Travmatologiya i ortopediya Rossii最新文献

{"title":"АРТРОСКОПИЧЕСКИЙ ШОВ БОЛЬШИХ И МАССИВНЫХ РАЗРЫВОВ ВРАЩАТЕЛЬНОЙ МАНЖЕТЫ ПЛЕЧЕВОГО СУСТАВА: КЛИНИЧЕСКИЕ РЕЗУЛЬТАТЫ И ДАННЫЕ МРТ // ARTHROSCOPIC REPAIR OF LARGE AND MASSIVE ROTATOR CUFF TEARS: CLINICAL OUTCOMES AND POSTOPERATIVE MRI FINDINGS","authors":"S. Yu.","doi":"10.21823/2311-2905-2017-23-3-53-68","DOIUrl":"https://doi.org/10.21823/2311-2905-2017-23-3-53-68","url":null,"abstract":"Purpose of the study – to identify incidence rate of recurrent rotator cuff (RC) tears, to evaluate outcomes of arthroscopic bone-tendon anchor suture, to determine the factors influencing arthroscopic treatment outcomes.Materials and methods. Medical history data, pre-operative x-rays and MRI of shoulder joints of 305 patients (main group) who underwent arthroscopic bone-tendon anchor suture repair of large or massive RC tears during 2010-2016 were included in the study. Follow up period ranged from 1 to 6 years postoperatively with mean value of 25,6±4,5 months. Telephone survey of patients was conducted after the surgery as well as a single examination of patients with evaluation by functional scales – UCLA, ASES, CS, VAS, DN4. Preoperative standard x-rays in AP and axial views were done in all patients. Arthropathy severity was evaluated by K.Hamada classification. Comparison of patient specific data, features of RC lesions and surgical treatment was made by Kruskal-Wallis test.Results. Good outcomes by ASES, CS and UCLA functional scales were obtained in 15 (5%) of patients, satisfactory – in 213 (69.8%), poor – in 77 (25.2%). Postoperative MRI data provided the following sub-distribution of patients: 49 (41.1%) patients with complete repair of RC tendons lesions, 38 (31.9%) patients with partial repair and 33 (27.0%) patients with recurrent tear of reconstructed tendon. Correlation analysis allowed to establish the limits for achieving good outcomes of arthroscopic bone-tendon anchor suturing for significant association with infraspinatus muscle atrophy (not exceeding 40%) and fatty infiltration of supraspinatus muscle (not exceeding 23.5%). В настоящее время отсутствует единый подход к хирургическому лечению пациентов с большими и массивными разрывами ВМПС. Поэтому выбор рациональной лечебной тактики остается открытым.Цель исследования – выявить частоту повторных разрывов ВМПС, оценить результаты артроскопического костно-сухожильного якорного шва, определить факторы, влияющие на исходы артроскопического лечения.Материал и методы. Материалом исследования послужили данные историй болезни, дооперационные рентгенограммы и МРТ плечевых суставов 305 пациентов (основная группа), которым был выполнен артроскопический костно-сухожильный якорный шов большого или массивного разрыва ВМПС в период с 2010 по 2016 г. Сроки наблюдения составили от 1 года до 6 лет после выполненных операций, средний срок – 25,6±4,5 мес. После хирургического вмешательства были проведены опрос пациентов по телефону и однократный осмотр с заполнением функциональных шкал UCLA, ASES, CS, ВАШ, ДН-4. Всем больным проводили дооперационную стандартную рентгенографию плечевого сустава в прямой и аксиальной проекциях. Степень выраженности артропатии плечевого сустава оценивали по классификации K. Hamada. Сравнение данных, характеризующих пациентов, особенности повреждения вращательной манжеты и проводимого хирургического лечения проводили с помощью теста Краскела — Уоллиса.Результаты","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"23 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2017-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68391925","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":"ХИРУРГИЧЕСКОЕ ЛЕЧЕНИЕ КОНТРАКТУР И ДВИГАТЕЛЬНЫХ УСТАНОВОК ВЕРХНЕЙ КОНЕЧНОСТИ У ДЕТЕЙ СО СПАСТИЧЕСКИМИ ФОРМАМИ ДЦП (ОБЗОР ЛИТЕРАТУРЫ)","authors":"Андрей Владимирович Андреев, Д. В. Рыжиков, Елена Владимировна Губина","doi":"10.21823/2311-2905-2016-22-3-135-145","DOIUrl":"https://doi.org/10.21823/2311-2905-2016-22-3-135-145","url":null,"abstract":"Specific upper limb disorders accompanying spastic cerebral palsy substantially restrict self-care, writing abilities, hinder movements with external support aids and limit work capability. Spastic upper limb represents a complex multilevel abnormality progressing with age and leading to increased suffering of the patient. Little interest towards surgical correction of spastic upper limb along with insufficient awareness on surgical rehabilitation options leaves considerable number of patients without relevant treatment. The present paper describes advances and complexities of orthopaedic correction for spastic arm in ICP, key classifications used and treatment outcomes based on scientific literature analysis.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"22 1","pages":"135-145"},"PeriodicalIF":0.3,"publicationDate":"2016-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68391842","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":"ВОССТАНОВЛЕНИЕ ФУНКЦИИ ВЕРХНЕЙ КОНЕЧНОСТИ ПРИ ДИАФИЗАРНЫХ ПЕРЕЛОМАХ ЛУЧЕВОЙ И ЛОКТЕВОЙ КОСТЕЙ ПОСЛЕ ПРИМЕНЕНИЯ МАЛОИНВАЗИВНЫХ СПОСОБОВ ОСТЕОСИНТЕЗА","authors":"А. Н. Челноков, А. Ю. Лазарев, Леонид Николаевич Соломин, Павел Николаевич Кулеш","doi":"10.21823/2311-2905-2016-0-1-74-84","DOIUrl":"https://doi.org/10.21823/2311-2905-2016-0-1-74-84","url":null,"abstract":"Introduction. Closed intramedullary nailing and external fixation are minimally invasive treatment options in radial and ulnar shaft fractures. We found no comparative studies of these methods in the current literature. Objective. A comparative analysis of both methods in radial and ulnar shaft fractures treated by closed intramedullary nailing and external fixation. Material and methods. 63 patients with forearm shaft fractures treated by closed intramedullary nailing (group I); 24 patients treated by external fixation (group II). All patients were operated within 30 days after injury. Postoperatively, all patients were evaluated clinically (range of motion of elbow and wrist, rotation of the forearm) and radiologically. Disability of the Arm, Shoulder and Hand (DASH) score was used to assess the functional status and quality of life. Results. The average time of radiological bone union in the group I and group II was 12,6 ± 1,4 weeks. and 12,7 ± 0,6 weeks, accordingly. Statistically significant differences in range of motion in the elbow and wrist occurred in 1 month after the surgery with the advantage in Group I. Restoration of rotation was faster in Group I up to 1 year after surgery. DASH scores in 2 month after the surgery were 11,2±1,96 in the nailing group (as in healthy population) and 45,2±6,7 in the external fixation group. In 6 months after surgery the subjective assessment of the quality of life did not differ in both groups. Conclusion. Both minimally invasive methods of surgical stabilization provide restoration of anatomy of the forearm and complete functional recovery in final outcome, but closed intramedullary nailing results with significantly more rapid restoration of range of motions and quality of life measures.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"22 1","pages":"74-84"},"PeriodicalIF":0.3,"publicationDate":"2016-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68391826","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":"BIOLOGICAL RESPONSE METHOD IN REHABILITATION OF PATIENTS AFTER HIP JOINT ARTHROPLASTY","authors":"A. Vasil'kin, S. I. Shaparyuk, S. B. Shevchenko, A. Denisov","doi":"10.21823/2311-2905-2016-22-4-35-44","DOIUrl":"https://doi.org/10.21823/2311-2905-2016-22-4-35-44","url":null,"abstract":"Purpose – to develop a comprehensive physio- and functional treatment with biological response method to improve rehabilitation outcomes in patients after hip joint arthroplasty. Materials and methods. The study included 154 patients who underwent hip joint arthroplasty. All patients were divided in two groups – test group (82 patients) and control group (72 patients). In addition to conventional rehabilitation the patients of the test group underwent 10-12 procedures using biological response equipment. Outcomes were evaluated by clinical examination (VAS pain dynamics, goniometry), functional diagnostics (EMG), biomechanical examination (stability) as well as life quality assessment by SF-36. Patients were followed up to one year. results. In result of the study the authors observed regress in complaints and clinical symptoms in patients of both groups. VAS evaluation demonstrated that in the test group pain decrease was more significant (at 15-20% at various time stages), was reported earlier (5,0±0,9 days) and persisted during the follow up period. ROM increase of operated hip in the test group was 15-20% higher than in control group according to goniometry analysis. Patients of both groups demonstrated increased range and frequency of biopotential in examined muscles as well as a reduced displacement of gravity center of the body. However, a larger degree of above changes was observed in patients of the test group following biological response procedures that provide for exercise of affected muscles as well as for antagonistic muscles. Life quality improvement was faster in patients of the test group. Conclusion. The authors reported correlating results of clinical and biomechanical examinations, electromyography and life quality assessments that altogether prove efficiency and prospects of presented comprehensive rehabilitation treatment utilizing biological response method in patients after hip joint arthroplasty.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"22 1","pages":"35-44"},"PeriodicalIF":0.3,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68391856","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":"Пути предупреждения тромбоэмболических осложнений в травматологии и ортопедии: экспериментальное исследование","authors":"A. P. Vlasov, G. A. Shevalayev, R. R. Kremcheev, A. V. Meleshkin","doi":"10.21823/2311-2905-2015-0-2-66-73","DOIUrl":"https://doi.org/10.21823/2311-2905-2015-0-2-66-73","url":null,"abstract":"Objective - to examine coagulative and lytic activity of blood and tissues out of a blood flow with the combined anticoagulation and antioxidant therapy in the early posttraumatic period at pelvic bone fracture. Material and methods. The study was based on estimation of coagulation activity of tissues (skeletal muscles, liver, kidneys, heart and lungs) and blood at pelvic trauma while receiving anticoagulation and antioxidant therapy. All studies were performed in accordance with the federal ethical and legal standarts of investigations in experimental animals and approved by the local ethics committee. Results. It was found that anticoagulation (fraxiparine) and antioxidant (mexidol) therapy at pelvic trauma reduce the disturbances in the hemostatic system in the early posttraumatic period. Correction of hemostatic disorders was observed not only not only in the blood (organismal level), but also in the liver, kidneys, heart, lungs (the organ level). The effect of combination therapy on skeletal muscles in the area of injury was especially important - isolated use of anticoagulation therapy did not give such significant effect. Conclusion. Thus we obtained that using anticoagulant and antioxidant therapy on pelvic trauma is pathogenetically substantiated. It affected not only the intrinsic but also on the extrinsic coagulation pathway, which significantly increased likelihood of hemostatic disorders in early posttraumatic period.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"1 1","pages":"66-73"},"PeriodicalIF":0.3,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68391512","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":"Clinicoanatomic study of optimal arthroscopic approaches to the elbow","authors":"I. Kuznetsov, N. Fomin, M. R. Salikhov, G. I. Zhabin, D. Shulepov, S. A. Bantser","doi":"10.21823/2311-2905-2015-0-1-32-41","DOIUrl":"https://doi.org/10.21823/2311-2905-2015-0-1-32-41","url":null,"abstract":"","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"1 1","pages":"32-41"},"PeriodicalIF":0.3,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68391315","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":"Данные регистра эндопротезирования коленного сустава РНИИТО им. Р.Р. Вредена за 2011-2013 годы","authors":"N. Kornilov, T. A. Kulyaba, A. S. Fil, Y. V. Muravyeva","doi":"10.21823/2311-2905-2015-0-1-136-151","DOIUrl":"https://doi.org/10.21823/2311-2905-2015-0-1-136-151","url":null,"abstract":"The knee arthroplasty register was established in Vreden Russian Research Institute of Traumatology and Orthopedics on 01.01.2011 and during the following 3 years the data about 6530 primary (91,7%) and revision (8,3%) cases were collected. The average age of patients was 62,72 ±11,5 years with the prevalence of women both in primary (80%) and revision (70%) arthroplasty cohorts. The main group consisted from the patients with knee osteoarthritis (92%) with annual growth of the obese. Total cemented knee replacement without patella resurfacing was the most popular type of primary arthroplasty (96%) with the prevalence of PCL retaining implants (62,13±3,84%). Despite annual decrease of revisions due to infection they predominate under aseptic cases: in 2011 - 64,7% and 35,3%, in 2012 - 62,8% и 37,2% , in 2013 - 53,1% and 46,9% accordingly. The main reason for non-infected revision TKA was implant loosening (17%). This is the first attempt to describe the trends in knee arthroplasty based on data from register of Russian Research Institute of Traumatology and Orthopedics. It’s structure allows to perform multifactorial analysis of knee replacement surgeries and in the future to evaluate implants survival rate.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"1 1","pages":"136-151"},"PeriodicalIF":0.3,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68391221","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":"Современные подходы к хирургическому лечению хронической задней нестабильности коленного сустава (обзор литературы)","authors":"I. Kuznetsov, N. Fomin, D. A. Shulepov, M. R. Salikhov","doi":"10.21823/2311-2905-2015-0-1-95-105","DOIUrl":"https://doi.org/10.21823/2311-2905-2015-0-1-95-105","url":null,"abstract":"The history of surgical treatment of the posterior cruciate ligament injuries spanned more than 100 years. The first publications describing knee surgical stabilization have appeared in the early 20th century Until the early 1980’s there were several original methods of surgical treatment of posterior cruciate ligament injury including a dynamic stabilization with plasty by local tissues. Since the 1980’s with the development of arthroscopy the approach to surgical treatment of knee ligament injuries has changed. The authors discussed both advantages and disadvantages of different techniques of arthroscopic posterior cruciate ligament plasty. This review presents different views on arthroscopic repair of posterior cruciate ligament at present time.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"1 1","pages":"95-105"},"PeriodicalIF":0.3,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68391438","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":"Диагностическое значение рентгенологических признаков тарзальных коалиций","authors":"A. V. Sapogovkiy, V. Kenis, R. H. Khusainov","doi":"10.21823/2311-2905-2014-0-1-86-91","DOIUrl":"https://doi.org/10.21823/2311-2905-2014-0-1-86-91","url":null,"abstract":"Tarsal coalition - is an abnormal fusion between two or more tarsal bones which can lead to foot pain, progressive foot deformity, and frequent ankle sprains. Radiological diagnosis of tarsal coalitions on the standard plain radiographs is difficult because of indirect visualization of the fusion zone. Computed tomography is helpful for confirmation of the diagnosis. Purpose: to determine diagnostic value of indirect radiological signs of tarsal coalitions. Material and methods. The analysis of the radiographs of 25 patients with confirmed tarsal coalitions and the radiographs of 37 patients with valgus deformities of feet without tarsal coalitions. Results. The sensitivity and specificity of tarsal coalitions radiological signs were determined. Sensitivity of the \"anteater nose\" in our study was 92,3%, specificity - 94,31%; C-sign had sensitivity 88,89% and specificity - 77,08%; “talar beak” symptom had sensitivity 36,36 percent and specificity - 97,14%. Conclusion. Sensitivity and specificity of indirect radiological signs of tarsal coalitions determined in our study have sufficient diagnostic value, and computed tomography of the foot should be done for confirmation of diagnosis.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"1 1","pages":"86-91"},"PeriodicalIF":0.3,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68391158","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":"Рецидивы косолапости у детей после лечения по методу Понсети","authors":"V. F. Blandinskiy, M. A. Vavilov, I. V. Gromov","doi":"10.21823/2311-2905-2013--1-99-103","DOIUrl":"https://doi.org/10.21823/2311-2905-2013--1-99-103","url":null,"abstract":"Congenital clubfoot is one of the most frequent pathologies of the musculoskeletal system. The treating of clubfoot by Ponseti gives promising results and complete correction of the deformity in 90-95% of patients sparing them from extensive surgery. In the Yaroslavl Regional Children's Hospital from May 2006 to December 2007 54 children (83 feet) with severe congenital clubfoot were treated. Treatment for all patients was initiated at the age of 1 year. With remote monitoring for 5 years recurrences were noted in 19.3% of cases. Despite its high efficacy in patients under the age of three years, non-compliance of brace wearing results in the number of recurrences and require re-gypsum. In older children (3 to 5 years) the treatment by Ponseti is supplemented by transfer of tibialis anterior muscle tendon. In cases of postoperative recurrence of the treatment program is complemented by local releases and arthrodesis.","PeriodicalId":43463,"journal":{"name":"Travmatologiya i ortopediya Rossii","volume":"1 1","pages":"99-103"},"PeriodicalIF":0.3,"publicationDate":"2013-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68391113","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}