PARAMETRY PRZESTRZENNE STATOGRAMÓW W DIAGNOSTYCE PATOLOGII UKŁADU MIĘŚNIOWO-SZKIELETOWEGO

The analysis of the spatial parameters of statograms in terms of the projection area of the common center of mass (CCM) in single and double support was performed, along with the magnitude of the total maximum area of the statogram and its relation to the area of the projection spot for each type of standing, and the area of the statogram according to the mathematical expectation. The high sensitivity of the spatial parameters of statograms is indicated by the values of the CCM spot plane in the case of single support, the ratio of the planes, and the angular asymmetry. The analysis of the parameters of statograms showed that for all types of standing volunteers of the control group, the area of the projection spot of the CCM was the smallest in both two-pronged standing, and in single support standing. In patients with osteochondrosis and with coxarthrosis (CA), the area of the spots was much larger, with a statistically significant difference observed in single support (p < 0.05). The ratio of the planes was statistically different between groups (р = 0.043): in the control group it was the maximum (0.38), which reflects the highest ability to maintain equilibrium, and the minimum (0.25) – in the group of patients with CA. An analysis of variance revealed a significant difference (p = 0.025) of asymmetry in body angle  between the study groups. The angle of the body rotation  in the case of single support is not statistically different in the study groups (p = 0.294), but this indicator can be considered as prognostic in terms of the diagnosis of pathology of the musculoskeletal system.Analiza parametrów przestrzennych statogramów za pomocą wskaźników obszaru rzutu całkowitego środka masy (ZCM) dla podparcia pojedynczego i podwójnego, wielkości całkowitego maksymalnego pola statogramu i stosunku powierzchni miejsca projekcji dla każdego rodzaju stania, obszaru statogramu zgodnie z oczekiwaniami matematycznymi. Analiza parametrów stabilogramów wykazała, że ​​dla wszystkich typów ochotników stojących w grupie kontrolnej obszar miejsca projekcji ZCM był najmniejszy zarówno w przypadku dwóch stanowisk, jak i jednego stanowiska. U pacjentów z osteochondrozą odcinka lędźwiowego kręgosłupa i statku kosmicznego powierzchnia plam była znacznie większa, z istotną statystycznie różnicą (p < 0,05) w pozycji stojącej. Stosunek płaszczyzn był statystycznie różny między grupami (p = 0,043): w płaszczyźnie kontrolnej był to maksimum (0,38), co odzwierciedla najwyższą zdolność do utrzymania równowagi, a minimum (0,25) - w grupie pacjentów z KA. Analiza wariancji wykazała znaczącą różnicę (p = 0,025) asymetrii w kącie obrotu ciała  między badanymi grupami. Kąt obrotu ciała w przypadku pojedynczego podparcia nie jest statystycznie różny w grupach badanych (p = 0,294), ale wskaźnik ten można uznać za prognostyczny pod względem diagnozy patologii układu mięśniowo-szkieletowego

Reamputation stumps below knee

Aim To investigate rehabilitation outcomes of patients with malformed tibial stumps. Methods Observations included 421 patients with residual limb diseases and malformations (extensive inactive scars adhered to the bone, excessively long or short stumps, bone filing, osteomyelitis of the stump, muscle attachment to the skin scar, excessive mobility and deviations of the fibula, improper filing). Four hundred and thirty-six (436) reconstructive surgeries were performed. A follow-up period was from 6 months to 15 years. Radiological, ultrasonic, tensometrical, and histological methods were used. Results Due to the frequent combination of several malformations and diseases in the same patient, non-free skin grafting with displaced dermal-subcutaneous flaps, which cover rather large defects, was widely used. The surgeries were performed simultaneously and allowed for reconstruction without shortening the bone lever stump. Complications in the form of marginal necrosis were obtained in three (0.71%) patients. The improved technique of muscle grafting with the fixation of muscles to the bone provided an elastic stump covering the bone filing. The authors have developed original methods of surgery to create a bone block of the tibia, which make it possible to obtain painless, highly functional stumps using partial support and ensure long-term use of modern prosthesis designs in 100% of cases. Conclusion Non-free dermal plasty with cutaneous-subcutaneous flap is the method of choice for closing skin defects on the residual limb. Muscle-bone fixation permits to eliminate some residual limb defects and to form an elastic muscular residual limb with closed bone filaments. Synostosis formation in different ways considerably improves functional quality of the residual limb

Current issues of security management during martial law

The authors of the book have come to the conclusion that toensuring the country’s security in the conditions of military aggression, it is necessary to use the mechanisms of protection of territories and population, support of economic entities, international legal levers of influence on the aggressor country. Basic research focuses on assessment the resource potential of enterprises during martial law, the analysis of migration flows in the middle of the country and abroad, the volume of food exports, marketing and logistics system. The research results have been implemented in the different decision-making models during martial law, information and economic security management, formation of personnel potential and assets of enterprises, food, energy and environmental security management, use of budgetary levers and financial instruments. The results of the study can be used in the developing of directions, programs and strategies for the post-war recovery of Ukraine’s economy and the attraction of foreign investments in the regions, decision-making at the level of ministries and agencies that regulate security management processes. The results can also be used by students and young scientists in the educational process and conducting scientific research on the problems of ensuring the country’s security