Saratov JOURNAL of Medical and Scientific Research

Alieva A.V.

Saratov State Medical University n.a. V. I. Razumovsky, Department of Traumatology and Orthopedics, Resident

Comparative analysis of surgical outcomes for achondroplasic children receiving PRP-therapy (a case-control study)

Year: 2020, volume 16 Issue: №3 Pages: 757-761
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Timaev M.Kh., Sertakova A.V., Alieva A.V.
Organization: Saratov State Medical University
Summary:

Objective: To assess surgical outcomes in achondroplasic pediatric patients receiving PRP-therapy (Platelet-Rich Plasma therapy) for lengthening long bones. Material and Methods: 27 achondroplasic patients had been examined and operated in the pediatric trauma orthopedic department of the Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n. a. V.I. Rasumovsky in 2014-2018, their mean age 4.7±2.1 у. o. (4-11 у. o. range). The examination involved conventional clinical examination as well as X-ray examination. All patients were divided into 2 groups, the division criteria being intraoperative application of PRP-therapy (autoplasma therapy or plasmolifting). Group 1 (n=14) was made up of patients who had underwent transosseous compression distraction osteosynthesis with no PRP employed while all patients of Group 2 (n=13) had received PRP injections. Results: The distraction consolidation index (DCI) in Group 1 (n=14) was 72±7 days/cm (good and satisfactory results) and the average length of the grown distraction was 4.5±2.5 cm. In PRP-therapy employed Group 2 DCI was 65±10 days/cm (good results) and the distraction length was 6.5±2.5 cm. In patients of Group 1 sectioned, lateral and central forms of the distraction prevailed while in patients who had received PRP-therapy spindle and cylinder forms of the distraction were observed. Conclusion: PRP-therapy employed in all stages of the elective distraction at limb osteotomy allows significant DCI improvement as well as activation of bone tissue remodeling in the osteotomy area, the geometric type of trabeculae formation being more beneficial.

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Optimization of surgical treatment tactics at a customary shoulder dislocation

Year: 2018, volume 14 Issue: №2 Pages: 240-243
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Norkin A.l., Klimov S.S., Levchenko K.K., Shormanov A.M., Alieva A.M., Katerusha A.M., Amanova M.M., Ulyanov V.Yu.
Organization: Saratov State Medical University
Summary:

 Saratov Journal of Medical Scientific Research 2018; 14 (2): 240-243. The aim: the optimization of surgical treatment tactics at a customary shoulder dislocation, based on "on-track Hill-Sachs / off-track Hill-Sachs" concept. Material and Methods. The research group consists of 42 patients aged from 19 to 52 years with chronic recurrent anterior shoulder instability, who underwent a surgical treatment to restore previous shoulder anatomic and topographic correlations. Patients were divided into two subgroups according to diagnostic arthroscopy results. The first subgroup includes 14 patients with impaction visualized (off-track Hill-Sachs), the second one — 28 patients with head shoulder stability (on-track Hill-Sachs). Patients of the first subgroup underwent open surgical intervention according to Bristow — Latarjetand shoulder arthroscopic repair was carried out in the second group. Results. One month after the surgical treatment median total estimated figure exceeded by 1.8 times in patients of the first subgroup and by 1.2 times, by Rowe, in patients of the second subgroup and decreased by 2.1 times in patients of the first subgroup and by 1.7 times, by DASH, in the second subgroup in comparison with the indices before the operation, that was illustrative of a good treatment result. Six months after the operation median total estimated figure exceeded by 1.2 times, by Rowe, in patients both of the first subgroup and the second subgroup and decreased by 2 and 2.1 times, by DASH, in patients of the first and the second group, relatively in comparison with the indices found one month after the operation, that was illustrative of an excellent treatment result in the late postoperative period. Conclusion. Patients with anterior shoulder instability caused by a glenoid fossa deficiency less than 25% in combination with off-track Hill-Sachs lesion, the most convenient way is the replacement of the bone loss by coracoid process transposition. In patients with on-track Hill-Sachs lesion arthroscopic repair is preferable.

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