CHANGE OF INDICES OF MINERAL DENSITY OF BONE TISSUE AT CHRONIC TRAUMATIC OSTEOMYELITIS

Comparative analysis of changes of indices of mineral density of bone tissue in patients with chronic traumatic osteomyelitis with different terms of shin synostosis, with united and ununited fractures was performed. Dependence of synostosis terms on the degree of decrease of mineral density of bone tissue on injured extremity was determined. Basing on the study of system and regional indices of mineral density on bone tissue we developed methods of prediction of bone tissue regeneration that allow to reveal disorder in the regeneration process, determine approximate terms of synostosis and estimate effectiveness of the treatment

Subjective Well-Being of Russian Female Personnel as an Indicator of Socio-Psychological Age

The present work is theoretical and empirical research on the socio-psycho- logical age of female personnel at enterprises with different organizational cultures. The main indicators of socio-psychological age include the level of commitment to organizational values, readiness for organizational changes, involvement in labor activity, and fatigue. The respondents are female employees of two large industrial enterprises. The female personnel working in a market-hierarchical type of organizational culture with an expressed innovative component reflect characteristics of a younger socio-psychological age while those working at an enterprise with a hierarchical-clan type of organizational culture display characteristics of a more senior socio-psychological age

PROBLEMS OF DIAGNOSIS AND SURGICAL TREATMENT OF HALLUX VALGUS (LITERATURE REVIEW)

Treatment of valgus deformity of the first toe is today one of the intensively developing areas of modern orthopedics. The complexity of treatment of this pathology is predetermined, first of all, by its multicomponent nature. Forefoot deformities are often the main cause of a decreased quality of life, which makes the patient irritable, inactive, and also makes it impossible to use standard footwear, and sometimes even orthopedic one. The purpose of our study was the analysis of scientific literature devoted to the problems of diagnosis and surgical treatment of valgus deviation of the 1st toe (hallux valgus). The materials of the study were domestic and foreign articles, reviews and monographs on the surgical treatment of hallux valgus, with mandatory analysis of long-term treatment outcomes. The history of the development of treatment of this pathology is presented with the analysis of surgical treatment methods aimed at different links of pathogenesis, as well as complications arising from the use of different techniques. The article presents modern trends in development and ways to improve the methods of surgical treatment of valgus deviation of the first toe. The analysis of the literature data showed significant success in the surgical treatment of valgus deviation of the first toe. However the current percentage of relapses may be due to the lack of an accurate method for determining proximal articular set angle (PASA) in the preoperative period, as well as the lack of the hallux valgus treatment able to eliminate valgus deviation of the first toe and avoid recurrence of the disease due to a more accurate correction of PASA

Using biodegradable screws in treatment of hallux valgus

The aim of the research was to assess using biodegradable screws in treatment of hallux valgus. We managed 40 female patients (average age 50 ± 2.51) with hallux valgus who where admitted to the orthopedic unit of Irkutsk Scientific Center of Surgery and Traumatology for operative treatment. All patients had X-ray, MRI and intraoperational examination of affected foot before the surgery and in postoperative period. All patients were operated using own surgical technique. Patients were divided into two groups: group 1 (22 patients) - osteosynthesis using biodegradable (PLGA) screws; group 2 (18 patients) - osteosynthesis using metal cannulated screws. In group 1 postoperative values of M1P1 angle were within normal range (9.67 ± 0.78°). According to MRI, proximal articular set angle (PASA) was corrected from 21.5 ± 0.35 to 4.17 ± 0.09°. 6 patients of the group 1 were complaining of pain and discomfort in the area of screw-head contacting soft tissues. The result of operative treatment in the group 2 resulted in the correction of M1P1 angle from 34 ± 1.63 to 7.67 ± 0.75°. After the surgery intraoperative PASA was back to the normal range (4.33 ± 0.34°). The comparison of the results of treatment of patients of groups 1 and 2 didn't reveal any statistically significant differences in the values of М1Р1, М1М2, М1М5 angles and PASA. The advantage of using biodegradable screws, compared to the metal ones, in the treatment of hallux valgus is the possibility of postoperative MRI of the foot with calculation of PASA to evaluate treatment results. The disadvantage of using biodegradable screws is engineering deficiency preventing screw-head from dipping into bone tissue and causing soft tissue traumatizing. Biodegradable and metal screws allow to obtain similar results of hallux valgus treatment

SUBJECTIVE WELL-BEING OF THE STAFF OF ENTERPRISES WITH DIFFERENT INVOLVEMENT IN INNOVATIVE PROCESSES: AGE ASPECT

The results of empirical investigations of subjective well-being of multi-age engineering staff at successful innovative enterprise and the enterprise with long-term problems of transition to innovative development format have been presented. Subjective well-being has been сonsidered as emotional regulator of labor activity and staff acceptance of innovations factor. Readiness for innovative changes, self-esteem of fatigue, health status, stress and age state of health has been studied as indicators of well-being. It has been shown that at ordinary enterprise the most unpleasant indicators of subjective well-being are typical for young staff, but at the innovative enterprise the staff regardless of age have a high level of subjective well-being which is manifested in a commitment to innovative values and personal involvement in the labor process

Surgical Treatment of Severe Deformities of the Toes in Rheumatoid Arthritis

The article presents the case of successful surgical treatment of a female patient with severe deformities of the toes arising from rheumatoid arthritis. After clinical and radiological examination the patient was diagnosed with a hallux valgus deviation of the first toe, with 64 degrees of valgus deviation angle, and a valgus-hammered deformity of the II, III, IV toes with a dislocation of the III and IV toes. There was a violation of the stato-dynamic function of the foot, severe pain. Two techniques of joint-preserving surgical treatment were selected. Correction of deformation of the first toe was carried out according to the author's technology, to correct the deformation of other toes, the Helal technique was used in the author's modification. The result of the treatment was the achievement of correction of the deformation of the first toe and the elimination of the deformation of the second, third, and fourth toes. The patient is satisfied with the outcome, the appearance of the left foot, its function, the ability to walk without pain and wear ordinary shoes.This clinical case of surgical treatment of severe deformities of the toes with rheumatoid arthritis shows the possibility and importance of joint-saving operations to obtain a good cosmetic and functional result. Performing osteotomy of the metatarsal bones in the proposed modifications allows to correct the hallux valgus deviation of the first toe and deformation of the other toes. As a result of using these technologies, it is possible to maintain metatarsophalangeal joints, eliminate dislocations and subluxations, restore joint function, form an arch of the transverse arch of the foot, relieve pain, thereby improving the anatomical and functional state of the entire foot

Problems of Surgical Treatment of Hammer Toes (Review of Literature)

Introduction. The urgency of the problem of surgical treatment of hammer-like deformity of the toes is due to the incidence of pathology, the presence of unsatisfactory results and postoperative complications.Objective. Analysis of scientific literature devoted to the problems of surgical treatment of hammer deformities of the toes.Materials. Analyzed domestic and foreign scientific publications on the classification and surgical treatment of hammer toes.Results. The article presents an analysis of the classifications of hammer-like deformity of the toes and instability of the metatarsophalangeal joints and an analysis of treatment methods aimed at eliminating various manifestations of deformity, with a description of the complications that have arisen. The systematization of methods for correcting hammer-like deformity of the toes was carried out.Conclusion. Analysis of the literature data allowed us to determine that the problems of treating hammer-like deformity of the toes are associated with the lack of a classification that would reflect the condition of the forefoot of each individual patient and allow choosing the optimal effective methods of treatment, as well as an algorithm for choosing tactics for surgical treatment of hammer-like deformity, which systematizes the methods treatment depending on the manifestations of deformity of the entire forefoot

Using a New Method for Preparing an Autograft for Anterior Cruciate Ligament Plasty

Background. Currently, work continues to improve the methods of arthroscopic reconstruction of the anterior cruciate ligament with an autograft, aimed at reducing the risk of postoperative failure.Aim of the study. To assess the immediate results of using a new method of preparing an autograft for anterior cruciate ligament plasty.Materials and methods. The analysis of the results of surgical treatment of 28 patients with old complete traumatic rupture of the anterior cruciate ligament, who were treated in the Department of traumatology and orthopedics of the Irkutsk Scientific Center of Surgery and Traumatology, was carried out. The patients were men aged 18 to 40 years. The common thing for all patients was the All-inside arthroscopic plasty of the anterior cruciate ligament. Two groups of patients were formed depending on the method of preparation of the autograft. The first group consisted of 18 patients in whom a well-known technique was used, including the formation of a four-bundle autograft from one tendon of the semitendinosus muscle. In 10 patients of the second group, a new method of preparing an autograft was used, including the stage of preliminary determination of the required length and thickness of the autograft, and the stage of forming an autograft from the tendon of the semitendinosus and gracilis muscles on the common tendon pedicle.Results. Comparative analysis of the immediate results of arthroscopic plasty of the anterior cruciate ligament with an autograft in case of its old complete traumatic injury revealed a significantly lower number of undesirable consequences when using a new method of preparing an autograft. In two cases, persistence of  the pain syndrome associated with arthritic changes in the joint was observed, in one patient there was a  restriction of movements in the knee joint, no synovitis, a sensation of instability of the knee joint, ruptures  and detachments of the autograft were found. All patients were satisfied with the achieved result.Conclusion. A new method of preparing an autograft for plasty of the anterior cruciate ligament allows  achieving anatomical reconstruction of the anterior cruciate ligament, optimal function of the knee joint,  reducing pain, significantly reducing the risk of developing knee instability, ruptures and abruptions of the autograft in the postoperative period due to an individual approach, increasing the strength of the autograft and the strength of its fixation in the bone canals

Infectious Complication of Revision Knee Replacement

The article presents the case of the patient having an infectious complication in the area of the endoprosthesis after performing revision knee replacement. Revision surgery was performed six months after the primary knee replacement due to the instability of the components of the endoprosthesis. In analyzing the case of an infectious complication, a six-point risk factor for the development of infectious complications was given taking into consideration the following factors: body mass index; ASA physical status evaluation; the presence of diabetes mellitus, concomitant systemic diseases; the presence of allergic reactions; the presence of previous operations on the joint; index of the ratio of segmented neutrophils and monocytes.The analysis made it possible to establish that the patient had a high risk of infectious complications before the surgery of the endoprosthesis replacement and determine the list of necessary preventive and therapeutic measures (glycemia correction, bacteriological examination of the knee joint puncture, rehabilitation of existing and possible foci of chronic infection, examination and treatment at the center of osteoporosis) that had not been held. The implementation of surgical treatment - revision knee replacement - against the background of a high risk of infectious complications led to the development of the infectious process. To stop the infection process, surgical treatment was performed, including necrectomy, debridement, drainage of the knee joint, without removing the components of the endoprosthesis. Remission was achieved.The clinical case of an infectious complication of revision knee arthroplasty is of interest, as it shows the importance of assessing adverse prognostic factors, establishing the degree of risk of infectious complications, and conducting the necessary preventive and therapeutic measures in the preoperative period to reduce the risk of developing an infectious process in the endoprosthesis area

Assessing risks of developing and persistence of infectious process in knee joint replacement

Despite of intensive work on improving endoprosthetic replacement constructions, using minimally invasive techniques, developing methods of prevention for and treatment of periprosthetic joint infection, relapse of infection process can reach up to 52 % after treatment.The aim of the study: to show the importance of identifying the risks of development and recurrence of periprosthetic infection after implantation of a knee joint endoprosthesis. A clinical case of the development of a deep periprosthetic infection in a patient after primary knee replacement and successful treatment of the resulting complication was demonstrated. The analysis of this case of an infectious complication using the proposed prognosis for the development of periprosthetic infection showed that before surgical treatment of the patient, the risk of an infectious process was not assessed, and appropriate preventive and therapeutic measures were not carried out.Materials and methods. In the treatment of developed periprosthetic infection of the knee joint, the author’s algorithm for choosing surgical tactics was used, which allowed to determine the high risk of recurrence of periprosthetic infection, evaluate additional criteria and choose the optimal type of surgical intervention – two-stage revision endoprosthetic, which allowed to stop the infectious process.New was the use of the proposed prognosis for the development of periprosthetic infection and the algorithm for choosing surgical tactics for periprosthetic infection, which make it possible to determine the necessary preventive measures to reduce the risk of an infectious complication and to apply the optimal type of surgical intervention to relieve periprosthetic knee infection