Surgical treatment of unstable fractures of the clavicle

Clavicle fractures are one of the most common types of injuries and range from 2.6 to 4% of all skeletal injuries. The aim of the study was to improve the results of surgical treatment of patients with fractures of the clavicle in the middle third. Material and methods. The study included 104 patients with fractures of the clavicle in the middle third. In the main group (48 patients) for osteosynthesis of the clavicle, a lockable rod of the original design was used, in the comparison group (56 patients) bone osteosynthesis was performed. Evaluation of the results was carried out on the DASH scale 3,6 and 12 months after osteosynthesis. Results: the proposed technology of operative treatment of clavicle fractures in the middle third with the use of an original compression blocking rod to improve the results of treatment of this group of patients. The developed algorithm for diagnosing, treating and rehabilitating victims with fractures of the collarbone allows to improve the results of treatment, provides for household and social reintegration of patients. Analysis of the results of the clinical trial revealed a significant advantage of the results on the DASH scale and a lower incidence of complications in the main group (p <0.05).Переломы ключицы относятся к одному из наиболее часто встречающихся видов травм и составляют от 2,6 до 4% среди всех повреждений скелета. Цель исследования: улучшение результатов хирургического лечения пациентов с переломами ключицы в средней трети. Материал и методы. В исследование вошли 104 пациента с переломами ключицы в средней трети. В основной группе (48 пациентов) для остеосинтеза ключицы использовался блокируемый стержень оригинальной конструкции, в группе сравнения (56 пациентов) проводился накостный остеосинтез. Оценка результатов проводилась по шкале DASH через 3,6 и 12 месяцев после остеосинтеза. Результаты: предложенная технология оперативного лечения переломов ключицы в средней трети с использованием оригинального компрессирующего блокируемого стержня улучшить результаты лечения данной группы пациентов. Разработанный алгоритм диагностики, лечения и еабилитации пострадавших с переломами ключицы позволяет улучшить результаты лечения, обеспечивает бытовую и социальную реинтгеграцию пациентов. Анализ результатов клинического исследования выявил достоверное преимущество результатов по шкале DASH и меньшую частоту осложнений в основной группе (р<0,05)

Hip arthroplasty in post-traumatic lesions of the acetabulum

Hip arthroplasty after acetabular injuries is complex and urgent problems of modem orthopedics. Objective: to study the outcomes of hip arthroplasty after acetabular injuries, presents survey data on 17 patients with an average age of 47,96 + 13,31 years. Were compared with patients with a destructive- dystrophic diseases who underwent hip arthroplasty. Hip arthroplasty with decompensated lesions are among the most effective technologies for surgical treatment, improving the quality of life of patients, but in patients after injuries of the acetabulum range of useful properties of this surgical technology is significantly reduced, which requires a special approach to the treatment of these patients based on the evaluation of the phase state connective tissue.Артропластика тазобедренного сустава после повреждений вертлужной впадины представляет сложную и актуальную проблему современной ортопедии. Цель исследования: изучить исходы артропластики тазобедренного сустава после повреждений вертлужной впадины, представлены данные обследования 17 пациентов, средний возраст которых составлял 47,96+13,31 лет. Проводилось сравнение с пациентами с деструктивно-дистрофическими заболеваниями, которым выполнялась артропластика тазобедренного сустава. Артропластика тазобедренного сустава при декомпенсированных поражениях относится к числу наиболее эффективных технологий оперативного лечения, улучшающих качество жизни пациентов, однако у лиц после повреждений вертлужной впадины диапазон полезных свойств данной хирургической технологии значительно уменьшается, что требует особого подхода к лечению этой категории пациентов на основе оценки фазового состояния соединительной ткани

Analysis of results of hip arthroplasty after osteosynthesis of the proximal femur

Hip arthroplasty with the destructive and degenerative lesions in the modem development of science, technology and medicine is considered the most effective method of ensuring social reintegration and home. However, according to a number of specialists increased complication rate arthroplasty in patients after osteosynthesis of the proximal femur. The purpose of research — to compare patient outcomes for hip arthroplasty technology after osteosynthesis of the proximal femur. Material and Methods: The study group comprised 38 patients who underwent hip arthroplasty after osteosynthesis of the proximal femur. The control group consisted of 43 patients with idiopathic hip osteoarthritis who underwent primary arthroplasty. Results: conducting joint replacement in patients of the main group was accompanied by an increase in the frequency of intraoperative and postoperative complications. Therefore, this group of patients requires a special approach to diagnosis and treatment.Артропластика тазобедренного сустава при деструктивно-дистрофических поражениях при современном развитии науки, технологии и медицины считается наиболее эффективным методом, обеспечивающим социальную и бытовую реинтеграцию. Однако, по мнению целого ряда специалистов частота осложнений эндопротезирования увеличивается у лиц после остеосинтеза проксимального отдела бедра. Цель исследования— сравнить результаты лечения пациентов по технологии артропластики тазобедренного сустава после остеосинтеза проксимального отдела бедра. Материал и методы: основную группу составили 38 пациентов, которым проводилась артропластика тазобедренного сустава по­ сле остеосинтеза проксимального отдела бедра. Контрольная группа представлена 43 пациентами с идиопатическим остеоартрозом тазобедренного сустава, которым проводилась первичная артропластика. Результаты: проведение эндопротезирования у пациентов основной группы сопровождалось увеличением частоты интраоперационных и послеоперационных осложнений. В связи с этим данная группа пациентов требует особого подхода к диагностике и лечению

DABIGATRAN – THE NEW APPROACH FOR DEEP VENOUS TROMBOSIS PROPHYLAXIS

The amount of total joint replacement is more than 1.5 mln world wide and requirement is increasing each year. Nevertheless one of the most dramatic complication after orthopedic manipulations are deep venous trombosis. As known, two aspects of prophylaxis are most important: duration of treatment and the doses of drags. The aim of study was to analys the influence of dabigatran for the risk of postop complications with the short time patients treatment complains. Treatment combination with dabigatran was clinically effective and the rate of adversing events was low. Thus we can conclude that treatment complains of dabigatran significantly higher then traditional injections of low molecular weight heparins

EXPERIMENTAL PROPHYLACTIC REINFORCEMENT OF THE PROXIMAL FEMUR IN SYSTEMIC OSTEOPOROSIS: GENERAL PROBLEMS AND CONTRADICTIONS IN ORTHOPEDIC PRACTICE

The paper deals with an experimental study of prophylactic reinforcement of the proximal femur in old patients suffering from various diseases that induce destructive and dystrophic changes in bone tissue and cause pathological fractures. The authors have developed a prophylactic reinforcement procedure and created the designs of original implants for its performance with the patents of the Russian Federation having been obtained. The performed mathematical modeling and bed tests of the strength of a reinforced bone-implant system prove the increased strength of the proximal femur by 23–93% and lower the risk of fracture in the occurrence of low-energy injury

THE STUDY OF RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH VERTEBRAL-SPINAL TRAUMA

A study of the efficacy of medical rehabilitation of 170 patients with spinal-cord injury through the application of modern rehabilitation and surgical technologies was conducted. Patients of I (control) group received standard set of conservative treatment and rehabilitation. Patients of II (main) group the rehabilitation was supplemented with therapeutic exercises with the use of loop complex «Hope» and the rate of adaptation to the stress of hypoxia in the late period of injury. Patient of III (control) group surgical treatment and the conventional range of rehabilitation were performed. Patients of IV (main) group the rehabilitation was completed with early activation using espandernogo complex «Hope» and the rate of adaptation to the stress of hypoxia in the late period of injury. It is proved that the developed complex rehabilitation of patients with spinal-cord injury using an early stable functional osteosynthesis with the minimum extent necessary, the use of complex «Hope» can improve the functional results at the expense of early motor activation, preventing the formation of contractures and muscle atrophy. The use of adaptation to the stress of hypoxia in the late period of vertebro-spinal cord injury improves overall health, reduces the severity of autonomic reactions, emotional stress, can cut pain syndromes

Bilateral reconstruction of palmar soft tissues defects of the hands after thermal injury

Introduction Thermal injury to the palmar surface of the hand is usually complicated by flexion desmogenic contracture of the finger joints. This condition is more complicated with significant wound areas and depths of soft tissue destruction. Conventional surgical methods and soft tissue reconstructions may fail to provide full restoration of the hand function. The objective was to present the optimal treatment strategy for patients with scar flexion contractures of the fingers after thermal injury to the palmar surface of both hands using a pediatric case report. Material and methods A child aged 2 years and 4 months underwent surgical treatment to include excision of scars, skin grafting of both hands with a vascularized fasciocutaneous flap raised with the radial artery. Result The patient could regain all types of hand grip on both sides 12 years after surgical treatment. Both hands were aesthetically acceptable. Discussion Treatment of patients with thermal injury and substantial soft tissue damage is a complex disease process. Conservative treatment and surgical procedures using non-vascularized skin flaps are normally used for the condition. These approaches are associated with cicatricial and arthrogenic flexion contracture of the finger joints. The radical treatment includes thorough wound debridement and early flap coverage and wound closure using a flap with an axial-pattern blood supply, free flaps and reverse-flow flaps. The surgical approach helps to avoid flexion contracture of the fingers initiating early restoration of professional, social stereotypes and stereotypes in everyday life. Conclusion The clinical observation has shown the possibility of one-stage organ-preserving surgical treatment using flaps with an axial blood supply