Using an Autograft from the Fibula Diaphysis in the Surgical Treatment of Patients with Fractures of the Proximal Humerus on the Background of Critical Osteoporosis

The frequency of unsatisfactory results of surgical treatment of patients with a fracture of the proximal humerus remains high and is up to 40 %. This is primarily due to the early instability of the metal structure against the background of osteoporosis and as a consequence of non-fusion of the fracture and the formation  of a false joint. The aim of the study was to evaluate the effectiveness and safety of a new surgical method for treating patients with a fracture of the proximal humerus against the background of critical osteoporosis. After the approval of the local ethics Committee, 2 groups of 10 patients were formed in the clinic: the patients of  main group were operated by the proposed method; the group of clinical comparison was operated by the standard method. In all clinical cases, fractures of the proximal humerus were consolidated on control radiographs. VAS assessment the pain syndrome in the early postoperative period showed that there were no  statistically significant differences in the shoulder joint area in the groups. Three months after surgery, when assessing the volume of movement in the shoulder joint (without the participation of the scapula), there was a statistically significant improvement in the main group: abduction – by 35° and external  rotation – by 25° (p<0.05). When assessing the range of motion of the operated shoulder joint using the ASES scale, a  statistically significant improvement was observed in the main group by 11.6 points after 3 months after  surgery. According to the assessment of the patient›s functional recovery according to the DASH scale, the indicators in the main group were statistically significantly better, which indicates a complete recovery of the shoulder joint function. Thus, the use of the proposed new method, in comparison with other known technologies for surgical treatment of fractures of the proximal humerus, allows achieving a more rigid and stable fixation of bone fragments in the aftermath of trauma and the presence of regional osteoporosis

Labour Potential of the Arctic Regions of the European Russia

The work considered the possibilities and directions of evolution of demographic development of the Arctic region, analyzed some characteristics of the labor potential of the population living in the Arctic regions of the European part of Russia.The purpose of the study is to substantiate the possibility of attracting the local population and the need to employment specialists from other regions of Russia for the development of the Arctic.To achieve the goal of the study, general scientifi methods were used — the collection and analysis of data from state statistics and sample surveys. The use of a systematic approach made it possible to comprehensively assess the situation on the territory under study and substantiate the possibilities for its development.Analysis of the quantitative characteristics of the labor potential of the studied regions showed a stable negative dynamics throughout the post-Soviet period. A number of reasons have been identifi  that contribute to the outfl   of population from the Arctic regions, the most important of which are the low standard of living compared to the Russian average, as well as the ineff     functioning of the mechanisms of northern guarantees and compensation. At the same time, the qualitative characteristics of labor potential, in particular, the level of education of the population can be increased due to the existing educational potential of neighboring regions.Conclusions about the need to attract people from the regions of the middle zone of Russia for the Arctic are made

The potential of digitalization of resource regions of the Russian North

Purpose: the study of the current state of the potential level of digitalization of the sectors of the economy of the northern regions of the resource type (NRRT) and to identify possible promising directions for their development.Methods: the research is based on the application of standard methods of data collection and processing, comparative analysis and rating assessment. The data of the Federal State Statistics Service and statistical collections of the Higher School of Economics for the period 2010–2020 were used.Results: the rating of the TOP 10 countries of the world on digital competitiveness is presented. A methodological approach is proposed to substantiate the attribution of NRRT subjects to the resource-type category by calculating the share of the statistical indicator "mining" in the structure of the gross regional product. An assessment of the resource dependence of the regions of the Far North was carried out, based on the analysis of which the criteria for assigning eight subjects of the Russian Federation to NRRT were determined. The analysis and assessment of the current state of the level of digitalization of NRRT, which showed the leading positions of the Magadan region, Yamalo-Nenets and Khanty-Mansi Autonomous Okrugs, was carried out. It is noted that the level of regional expenditures on the introduction and use of digital technologies does not significantly affect the composite integral index of the digitalization potential of the northern resource–type regions.Conclusions and Relevance: the development of methodology and research on digitalization of resource regions of the Russian North, the results of which are presented in this article, is being implemented in a number of areas: the development of a conceptual scheme and a system of indicators for monitoring the northern regions; the development and construction of a composite index of development of the digital economy in the regions of the North; the development of methodology for monitoring the development and use of "end-toend" digital technologies (technologies for working with big data); monitoring and assessment of the level of development of the digital economy in the Arctic municipalities; the study of the relationship between socio-economic and digital development of the regions of the Russian North; the development of digital technologies of regional and municipal management and the study of socio-economic effects of their implementation; the study of digital transformation of priority economic sectors of the northern regions

Assessment of the effectiveness of surgical treatment of patients with massive tears of the rotator cuff tendons using arthroscopically assisted transposition of the latissimus dorsi tendon

Rotator cuff tears are one of the most common musculoskeletal injuries and account for about 20 %. Massive rotator cuff tears account for up to 40 % of all tears. There  is  no  single approach in the treatment of patients with massive rotator cuff tears. We have developed a new method of surgical treatment of these patients – arthroscopically assisted transposition of the latissimus dorsi tendon using 1/2 of the tendon of the long peroneal muscle. The aim of the study. To assess the effectiveness of surgical treatment of patients with massive rotator cuff tears who had arthroscopically assisted transposition of the latissimus dorsi tendon using an autograft of a 1/2 of the tendon of the long peroneal muscle. Materials and methods. The study included 15  patients with Patte stage  III and Thomazeau grade 2–3 massive rotator cuff tears, who had arthroscopically assisted transposition of the latissimus dorsi tendon using 1/2 of the tendon of the long peroneal muscle. Results. The article presents the long-term results of surgical treatment of patients using the developed method. The following criteria were evaluated: average age; time since injury; duration of surgery. Functional outcome was assessed using the ASES (American Shoulder and Elbow Surgeons) scale. Taking into account the indicators on the ASES functional scale 1 year after surgical treatment, the following results were obtained: excellent – in 14 (93.3 %) patients, satisfactory – in 1 (6.7 %) patient. Conclusion. The developed method allows us to restore the function of the shoulder joint as early as it possible, to reduce the severity of the pain syndrome and to improve the quality of life of patients

Assessment of the effectiveness of surgical treatment of patients with massive ruptures of rotator cuff tendons using latissimus dorsi tendon transposition

Rotator cuff ruptures are the most common injuries of shoulder joint with an incidence of about 20 %. This pathology is more common in adults over 60 years of age because it is caused by degenerative changes in the tendon. Massive injuries account for 10–40 % of all rotator cuff injuries. Currently, there is no unified surgical tactics for the treatment of patients with massive ruptures of rotator cuff tendons.The aim. To assess the efficiency of transposition of the latissimus dorsi tendon in patients with massive ruptures of the rotator cuff tendon.Materials and methods. The study included 15 patients with Patte stage III massive ruptures of the rotator cuff who had transposition of the latissimus dorsi tendon.Results. The article presents clinical cases of surgical treatment of patients. The following criteria were assessed: mean age; time since injury; duration of the surgery; blood loss volume; functional results by the ASES (American Shoulder and Elbow Surgeons) Shoulder Score. Taking into account the ASES Shoulder Score indicators 1 year after the surgical treatment, the following results were obtained: excellent results – in 9 (53.3 %) cases; good results – in 1 (13.4 %) case; satisfactory results – in 5 (33.3 %) cases.Conclusion. When preserving the articular cartilage, the method of choice in the treatment of patients with massive ruptures of rotator cuff tendons is transposition of the latissimus dorsi tendon. At the same time, an incomplete restoration of the function of the injured limb was registered in 33.3 % of patients, which requires further study and modification of the known method of transposition of the latissimus dorsi tendon

MODERN METHODS OF ANTERIOR CRUCIATE LIGAMENT TENDOPLASTY (LITERATURE REVIEW)

The first description of surgical treatment of anterior cruciate ligament injuries has become known about a hundred years ago. At the beginning, complete ruptures of the anterior cruciate ligament was treated by open restoration with arthrotomy. At present, open ACL plasty is practically out of use, except for single cases. In recent decades, worldwide, surgical treatment of knee ligament injuries has been performed with arthroscopic techniques. It has long been proven that arthroscopic operations are able to restore the primary anatomy of the damaged joint, combining anatomical validity and minimal traumaticity, pathogenetic justification and high functional efficiency. For more than 50 years, surgeons have been offered many different materials and methods for ACL reconstruction, but nevertheless there is currently no consensus on the choice of rational treatment tactics and the percentage of unsatisfactory results remains significant. Based on the data of modern authors, it can be concluded that the issue of knee joint ligaments damage not only does not lose its relevance, but, on the contrary, due to the increased interest in active lifestyle, it becomes more and more popular and studied. The article presents various views on the basic methods of arthroscopic restoration of the anterior cruciate ligament of the knee joint at the present stage of the development of surgery

The Ethnic 'Other' in Ukrainian History Textbooks: The Case of Russia and the Russians

This paper examines portrayals of Russia and the Russians in two generations of Ukrainian history textbooks. It observes that the textbooks are highly condemning of Ukraine's main ethnic other in the guise of foreign ruler: the tsarist authorities and the Soviet regime are always attributed dubious and malicious intentions even if there is appreciation for some of their policies. By contrast, the books, certainly those of the second generation, refrain from presenting highly biased accounts of the ethnic other as a national group (i.e. Russians). Instances where negative judgements do fall onto Russians are counterbalanced by excerpts criticizing ethnic Ukrainians or highlighting conflicting interests within the Ukrainian ethnic group. The negative appraisal of the ethnic other as foreign ruler is clearly instrumental for the nation-building project as it sustains a discourse legitimating the existence of Ukraine as independent state. However, recent trends in history education, the paper concludes, suggest that the importance of nurturing patriotism as a national policy objective is diminishing

Influence of disturbed conditions of reparative regeneration of bone tissue on the dynamics of thyroid hormones

Managing bone tissue regeneration is a key problem in traumatology and orthopedics. The researches proved that thyroid hormones affect hemostasis and reparative regeneration of bone tissue favorably and promote osteogenesis and bone consolidation. The aim of this research is to study the influence of disturbed reparative regeneration on the concentration of thyroid hormones in blood in the dynamics. Experimental research on rabbits (n = 12) with modelling of disturbed reparative regeneration revealed disorder in thyroid hormones synthesis and different directions of T3 and unbound T3 production on the 35th day when the maximum decrease of T3 (2 times) and unbound T3 (1.5 times) compared to normal values was registered. The analysis of production of T4 and unbound T4 revealed suppression of the values from the 1st to 50th day and gradual increase in unbound T4 from the 50th day. The most significant manifestation of thyroid gland reaction on the disturbed reparative regeneration of shin bones was the decrease in T3 and peripheral conversion of thyroid hormones up to 50th day with formation of false joint in these terms

Primary plasty of an Achilles tendon by plantar muscle tendon (clinical case)

Patient T., 43 years old arrived in clinic with complaints to the pains in lower thir of the right shin, limitation of movements in right ankle joint, inability of using right lower extremity. An. operative treatment was realized in clinic: suture of rupture of Achilles tendon by Cuneo with plastics by the tendon of long plantar muscle. In 4 weeks plaster immobilization was removed, the patient started measured loading of operated extremity with additional cane support. In 6 weeks full load on operated extremity was allowed and the patient returned to work. In 2 months patient received repeated trauma. During the examination local painfulness in the area of operative intervention was revealed. At the palpation it was revealed that integrity of plantar muscle tendon isn't broken. Control MRR of right shin was made: as the result of control examination the injury of plantar muscle tendon wasn't revealed. Immobilization of operated extremity in neutral position of a foot by functional brace was recommended to the patient. Measured, loading with additional additional cane support was approved. In 2 weeks the immobilization was removed, function of operated extremity is fully restored. Conclusion: if proposed method allows to start earlier loadings and. to decrease possibility of repeated rupture of reconstructed plantar muscle tendon in the most active period of rehabilitation

Preserved sections of steppes as the basis for the future ecological framework of Belgorod oblast

The article provides a historical analysis of the transformation of the region’s steppes, the results of an inventory with remote sensing methods of the preserved sections of the steppes, assessment of the potential of their flora for the development of restoration succession, and the effectiveness for preservation of the steppe biodiversity of the regional network of specially protected areas and the formation of an ecological framewor