N.N. Priorov Journal of Traumatology and Orthopedics最新文献

{"title":"Total resection of the symphysis pubis in a patient with postpartum symphysitis: clinical case","authors":"Y. Gudushauri, Malkhaz G. Kakabadze, A. Lazarev, V. V. Konovalov, Evgeniy I. Kalinin, I. N. Marychev","doi":"10.17816/vto108842","DOIUrl":"https://doi.org/10.17816/vto108842","url":null,"abstract":"BACKGROUND: Complete rupture of the symphysis during childbirth is a rare but serious complication, with a frequency of 0.03%3%. Small partial tears with minor discrepancies are an indication of conservative therapy, which only requires the use of a pelvic brace. Larger symphyseal tears should be treated with surgery and fixation. \u0000CLINICAL CASE DESCRIPTION: This report presents a clinical case of successful orthopedic correction of symphysitis after delivery by cesarean section. A 25-year-old patient underwent total resection of the symphysis pubis with supra-acetabular fixation and external fixation device of a rod arrangement for 12 weeks. \u0000CONCLUSION: Several surgical techniques in combination with defect plasty with biocomposite material KollapAn-С made it possible to achieve a long-term positive result.","PeriodicalId":308632,"journal":{"name":"N.N. Priorov Journal of Traumatology and Orthopedics","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131586113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical simulator for the training of traumatologists: pilot work","authors":"Timofey A. Paramonov, I. Markin, Vladimirova An, S. Kushnarev, Pyotr K. Potapov, Kirill A. Vedishchev, N. Varlamova, Artur R. Muzafarov, Renat R. Baykiev, E. A. Zhurbin, Denis A. Otavin, Iraida A. Zabirova","doi":"10.17816/vto110979","DOIUrl":"https://doi.org/10.17816/vto110979","url":null,"abstract":"BACKGROUND: Pelvic fractures are one of the most complex and fatal injuries because numerous large blood vessels are affected. They entail partial or complete loss of working capacity and have a high mortality rate. In medical practice, the number of pelvic fractures is fewer than that of other types of fractures, and specialists often lack practical experience and skills in the treatment. Thus, for the training, or advanced training of specialists, more serious theoretical training is required, which is unproductive without high-quality training simulators and models. \u0000AIM: The study aimed to develop and manufacture an easy-to-use simulator that mimics human soft tissues and makes it possible to comprehensively prepare and educate specialists in the technique of installing an external fixation device for unstable pelvic fractures. \u0000MATERIALS AND METHODS: To create the simulator, several main stages were completed: obtaining samples of the pelvic bones, making a mold for casting, and directly assembling the simulator. To obtain bone samples, computed tomography scans and magnetic resonance therapy images were used, on which a three-dimensional (3D) model of the pelvic bones was obtained. Based on this model, anatomically accurate copies of the pelvic bones were made using additive technologies. Then, a 3D digital computer model was developed, and a mold for casting the finished product was made. Bone samples were placed inside the mold, and the mold was gradually filled with a gelatinglycerin compound, which after hardening mimics human soft tissues. \u0000RESULTS: A prototype of a medical simulator for teaching the installation of the concomitant injury kit apparatus for unstable pelvic fractures was made. \u0000CONCLUSION: The manufactured simulator can be widely used in educating and training specialists given its sufficiently high anatomical accuracy, ease of maintenance, and good potential for mass production.","PeriodicalId":308632,"journal":{"name":"N.N. Priorov Journal of Traumatology and Orthopedics","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114065967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features of ultrasound diagnostic syndesmotic ankle injuries in middle and older children: prospective comparative study","authors":"A. I. Dorokhin, A. Adrianova, Sergey A. Drozdov, Nikolai I. Karpovich, V. A. Malchevskii","doi":"10.17816/vto108189","DOIUrl":"https://doi.org/10.17816/vto108189","url":null,"abstract":"BACKGROUND: Diagnostics and treatment of syndesmotic ankle injuries in children is one of the important problems in pediatrics. The generally accepted examination algorithms and standards developed for adult patients do not apply to children. The ligamentous apparatus in children is much more elastic, and the tibiofibular space is smaller, which significantly complicates the diagnostic search. \u0000OBJECTIVE: This study aimed to create a diagnostic algorithm for examining middle and older children with ankle joint injuries. \u0000MATERIALS AND METHODS: To create a diagnostic algorithm, whether the ultrasonographic stress test of external foot rotation in adult practice is relevant for patients with closed growth zones was investigated. Two open cohorts of middle and older children were formed. The first cohort included children aged 1114 years with a closed growth zone of the distal tibia, and the second cohort included children aged 1517 years with a closed growth zone. The inclusion criteria were the absence of injuries of the studied ankle joint and the correspondence of the body mass index to the age norm. \u0000RESULTS: The variability of the tibiofibular space during the stress test of external foot rotation in children with a closing growth zone averages 3.035 mm and in children with a closed growth zone was 2.319 mm. Data indicate a high degree of elasticity of the anterior tibialperoneal ligament in children in contrast to adults in whom this structure is more rigid. In children experiencing pain, active muscle resistance makes the test of internal rotation ineffective, and excessive elasticity of the structure in the area of a healthy joint does not give a correct comparative result for the operator. \u0000CONCLUSION: The use of a test with internal rotation for diagnosing damage to the distal tibiofibular syndesmosis in children with closing and closed growth zones is limited, and the operator must rely on other ultrasound signs of damage to this structure.","PeriodicalId":308632,"journal":{"name":"N.N. Priorov Journal of Traumatology and Orthopedics","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128588036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mycoplasma as a possible trigger for the development of idiopathic avascular necrosis of the femoral head","authors":"Anatoliy S. Mikhaylov, N. P. Prishchepa, D. V. Kovalev, A. Efimov, P. V. Fedotov, M. I. Ivanov, Nikolay A. Kryuchkov","doi":"10.17816/vto108677","DOIUrl":"https://doi.org/10.17816/vto108677","url":null,"abstract":"BACKGROUND: The death of bone tissue cells with impaired blood supply, followed by the development of secondary arthrosis/arthritis of the adjacent joint, is most characteristic of osteonecrosis of the femoral head. This condition is common in young patients mainly in men of working age. Hip arthroplasty at a young age has a high risk of loosening of the endoprosthesis components, which can lead to many repeated surgical interventions. In recent years, hypotheses about the possible role of infectious agents in articular pathology have been discussed, as evidenced by the detection of specific antibodies and antigens of pathogens in the joint fluid and periarticular tissues. Mycoplasmas can trigger the development of osteonecrosis because the bone marrow is the main depot and source of endogenous reinfection (when immunity is weakened). \u0000АIM: This study aimed to identify signs of the presence of mycoplasmas in the soft tissues of the hip joint and bone marrow of the femur during hip arthroplasty in patients with idiopathic avascular necrosis of the femoral head. \u0000MATERIALS AND METHODS: Clinical and laboratory data of 36 patients with idiopathic aseptic necrosis of the femoral head who underwent total hip arthroplasty were analyzed, and 11.1% of the patients had a history of sexually transmitted diseases. The tissues of the synovium and bone marrow were examined by polymerase chain reaction for the presence of DNA to sexually transmitted infections. \u0000RESULTS: The average age of the patients was 42.7 years, and the average period from disease onset to the time of surgery was 46.2 months. Bilateral joint damage was found in 78% of cases, and 91.7% of the patients had stage 4 femoral head disease (ARCO). The preoperative Harris score was 33.7 points on average. In history, 4 (11.1%) patients had sexually transmitted diseases. During the study, when analyzing tissue samples of the synovial membrane and bone marrow, DNA fragments of Chlamydia trachomatis, Mycoplasma genitalium, Ureaplasma spp., and M. hominis were not isolated in any case, including in patients with previous mycoplasma and chlamydial infection. \u0000CONCLUSION: The absence of mycoplasma suggests that a history of sexually transmitted diseases does not significantly affect the outcomes of hip arthroplasty in aseptic necrosis of the femoral head.","PeriodicalId":308632,"journal":{"name":"N.N. Priorov Journal of Traumatology and Orthopedics","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117048740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic scolioosis: long-term results of treatment of patients with the method of transpedicular fixation. Retrospective longitudinal study","authors":"Y. Zeynalov, Aleksander V. Burtsev","doi":"10.17816/vto110815","DOIUrl":"https://doi.org/10.17816/vto110815","url":null,"abstract":"BACKGROUND: Тhe study of the treatment results of patients with idiopathic scoliosis should include both objective assessment methods, such as radiography and multispiral computed tomography, and subjective methods related to the response of the patient or his/her parents to treatment. A set of indicators will only allow an objective assessment of the long-term treatment outcomes. \u0000AIM: To examine long-term treatment results of posterior transpedicular fixation in patients with idiopathic scoliosis of varying severity. \u0000MATERIALS AND METHODS: Long-term treatment results by posterior transpedicular fixation were studied in 300 patients with idiopathic scoliosis of varying severity. To assess the effectiveness of treatment, clinical and radiological diagnostic methods and SRS30 and SRS22 questionnaires were used. \u0000RESULTS: Treatment results in 1 year were studied in all patients and in 2 years in 225 patients (75%). In 150 patients (50%), the long-term treatment results was studied in 5, and in 15 of them (10%) in 1012 years. The achieved correction value was maintained with a slight loss depending on the magnitude of the initial deformity and correction achieved after the operation. The SRS22 questionnaire 2 years after treatment of grade II deformity (according to Chaklin) showed that the indicators of postoperative function and remained practically unchanged, and the scores on self-esteem, appearance, and attitude were higher (p 0.05). In grade IV deformity, the scores on the appearance and attitude of others were high without significant differences. \u0000CONCLUSION: Dorsal correction of the spine using transpedicular implants in patients with idiopathic scoliosis allows obtaining good treatment outcomes, which was confirmed by the preservation of correction during dynamic X-ray examination and assessment using the SRS22 questionnaire.","PeriodicalId":308632,"journal":{"name":"N.N. Priorov Journal of Traumatology and Orthopedics","volume":"1315 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132440255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoprosthesis replacement of the sternum handle in G1 chondrosarcoma: clinical case","authors":"A. A. Snetkov, D. Khaspekov, A. I. Snetkov, Gennadiy N. Machak","doi":"10.17816/vto109447","DOIUrl":"https://doi.org/10.17816/vto109447","url":null,"abstract":"BACKGROUND: Malignant neoplasms with lesions of the chest are quite rare in the sternum and range from 0.5 to 3.1% of the total number of patients with bone tumors of all localizations. In this connection, there are few publications describing the tactics of surgical treatment and methods of prosthetics of the formed defect. The present article describes a clinical case of successful application of an individual prosthesis of the manubrium of the sternum in G1 chondrosarcoma. \u0000CLINICAL CASE DESCRIPTION: to present a clinical observation of the surgical treatment of an 18-year-old patient with G1 chondrosarcoma of the manubrium of the sternum, with individual prosthetics. \u0000CONCLUSION: The use of modern 3D technologies based on the results of CT modeling allows, not only to plan the volume of necessary bone resection, but also to manufacture high-tech prostheses by using 3D printing to replace the defect with planning sufficient support capacity and function.","PeriodicalId":308632,"journal":{"name":"N.N. Priorov Journal of Traumatology and Orthopedics","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127768439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-stage ventral correction of the secondary thoracolumbar kyphosis in a patient with failed transpedicular fixation of Th12 fracture","authors":"V. Ostrovskij, A. Shulga, V. Zaretskov, S. Bazhanov, Sergey V. Likhachov, Alexey A. Smolkin","doi":"10.17816/vto106716","DOIUrl":"https://doi.org/10.17816/vto106716","url":null,"abstract":"The main surgical treatment technique of thoracic and lumbar spine acute injuries is transpedicular fixation, the failure of which, according to the literature data, occurs in 1015% of cases. There are no common views on tactics and the surgical technique used to deal with the consequences of unstable transpedicular spondylosynthesis. And the publications devoted to the use of isolated anterior interventions are the least common. \u0000We present a case study of the surgical management of the 71 years old patient with secondary thoracolumbar kyphosis that progressed after failed transpedicular fixation of Th12 fracture. The deformity was corrected with one-stage anterior approach and ventral crew system.","PeriodicalId":308632,"journal":{"name":"N.N. Priorov Journal of Traumatology and Orthopedics","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128135800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of fractures of the proximal femur in people older than 50 years: what has changed in the last 30 years?","authors":"Mikhail Samarin, Zaid A. Asi Habiballah, A. V. Krivova, S. Rodionova, I. A. Solomyannik","doi":"10.17816/vto109748","DOIUrl":"https://doi.org/10.17816/vto109748","url":null,"abstract":"The analysis of works devoted to the issues of the epidemiology of fractures of the proximal femur confirms the relevance of these studies, which is associated with both the aging of the population and the increase in cases of osteoporosis and the number of fractures against this background. The review presents data on the hospitalization of patients in Russia and the CIS countries with PPBP. It is shown that selective hospitalization of patients with PPBP does not allow obtaining objective data on their prevalence, while this information is an important component of planning and organizing medical care, including at the stage of providing specialized trauma and orthopedic care. As for treatment, in Russia and the countries there is a low level of surgical and high conservative treatment using outdated techniques. This approach reduces the possibility of almost 70% of patients returning to the quality of life they had before the fracture. At the same time, monitoring the situation can be the first step in organizing organizational measures in a particular country or region to improve the detection of fractures and their treatment.","PeriodicalId":308632,"journal":{"name":"N.N. Priorov Journal of Traumatology and Orthopedics","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131696676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior pelvic ring injuries: classification, diagnosis, methods of treatment","authors":"N. A. Aganesov, A. Lazarev, A. A. Kuleshov, M. S. Vetrile, I. N. Lisyansky, S. N. Makarov, V. R. Zakharin","doi":"10.17816/vto109172","DOIUrl":"https://doi.org/10.17816/vto109172","url":null,"abstract":"This article aimed to familiarize the reader with the features of classification, diagnosis, and treatment methods of posterior pelvic ring injuries. It presents a review of literatures from PubMed (MEDLINE) and eLibrary investigating posterior pelvic ring injuries. A total of 67 scientific papers were covered. Modern aspects of classification, diagnostics, and surgical methods of treatment of the posterior pelvic ring injuries were analyzed. However, the classification of posterior pelvic injuries remains a difficult problem. Currently, various classifications of sacral fractures have been proposed, but sacral fractures cannot be considered separately from the entire pelvic ring because it is not only a part of the spine but also of the pelvis. The gold standard diagnostic modality of a patient with suspected pelvic ring damage is computed tomography, which reduces the frequency of missed or delayed diagnosis of pelvic injuries. Spino-pelvic fixation in combination with iliosacral screws or plate (triangular osteosynthesis) is the most stable technique for the stabilization of the dorsal pelvic ring. However, the higher risks of failure of the postoperative wound and the risks of deep infection with subsequent removal of the metal fixator should be considered. In the absence of clinically significant displacement, but in the presence of pelvic ring instability, minimally invasive methods of the stabilization of the posterior pelvic ring are preferred.","PeriodicalId":308632,"journal":{"name":"N.N. Priorov Journal of Traumatology and Orthopedics","volume":"145 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114003690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-vascularized toe phalanges transplantation in congenital hand malformations","authors":"Pavel A. Matveev, I. Shvedovchenko, A. Koltsov","doi":"10.17816/vto108463","DOIUrl":"https://doi.org/10.17816/vto108463","url":null,"abstract":"According to the world literature, congenital malformations of the upper limb are found in 2.37.9 per 10 thousand live births, while anomalies in the development of the hand occur in 6595% of patients, the most common are reduction anomalies (brachydactyly, ectrodactyly, adactyly, hypoplasia). Various methods of reconstructive plastic surgery are known in the world literature, including microsurgery, compression-distraction osteosynthesis, various types of skin, tendon-muscle and bone plasty, as well as prosthetics. Non-vascularized toe phalanges transplantation is a less common method, which is effective and technically accessible in case of reduction anomalies of the hand. This study is aimed at studying the relevance of the application of the presented method based on the analysis of world literature. \u0000The aim of the review is the analysis of the world experience of using non-vascularized toe phalanges transplantation in case of congenital hand malformations. A search was made for literature sources in the open electronic databases PubMed and eLibrary for the last 110 years. The publications devoted to the study of the effectiveness of transplanting the phalanges of the toes into defects of the fingers in clinical practice are analyzed. This method has a number of advantages: low morbidity for the donor foot, minimal risk of resorption of the transplanted graft, restoration of the anatomy of the formed finger, preservation of blood supply and sensitivity in the formed finger, the possibility of phalanx growth while maintaining the growth zone, the functionality of the fingers. At the same time, such issues as the detailed functioning of the growth zone of the non-perfusion phalanx after its transplantation, the reasons for the continuation or cessation of growth in the short term after surgery, the resorption of displaced phalanges, and the dependence of the mobility of the reconstructed fingers on the technology of interventions are not indicated anywhere. \u0000Conducting further research on the role of transplantation of non-vascularized toe phalanges in the pathology of the hand in children seems to be an actual task.","PeriodicalId":308632,"journal":{"name":"N.N. Priorov Journal of Traumatology and Orthopedics","volume":"127 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131510124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}