ENDOSCOPIC SURGICAL TREATMENT OF RECURRENT BAKER’S CYSTS

Purpose of the study - to study the causes of synovitis in patients with recurrent Baker’s cyst, to evaluate the effectiveness of endoscopic treatment of popliteal cysts . Materials and methods. From 2009 till 2013 we observed 34 patients with Baker's cyst. In 18 (52.9%) patients of the main group endoscopic technique was applied, in 16 (47.1%) patients of the comparison group a cystic bag was isolated and dissected with open technique, and then cystic gate was sutured. Results. In 10 (55,6%) patients of the main group the pain disappeared in the first postoperative day (

ПРИМЕНЕНИЕ ДАБИГАТРАНА ЭТЕКСИЛАТА (ПРАДАКСА®) У ПАЦИЕНТОВ С ЗАКРЫТЫМИ ДИАФИЗАРНЫМИ ПЕРЕЛОМАМИ БЕДРА И ГОЛЕНИ

The results of application of dabigatran etexilate in treatment of 56 patients aged 60 to 89 with closed diaphyseal fractures of femur and tibia undergone intramedullary osteosynthesis were studied. The patients were divided into 2 groups. The first group consisted of patients receiving standard anticoaqulant therapy. The second one included patients who used etyek-silat (pradaxa OS) in early postoperative period. The results of treatment in these groups were analysed and compared. Evidence-based significant advantage of dabigatran etexilate (pradaxaR) administration in early postoperative period was revealed.В статье, посвященной применению дабигатрана этексилата (Прадакса®) у пациентов с закрытыми диафизарными переломами бедра и голени, изучены результаты лечения 56 пострадавших, в возрасте от 60 до 89 лет, которым был выполнен интрамедуллярный остеосинтез. Пациенты были разделены на 2 группы. В первую группу вошли больные, которым применялась стандартная антикоагулянтная терапия. Во вторую группу - пациенты, которым в раннем послеоперационном периоде назначался дабигатрана этексилат (Прадакса®). Изучены результаты лечения в группах, проведено их сравнение. Выявлено значимое преимущество применения в раннем послеоперационном периоде дабигатрана этексилат (Прадакса®) с точки зрения доказательной медицины

Use of oral anticoagulants after intramedullary nailing of femur and tibial fractures in trauma department

The authors evaluated of the effectiveness of new oral anticoagulants in patients with diaphyseal fractures of the femur and tibia.We analyzed the effectiveness of thromboprophylaxis in 85 patients with diaphyseal fractures of the femur and tibia in the early postoperative period. Patients were divided into 3 groups: group 1 - patients, who was taking enoxaparin, group 2 - dabigatran etexilate, group 3 - rivaroxaban. We evaluated the frequency of thromboembolic complications and bleeding for 4 weeks after intramedullary nailing of femur and tibia.The lowest frequency of postoperative bleeding was observed in patients treated with dabigatran etexilate. In addition, the minimum frequency of complications was observed among patients of the second group of the study (9.7% in the group receiving dabigatran etexilati compared with 27.8% for the combined group I and III).Statistically significant differences between groups of patients taking oral or parenteral anticoagulants was not obtained

Osteosynthesis of femoral neck fractures: dynamic hip screw (DHS) or mini-invasive Targon FN system?

Objectives: to investigate the long-term outcomes of femoral neck fractures that were surgically fixed using various types of extramedullary implants in patients aged 65 years and younger. Material and methods: We analyzed the clinical results of surgical treatment of femoral neck fractures by extramedullary osteosynthesis in 94 patients aged 38 to 65 years old (71 women and 23 men). The patients were divided into 3 groups according to AO/ASIF fracture classification. We used different techniques of osteosynthesis: with DHS or with Targon FN. In all patients the mental status rate SPMSQ), osteoporosis degree (Singh index), general somatic status (WHO scale) were evaluated in the preoperative period. We also evaluated next intraoperative parameters: duration of surgery, blood loss, quality of reduction, long of incision. In a year after surgery we assessed functional results (Harris Hip Score) and analysed postoperative complications. Results: It was found the inverse correlation (r = -0,8) of total preoperative parameters (WHO scale, the Singh index and mental status SPMSQ) and postoperative functional results on Harris Hip Score. With the reliability of

ROLE OF SUBSTRATE ANTIHYPOXANTS IN CORRECTION OF ABNORMALITIES OF MYOELECTRICAL ACTIVITY OF GASTROINTESTINAL TRACT IN VICTIMS WITH SEVERE COMBINED TRAUMA

The abnormalities of myoelectrical activity of gastrointestinal tract were detected in 80 victims with severe combined trauma. There were observed a decrease of total electrical activity and dyscoordination of electrical activity of sections of gastrointestinal tract. An application of substrate antihypoxants should normalize the indices of myoelectrical activity of gastrointestinal tract. This approach allowed elimination of imbalance of total power between superposed (the stomach, the duodenum) and other sections of gastrointestinal tract. This would remove dyscoordination contraction of the jejunum and the ileum