Saratov JOURNAL of Medical and Scientific Research

Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics»

Efficacy and safety of hydroxyapatite-coated spokes in patients with femoral neck fractures in a multiple trauma

Summary:

Purpose: to evaluate the efficacy and safety of hydroxyapatite coated spokes for osteosynthesis in patients with femoral neck fractures in a multiple trauma. Material and Methods. We studied 26 patients of both sexes with severe injuries (on the ISS scale, the severity of the injury corresponded to 22-27 points). All revealed a fracture of the femoral neck, which was combined: with bruises of the brain (N=6) or kidney (N=12), fractures of the pelvis (N=18), ribs (N=8) or shin bones (N=4), rupture of the lung (N=4). All underwent treatment aimed at stabilizing the function of internal organs and systems, osteosynthesis of the femoral neck with a bundle of spokes with their fixation in the llizarov apparatus. Patients were randomized into 2 groups: main (N=11) — for osteosynthesis spokes with hydroxyapatite coating were used; control (N=15) — spokes without coating were used. To assess the effectiveness and safety of the use of spokes with hydroxyapatite coating, clinical and laboratory methods were used. Results. In the main group, positive results of treatment were observed in 10 patients (90.9%; Cl: 67.9-99.9%), in the control group-11 (73.3%; Cl: 48.9-91.8%). The patients of the main group have an average fracture consolidation time of 1.2 times less. After surgery, the activity of alkaline phosphatase is higher (P=0.04). The frequency of deviation of laboratory blood parameters from the norm in these patients is comparable with the frequency noted in the control group. Conclusion. The use of spokes with hydroxyapatite coating in the treatment of patients with femoral neck fractures in conditions of multiple trauma reduces the duration of fixation of bone fragments and increases the number of positive results of treatment by reducing the number of complications.

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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.

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Comparative analysis of treatment outcomes in patients with femoral neck fracture using monolateral wire and half-pin fixator of the authors' design and transosseous fixation wires

Year: 2014, volume 10 Issue: №4 Pages: 627-635
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Allakhverdiev A.S., Soldatov Y.P.
Organization: Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics»
Summary:

Objective. The purpose of the study is to analyze the errors, complications and outcomes of the operative treatment of patients with femoral neck fracture in the 1st group with application of wires bundle and fixation in the llizarov frame (64 cases) and in the 2nd group with application of developed monolateral wire- and half-pin device (23 cases). Material and Methods. The observation of 87 patients with fractures of the femoral neck. Operations performed using spokes kit for transosseous osteosynthesis by GA llizarov and develop devices for the treatment of patients with
fractures of the proximal femur. Two groups of patients were studied: duration of surgery, duration of osteosynthesis, complications, and outcomes (in terms of one year after the dismantling clips) using the modified scale Luboshyce — Mattis — Schwartzberg. Results. Fracture repair was achieved in 40 patients (62,5%) of the 1st group. The following complications were observed in this group: non-union and pseudarthrosis — in 21 (32,8%) case; aseptic necrosis of the femoral head in 3 (4,7%) cases; hip ankyloses — in one (1,6%) case, breakage and migration of wires into the joint cavity and smaller pelvis — 3 (4,7%) patients and cutting out of wires from the femoral head was observed in 3 (4,7%) cases. Totally 61 complication were revealed. In the second group of the patients non-union was found in one patient (64 years old). Complications were observed in 6 patients of this group — pint-tract infection, moderate secondary displacement of the fragments (the patient fell down on the operated limb) and wire breakage. Conclusion. The efficiency of the femoral neck osteosynthesis with application of elaborated monolateral wire- and half-pin fixator made up 95,7% of the positive outcomes (in osteosynthesis using bunch of wires with llizarov frame fixation the same 60,9% of the positive outcomes).

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Microelement content of bone tissue in transosseous osteosynthesis by II-izarov technique in high-altitude destinations (experimental research

Year: 2014, volume 10 Issue: №1 Pages: 119-123
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Erokhin A.N., Isakov B.D., Nakoskin A.N.
Organization: Bishkek State Medical Academy, Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics»
Summary:

Aim: To study the redistribution of microelements in bone tissue in osteosynthesis in high-altitude destinations. Material and Methods. The study was performed on 72 mongrel dogs of both sexes aged 1-3 years, weighing 10—15 kg. 32 dogs have been experienced the extended leg in lowlands destinations, another group of 32 animals have been experienced elongation produced in high-altitude destinations. The control group consisted of 8 healthy dogs of low mountain areas. The standard technique of surgery has been used in the research. Microelement composition has been studied by atomic absorption spectrophotometer AAS-1 N (Germany) in the long bones and the distraction regenerate. Shapiro —Wilk test was applied to analyze the normality. The data evaluation has been done by Student's t-test for unpaired samples. Results. Calcium and microelement imbalance has been obtained during transosseous osteosynthesis in high-altitude destinations, which causes functional changes in the musculoskeletal system, with similar clinical picture of Kashin — Beck. In the conditions of high-altitude destinations elongation of bones causes changes in microelements in the distraction regenerate. Conclusion. During distraction osteosynthesis in high-altitude destinations phase changes of microelements have been formed in the bone regenerate, which prognoses physiologically the formation of a false joint.

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The state of the vegetative nervous system in patients with gonarthrosis for surgical treatment before and after surgical treatment

Year: 2012, volume 8 Issue: №4 Pages: 975-979
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Dolganova T.I., Biriukova M.lu., Karasev E.A., Buravtsov P.P., Karaseva T.lu.
Organization: Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics»
Summary:

Aim. Analyzing the vegetative tensity of organism» functional systems before and after surgical treatment of elderly patients with metabolic-and-dystrophic gonarthrosis. Methods. The evaluation of vegetative homeostasis, reactivity of the vegetative nervous system by the data of variation pulsometry («REAN-POLY» RGPA-6/12, Taganrog) in 60 patients with gonarthrosis at the age of 50-72 years and the disease duration — 9+1.5 years before and after surgical treatment: total tunnelization (Group I), tunnelization with osteotomy of leg bones for correction of limb biomechanical axis (Group II), treatment-and-diagnostic arthroscopy (Group III). Results. The reduction of the level of hypoxia tolerance and the decrease of the processes of general adaptation one month after surgery in Group I was registered in 40% of patients. As for patients of Group II, by the end of the period of fixation with the llizarov device — in 50%. As for those of Group III after arthroscopy — in 10% of patients. Among the patients whose 1С / 1С calculated parameter after surgical treatment was registered 10.0 before treatment in 70% of cases. At rest, marked vagotonia was registered with hypersympathicotonic reaction to orthotest, as well as with sharp decrease of the proportion of second-order slow waves while transition to standing position (VLF proportion

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Functional Muscular Condition Dynamics at Osteoarthrosis Conservative Treatment of Major Joints of Lower Extremities

Year: 2009, volume 5 Issue: №2 Pages: 250-254
Heading: Traumatology and Orthopedics Article type: Original article
Authors: N.V. Sazonova, М.S. Sayfutdinov
Organization: Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics»
Summary:

The method of global electromyography has been used for the evaluation of 231 patients aged from 16 to 74 (43,7±0,8) with bilateral osteoarthrosis of major joints of lower extremities I-III degrees before the course of conservative treatment, immediately after the end of conservative treatment and in three months. Conservative treatment of patients with osteoarthrosis of major joints of lower extremities has been shown to cause restructuring of EMG patterns of maximal voluntary muscle contraction in lower extremities accompanied by decreased asymmetry of activity levels in muscle pairs and less observations of pathologically changed EMG that results in improved functional condition of the locomotor system.

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