Saratov JOURNAL of Medical and Scientific Research

Norkin A.I.

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n.a. VI. Razumovsky, traumatologist-orthopedist of the First Traumatology and Orthopedics Department, Assistant of Traumatology and Orthopedics Department, Candidate of Medical Science

Comparative analysis of clinical outcomes of various methods of anterior cruciate ligament arthroplasty in knee joint in complete rupture of the ligament.

Year: 2018, volume 14 Issue: №2 Pages: 251-259
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shormanov A.M., Norkin A.l., Klimov S.S., Chibrikova Ju.A., Ulyanov V.Yu., Bakhteeva N.Kh.
Organization: Saratov State Medical University
Summary:

The aim is to carry out the analysis of outcomes of anterior cruciate ligament arthroplasty undertaken by various methods in patients with complete ligament rupture. Material and Methods. 104 patients diagnosed with complete rupture of anterior cruciate ligament (ACL) in knee joint who underwent knee joint arthroplasty fulfilled by various methods were the object of the present study. Clinical outcomes of the treatment were estimated by clinical signs of ACL failure, the degree of functional impairment of knee joint (IKDC 2000) and motor pathology assessed instrumentally. Results. Significantly better function restoration in knee joint occurring as early as 3 months postoperatively has been stated in the group of patients with two-bundle ACL arthroplasty by synthetic implant "DONA-M" on the basis of IKDC subjective knee indices. Negative Lachman test and Pivot shift test were demonstrated as early as 3 months postoperatively by all patients after two-bundle ACL arthroplasty with synthetic implant "DONA-M", reduced support asymmetry 6 months postoperatively was stated in all patient groups as well as run path and surface area in patients with single-bundle ACL arthroplasty by synthetic implant "DONA-M". Conclusion. The use of single- and double-bundle ACL arthroplasty with synthetic implant and ACL arthroplasty with autograft of semitendinosus (ST) and gracilis allows providing equally full-fledge restoration of injured knee joint, without statistically significant differences between the groups, in great majority of patients up to 12 months of follow-up period which is proved by normalized knee joint function, the absence of ACL failure and motor pathology signs estimated instrumentally. Key words: knee joint, anterior cruciate ligament (ACL), co

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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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Computer modeling of biomechanical systems «femoral bone — endoprosthesis / transplant — tibia» in different methods of anterior cruciate ligament plastics in knee joint

Year: 2017, volume 13 Issue: №3 Pages: 764-768
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shormanov A.M., Ivanov D.V., Norkin A.l., Ulyanov V.Yu., Bakhteeva N.Kh., Klimov S.S., Chibrikova Yu.A.
Organization: Saratov State Medical University
Summary:

The aim: to specify the indices of dislocation (displacement) and effective stress in biomechanical systems «femoral bone — endoprosthesis / transplant — tibia» in different methods of anterior cruciate ligament by computer modeling of a knee joint geometrically, physically and mechanically similar to human. Material and Methods. Steady-state tasks of the stress given on a knee joint after anterior cruciate ligament plastics fulfilled by different methods were resolved numerically by the method of finite elements implemented in the system of finite element analysis. Results. Maximum dislocations comprised 3.45 mm. for the method of single-beam plastics of ACL, 0.35 mm. for two-beam plastics and 0.93 mm. for plastics with semi-tendinous and gracilis tendons. Maximum stress were 1190 MPa for single-beam plastics of ACL, 141 MPa for two-beam plastics and 150 MPa for plastics with semi-tendinous and gracilis tendons. Conclusion. Finite element modeling of different ways of ACL plastics indicates higher stability of synthetic endoprosthesis under rising stress in case of two-beam plastics and transplant of semi tendinous and gracilis tendons compared to the single-beam plastics.

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Decompressive stabilizing operations in the treatment of complicated aggressive hemangiomas of transitional spine.

Year: 2017, volume 13 Issue: №3 Pages: 746-751
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Likhachev S.V., Arsenievich V.B., Salina E.A., Stepukhovich S.V., Norkin A.l., Mizyurov S.A., Zaretskov V.V.
Organization: Saratov State Medical University
Summary:

The aim: to study the efficiency of surgical treatment of complicated aggressive hemangiomas in transitional spine. Material and Methods. Decompressive stabilizing operations were made to 26 patients aged 35-52 years with hemangiomas of vertebral bodies. Individual surgical features varied due to the character and level of the injury. Results. In the experimental patients' group in admission there was neurological deficit of compressional origin associated with the critical values of luminal narrowing due to the epidural component of the neoformation. Stable antalgic effect and decrease in neurological deficit were seen postsurgically. Conclusion. While choosing the surgical option of decompressive stabilizing treatment a surgeon should take into account roentgenomorphometric features of the injured vertebrae. Adequately planned intervention fulfilled with the account of the injury character allows obtaining favorable outcomes as well as LQ improvement, neurological deficit decrease and the elimination of pain syndrome.

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Modern Treatment Methods of Habitual Shoulder Dislocation (Literature Review)

Year: 2010, volume 6 Issue: №3 Pages: 687-692
Heading: Traumatology and Orthopedics Article type: Review
Authors: Dlyasin N.G., Norton A.I., Gramma S.A., Gorshkov V.Ju., Derevjanov A.V.
Organization: Saratov Scientific Research Institute of Traumatology and Orthopedics
Summary:

In the literature review the groups of the most applicable surgical interventions in treatment of patients with habitual shoulder dislocation are cited. The tendency to increase an application of arthroscopic operations seek to eliminate some realizing factors of dislocation of the humeral head is observed

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Spinal Hemangiomas

Year: 2010, volume 6 Issue: №2 Pages: 428-432
Heading: Traumatology and Orthopedics Article type: Review
Authors: I.A. Norkin, S.V. Likhachev, A.Yu. Chomartov, A.I. Norkin, D.M. Puchinian
Organization: Saratov Scientific Research Institute of Traumatology and Orthopedics
Summary:

The given article considers the modern view on etiology, pathogenesis, classifications, clinical picture, diagnosis and treatment of spinal hemangiomas. Advantages of vertebroplasty over the other techniques of treatment of studied pathology are presented

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Treatment Results of Injuries of Thoracic and Lumbar Backbone Departments at Osteoporosis Patients

Year: 2009, volume 5 Issue: №2 Pages: 245-247
Heading: Traumatology and Orthopedics Article type: Original article
Authors: V.V. Zaretskov, A.Y. Shulga, A.Y. Chomartov, V.B. Arsenievich, D.Y. Sumin, A.I. Norkin
Organization: Saratov Scientific Research Institute of Traumatology and Orthopedics
Summary:

Information relates to radiologic (computer tomography) manifestations providing the visualization of thoracic and lumbar backbone department injuries at osteoporotic patients. Contemporary methods of transcutaneous and trans-pedicle vertebroplasty with bone cement allows to obtain a stable positive healing effect against such pathologies.

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