and patients at the early stages of gonarthrosis. Materials and Methods. The content of cartilage oligomeric matrixprotein (COMP), superoxide dismutase-2 (mitochondrial) (SOD-2) and interleukin-1 (3 (IL-1 (3) was studied in 34 individuals with initial signs of gonarthrosis (main group) and in 20 conventionally healthy individuals (control group) in blood serum by ELISA. Results. In the serum of patients with GA, the content of COMP (Me=20.67 pg/ml; 25% quartile 14.70; 75% quartile 27.15) and IL-1(3 (Me=4.74 pg/ml; 25% quartile 3.93; 75% quartile 5.90) was statistically significantly higher (p<0.05) than in the control group: COMP (Me=15.27 pg/ml; 25% quartile 8.86; 75% quartile 20.76 and IL-1(3 (Me=3.59 pg/ml; 25% quartile 2.75; 75% quartile 3/83). A correlation analysis in the control group revealed a positive strong correlation between COMP and IL-113 (r=+0.70; p=0.01) and a tendency toward a negative moderate association between COMP and SOD2 (r=-0.43; p=0.08); in the main group between these indicators, the connections were weak, statistically insignificant. Conclusion. Patients in the early stages of primary GA compared with healthy individuals confirmed the presence of destructive processes in the articular (hyaline) cartilage and the activation of the proinflammatory element of the cytokine profile and the enzyme level of the antioxidant system of the blood. The correlation analysis revealed a decrease in the strength of functional links in patients with GA, between the indicators of COMP — IL-1 (3 and COMP — SOD2, which indicated a change in the regulatory effects of proinflammatory cytokines and the enzyme element of the antioxidant system of the blood on the structural-metabolic state of the articular (hyaline) cartilage in the initial stage process.

Keywords: superoxide dismutase (SOD2), osteoarthrosis, interleukin-1 p, cartilage oligomeric matrix protein (COMP)

The aspects of minimally invasive surgery of forefoot static deformities

Year: 2018, volume 14 Issue: №3 Pages: 540-545
Heading: Traumatology and Orthopedics Article type: Review
Authors: Imamov A.M., Norkin I.A., Voskresenskiy O.Yu., Emkuzhev O.L., Muradaliev K.M., Zotkin V.V., Zubavlenko R.A.
Organization:
Summary:

The review illustrates various approaches to the potential of minimally invasive surgery in forefoot static deformities treatment. We demonstrated that methods aimed at the performance of nonlocking wedge osteotomy of first metatarsal bone and of proximal phalanx of big toe with preservation of cortex wedge contralateral to the base as well as of central metatarsal, extending tenotomies of flexors without tendon suture are the base for minimally invasive correction of forefoot static deformities providing orthopedically correct orientation of metatarsal heads under the early full postoperative load on the foot and preventing excessive dislocation of tendon ends.

Keywords: foot, forefoot, minimally invasive surgery, static deformities

Complex diagnostics and treatment potential of deep implant- associated infection of knee joint

Year: 2018, volume 14 Issue: №3 Pages: 537-540
Heading: Traumatology and Orthopedics Article type: Review
Authors: Zubavlenko R.A., Ulyanov V.Yu.
Organization: Saratov State Medical University, Saratov State Medical University n.a. V I. Razumovsky, Scientific Research Institute of Fundamental and Clinical Uronephrology
Summary:

The review of open access literature on the issues of complex diagnostics and treatment potential of implant-associated infection of the knee joint area was given in the article. We describe clinical signs, the potential of laboratory diagnostics of deep implant-associated infection from the point of view of sensitivity and specificity as well as main methods of surgical treatment of the pathology.

Keywords: diagnostics, implant-associated infection, treatment

Morphofunctional state of spleening under light desynchronosis in the experiment

Year: 2018, volume 14 Issue: №3 Pages: 533-536
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Zlobina O.V., Ivanov A.N., Karetnikova A.Yu., Terekhina E.S., Bugaeva I.O.
Organization: Saratov State Medical University
Summary:

 Aim: to study the effects of light desynchronosis on the morphofunctional state of the spleen of white male rats. Material and Methods. The study of light desynchronosis was carried out on 48 male rats using the Light Light model with an illumination power of 300 Ix in the daylight and 500 Ix in the dark. The laboratory animals in the experiment were divided into four groups: the control and three experimental ones, in which they were exposed to light for 1 day, 10 days, 21 days respectively. In the course of morphometry of histological sections of the spleen, the following parameters were assessed: the area of white pulp lymphoid follicles, B- and T-clependent zones of white pulp, the number of germinative centers and immunoblasts in B- and T-zones. Results. On day 1 of the experiment, an increase in the area of the lymphoid follicle, periarterial and B-dependent zones, an increase in the number of immunoblasts and reproduction centers was registered. By the 10th day there was a partial restoration of these indicators relative to the control values. On the 21st day of the experiment, a decrease in the growth dynamics of all the morphometric parameters of the spleen was observed. Conclusion. Light desynchronosis induces by the Light Light model leads to the development of the pathology of the immune system with an extensive shift of all measurable indicators. Key words: morphofunctional state of the spleen, morphometric criteria, light desynchronosis, immunity.

Keywords: immunity, light desynchronosis, morphofunctional state of the spleen, morphometric criteria

The method of controlled growth for the correction of axial deformities of lower extremities in children

Year: 2018, volume 14 Issue: №3 Pages: 529-532
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Dokhov M.M., Mashukov T.S., Sertakova A.V., Rubashkin S.A., Timaev M.Kh., Kurkin S.A.
Organization:
Summary:

Aim: to estimate the outcomes of the method of controlled growth in the correction of axial deformities of lower extremities in children. Material and Methods. We fulfilled the analysis of surgical results of 37 children aged 3-13 yrs. with leg axial deformities, valgus (20) and varus (17) leg deformities at the level of knee joints. All patients were operated in the growth area with the method of controlled growth — temporary epiphysiodesis of external portions of distal growth areas in femoral bones. The assessment of controlled growth method was conducted at 3-14 months for valgus and 6-15 months for varus leg deformities. Results. The assessment of controlled growth method use indicated clinically and X-ray proved reduction in femoral-tibial angle before the elimination of metal construction in valgus deformity 4.1 times, in varus 3.8 times. Conclusion. The method of controlled growth is highly effective correction method for axial deformities of lower extremities in children, and is minimally traumatizing.

Keywords: controlled growth, valgus and varus deformities

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

Keywords: fracture, intramedullary osteosynthesis