Ortopediia travmatologiia i protezirovanie最新文献

{"title":"CURRENT ISSUES OF TREATMENT AND REHABILITATION OF VICTIMS WITH A COMBAT INJURY OF THE LOCOMOTOR SYSTEM ON THE MODERN STAGE (REVIEW)","authors":"V. Tankut, I. Golubeva, Mykola Rykun, Kostyantyn Berenov, Viktoria Androsenkova","doi":"10.15674/0030-59872023284-90","DOIUrl":"https://doi.org/10.15674/0030-59872023284-90","url":null,"abstract":"With a beginning of active battle actions in Ukraine the number of victims with gunshot, mine-explosive and shrapnel injuries of the locomotor system among both the military and the civilian population increased sharply. Therefore, the problems of treatment and rehabilitation of victims of hostilities have become especially acute in the last year. Aim. To analyze literary sources on the issue of providing medical aid for gunshot injuries of the musculoskeletal system, to identify problems and prospective directions of rehabilitation treatment of the consequences of combat trauma. Methods. An analytical review of scientific works on the treatment of gunshot and mine-explosive injuries of the musculoskeletal system and their consequences was conducted. Results. It is shown that in recent decades, as a result of the creation of modern firearms and explosive shells, the scale and severity of traumatic injuries have increased significantly, and the frequency of multiple and combined injuries has also increased. Fire injuries of the musculoskeletal system are accompanied by many complications and unsatisfactory anatomical and functional results of treatment. Such injuries are characterized by a traumatic disease that develops in response to combat trauma and has a long and complicated course, high rates of mortality and severe disability. Extremity injuries are the most common — 65‒75 %, and in some combat operations — 80 % or more. The most serious injuries include mine-explosive injuries, which are accompanied by massive damage to the soft tissues of the limbs, main vessels and nerves, and the development of compartment syndrome. 19.1–52.9%) and permanent disability. Conclusions. Damages of the spine and spinal cord lead to high mortality (19.1–52.9 %) and permanent disability. Conclusions. Despite the significant number of developed restorative treatment and rehabilitation technologies victims with gunshot and mine-explosive injuries, specialists continue to improve methods of physical rehabilitation, and work on eliminating problems and shortcomings that still exist in the organization of rehabilitation measures.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47822081","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":"STUDY OF THE INFLUENCE OF THE POSITION OF THE TENDON GRAFT HAMSTRING MUSCLE ON THE STABILITY OF THE KNEE JOINT UNDER THE CONDITIONS OF PLASTICITY OF THE STRUCTURES OF THE POSTEROLATERAL ANGLE","authors":"M. Golovakha, S. Panchenko, Stanislav Bondarenko, Andrey Bezverkhyi","doi":"10.15674/0030-5987202325-12","DOIUrl":"https://doi.org/10.15674/0030-5987202325-12","url":null,"abstract":"Damage to the posterolateral angle of the knee joint is an injury that occurs occasionally and can be isolated or combined with tears of the posterior or anterior cruciate ligaments. The key link of damage to the posterior lateral corner is the rupture of the tendon of the hamstring muscle, mained stabilizer of excess external rotation lower legs. Objective. Determine the optimal fixation position tendon graft on the posterior surface of the tibia subject to recovery of the hamstring muscle which ensuring the greatest stability of the lower leg during external rotation. Methods. Models of the knee joint were built with different  attachment points of the popliteal graft muscle in the ANSYS software environment. The criteria for evaluating the effectiveness of selecting the fixation point of the transplant were chosen as the degree of movement of the finite parts elements of the model. Results. The smallest movements in all directions received in the case when the transplant fixed as far as possible outwards and upwards, near the joint surface. Maximum — in the direction of the coordinate axes, as well as full movement were recorded for the control model, in the absence of the hamstring tendon The nature of the distribution of displacement fields in all models p graft and control were identical. Biggest there were additional displacements in the direction of the x axis (outward). on the front border of the platform, and the largest negative (so far redins) on the back. The largest additional shifts to the sides the y (front) axes are fixed at the leftmost limit and the largest negative (back) — to the rightю Conclusions. In view of the stability of the lower leg during rotational loading, the most effective is fixation of the hamstring graft on the back surface of the fibula is as late as possible and closer to its cardiac surface, finished in this case, the dimensions are found to be the smallest in all directions. The greatest displacement in all directions obtained in the control model for less tendon hamstring muscle.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44286909","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":"ANATOMICAL AND FUNCTIONAL PREREQUISITES FOR THE DEVELOPMENT OF ENDOPROSTHESIS INSTABILITY AFTER MONOCANDYLAR KNEE ARTHROPLASTY","authors":"O. Karpinska, Rami Tale Khaled Wahbeh","doi":"10.15674/0030-59872023213-18","DOIUrl":"https://doi.org/10.15674/0030-59872023213-18","url":null,"abstract":"Monocondylar knee arthroplasty allows to restore normal kinematics and function of the knee joint in the case of osteoarthritis limited to the medial or lateral part of the joint. Objective. To identify the patterns and features of secondary anatomical and functional changes in the knee joint after monocandylar arthroplasty depending on the patientʼs gender, weight, etiology of gonarthrosis, the magnitude of the primary joint deformity and bone tissue condition. Methods. The results of the examination of 71 patients (age 37–83 years, follow-up period 3–10 years) were analyzed. In 20 (28.2 %) patients, problems with the arthroplasty joint occurred. joint: increased frontal deformity angle — 8 (40 %), decreased joint mobility — 12 (60 %), pain in the implantation area — 10 (50 %). Results. Preoperative factors that may affect the outcome of monocandylar knee arthroplasty were identified. The main one is reduced bone density, especially localized osteoporosis. In the presence of osteoporotic areas in the area of arthroplasty, the risk of endoprosthesisinstability can reach 100 %. The second important factor is frontal deformities of the knee joint of more than 10°. Other factors, such as obesity, meniscal and crossed ligament injuries, fractures of the femoral and tibial condyles, also affect the development of complications, especially with a simultaneousdecrease in bone mineral density and/or significant frontal deformity of the knee joint. Conclusions. Monocondylar knee arthroplasty is a reliable, costeffective, low-traumatic method of treating gonarthrosis, but subject to clear indications for its implementation. In the long term, patients with osteoporosis, meniscal and ligamentous injuries, fractures of the condyles, and frontal deformities of more than 10° may develop signs of endoprosthesis instability.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46047050","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":"CHANGES IN MARKERS OF BONE TISSUE REMODELING AND THE INFLAMMATORY PROCESS IN THE BLOOD SERUM OF WHITE RATS IN CASE OF DEFECT FILLING OF THE FEMUR WITH IMPLANTS BASED ON POLYLACTIDE AND TRICALCIUMPHOSPHATE WITH MESENCHYMAL STEM CELLS","authors":"N. Gontar","doi":"10.15674/0030-59872023233-42","DOIUrl":"https://doi.org/10.15674/0030-59872023233-42","url":null,"abstract":"Objective. Based on the analysis of markers of inflammation and metabolism of bone tissue in the blood serum of laboratory rats, to evaluate the course of bone remodeling after filling the defect in the distal metaphysis of the femur with 3D-printed implants based on polylactide and tricalcium phosphate (3D-I) alone or in combination with mesenchymal stromal cells (MSCs). Methods. 53 white rats were used, which were divided into groups: intact (5 animals) — the operation was not performed; Control (15) — 3D-I; Experiment I (15) — 3D-I + cultured alloMSCs; Experiment II (15) — 3D-I + introduction of alloMSCs into the area of surgical intervention 7 days after implantation. The following were studied: the content of glycoproteins (GP), interleukin-6 (IL-6), osteocalcin, chondroitin sulfates (CS), total protein, calcium, alkaline (AlP) and acid phosphatase (AP) activity, and their ratio, mineralization indices were calculated. Results. Compared with intact animals, higher indicators were determined in the rats of the Control group: the content of GP by 39.73; 32.88; 23.29 %; CS — 250.00; 222.09 and 196.51 %, AlP activity — 81.67, 51.03, 39.36 %, on the 15th, 30th, and 90th days of the experiment; IL-6 — 44.89; 60.06 % on the 15th and 30th days. In the rats of the Experiment I g roup: the content of GP — by 82.19; 65.75, 57.53 %, IL-6 — 72.14; 96.59; 79.88 %, CS — 306.98; 276.74; 253.49 %; AlP activity — 63.73; 129.70; 51.28 %, on the 15th, 30th and 90th days of the experiment. In the Experiment II group: on the 15th, 30th and 90th days, the content of GP was higher by 27.40; 26.03; 129.18 %; CS — by 175.58; 137.21 and 115.12 %; AlP activity — 192.99; 178.02, 76.31 %; on the 15th and 30th days: IL-6 — by 37.46; 20.74 %. Conclusions. In the case of filling the defect with 3D-printed implants, biochemical signs of moderate inflammation were determined; 3D-printed implants together with MSCs — pronounced inflammation, slowing of bone formation, formation of connective tissue; 3D-printed implants with postoperative injection of MSCs — moderate inflammation and optimal conditions for healing the defect with bone tissue.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42297703","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":"X-RAY ASSESSMENT OF THE EFFICIENCY OF HYBRID STABLE-ELASTIC FIXATION UNSTABLE ANKLE FRACTURES","authors":"V. Sulyma, A. Chuzhak, Yu.O. Filiak, Uliana Kuz, Lubomyr Yuriychuk, Yurii Symchych","doi":"10.15674/0030-59872023219-24","DOIUrl":"https://doi.org/10.15674/0030-59872023219-24","url":null,"abstract":"The level of complications after treatment of patients with bone fractures stays high 22–60 %. Understanding ankle-foot joint biomechanics is critical for choosing trendy methods hybrid fixation or the traditional fixation of the fibula plate and positional screw for distal syndesmosis. Objective. To analyze the effectiveness of surgical treatment of patients with unstable trans- and suprasyndesmosis fractures with hybrid stable-elastic fixation (HSEF) in comparison with the traditional method of fixation with a bone plate with a positioning screw according to X-ray morphometric parameters. Methods. 82 patients with unstable trans- and suprasyndesmotic fractures of the fibula. The main (I group) of the study consisted of 18 (21,95 %) patients with an average age of (41,6 ± 15,5) years who operated with hybrid stable-elastic fixation, and the control (II group) — 64 (78.05 %) patients with an average age of (52,4 ± 15,7) years, who operated with a bone plate with a positioning screw. Results. The TTA was 0.63 times lower than in patients after traditional fixation. For type C fractures in patients after HSEF, the value of TTA was also 0.78 times (p = 0.0005). Conclusions. The analysis of X-ray morphometric parameters of the angle of inclination of the talus bone and the talus-tibia angle confirms the advantage of hybrid stable-elastic fixation in trans- or supra-syndesmotic fractures of the fibula with damage to the distal inter-tibial syndesmosis. According to the value of the index of the angle of inclination of the talus in patients after hybrid stable-elastic fixation, lower risks of ankle-foot joint instability in the p/o period were found than in patients after traditional osteosynthesis. Median values of the talus-tibia angle indicated a tendency to shorten the fibula in patients after traditional osteosynthesis.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44415730","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":"SERUM VITAMIN D IN PATIENTS WITH BENIGN, PRIMARY MALIGNANT AND METASTATIC BONE TUMORS","authors":"O. Drobotun, Мykola Ternovy, Мykola Kolotilov","doi":"10.15674/0030-59872023250-55","DOIUrl":"https://doi.org/10.15674/0030-59872023250-55","url":null,"abstract":"Participant in the process of normal bone remodeling is vitamin D, which, in addition, has antiinflammatory (anti-cytokine), anti-proliferative and anti-tumor  effects. Objective of the study is to assess the level of 25-hydroxyvitamin D3 concentration in blood serum before the start of treatment in patients with benign, primary malignant and metastatic bone tumors, taking into account polymorbidity. Materials and methods. The following patients were included in the study: 21 patients with benign pelvic bone tumors; 52 patients with malignant tumors of the bones of the pelvis and lower limbs; 52 patients with metastatic tumors of the bones of the pelvis and lower limbs. The control group consisted of 22 practically healthy volunteers without chronic diseases. The content of vitamin D was determined by the immunochemiluminescence method. The results. The content of vitamin D in blood serum in patients with benign bone tumors is in the range from 22.4 to 29.6 ng/ml, with primary malignant tumors — from 7.8 to 15.9 ng/ml, with metastatic ones — from 13.8 to 15.5 ng/ml. There are no statistically significant differences between the histotypes of primary malignant bone tumors (p > 0.05). Conclusions. Polymorbidity statistically significantly increases vitamin D deficiency in patients with osteogenic sarcoma and patients with metastatic bone tumors (p < 0.05). According to the national classification of vitamin D content, patients with benign bone tumors have a suboptimal level of vitamin D, while patients with primary malignant and metastatic bone tumors have vitamin D deficiency.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49224799","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":"MATHEMATICAL MODELING OF VARIANTS OF TRANSPEDICULAR FIXATION AT THE THORACOLUMBAR JUNCTION AFTER ТHХІІ VERTEBRECTOMY DURING TRUNK BACKWARD BENDING","authors":"O. Nekhlopochyn, V. Verbov, I. Cheshuk, Mykhailo Karpinsky, O. Yaresko","doi":"10.15674/0030-59872023243-49","DOIUrl":"https://doi.org/10.15674/0030-59872023243-49","url":null,"abstract":"Fractures at the thoracolumbar junction are the most common traumatic spinal injuries. Advances in instrumentation for vertebral body replacement have significantly improved surgical techniques.However, the biomechanical characteristics of stabilizing surgeries have been insufficiently studied. Objective. To investigate the stressstrain state (SSS) of a mathematical finite element model of the humanthoracolumbar spine during trunk backward bending after ТhХІІ vertebra resection, considering different transpedicular fixation options. Methods. A mathematical finite element model of the humanthoracolumbar spine — ThIX‒LV vertebrae — was developed. The ТhХІІ vertebra was removed, and an interbody support and transpedicularsystem with 8 screws were implanted to simulate the postsurgical state after a ТhХІІ burst fracture with wide laminectomy, facetectomy, and corpectomy. The influence of transpedicular screw length and the presence of cross-links on the SSS of the model wasexamined. Results. The use of bicortical screws reduced stress levels in the bone elements of the model, except in the regions around the screws in the lumbar vertebrae, when compared to short screws.Installing cross-links decreased stress levels at all control points compared to models without cross-links. Specifically, in the presence of cross-links, the SSS values at the entry points of the short screwsinto the vertebral bodies of ThX, ThXI, LI, and LII were 2.3, 1.8, 1.2, and 5.0MPa, respectively, compared to 2.7, 2.0, 1.5, and 6.1 MPa in the models without cross-links. In the case of bicortical screwswithout cross-links, the stress values at the screw entry points into the pedicles of the corresponding vertebrae were 2.9, 1.5, 8.2, and 11.2 MPa, respectively, compared to 2.7, 1.5, 7.5, and 10.2 MPa in the models with cross-links. Conclusions. When the trunk is tilted backward, the use of cross-links reduces stress levels at all control points in the models, regardless of the screw length used. Bicortical transpedicular screws increase stress levels on the screws themselves and in the lumbar vertebral bodies surrounding them.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46929519","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":"[Bite wounds].","authors":"V. R. Oster, V. Chikin","doi":"10.1542/9781610025225-part02-ch008","DOIUrl":"https://doi.org/10.1542/9781610025225-part02-ch008","url":null,"abstract":"","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":"50 1","pages":"57-9"},"PeriodicalIF":0.0,"publicationDate":"2021-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79323828","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":"Aĭdyn Salarovich Imamaliev.","authors":"V. I. Zorya, V. I. Zorya","doi":"10.17816/vto201118490-91","DOIUrl":"https://doi.org/10.17816/vto201118490-91","url":null,"abstract":"In July 2001, Doctor of Medical Sciences, Professor of the Department of Traumatology, Orthopedics and Military Field Surgery of the Moscow State Medical and Dental University, Honored Scientist of the Russian Federation, Honored Inventor of the Russian Federation Aidyn Saparovich Imamaliev turned 75 years old.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":"1 1","pages":"90-1"},"PeriodicalIF":0.0,"publicationDate":"2011-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75684517","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":"[Konstantin Mitrofanovich Sivash].","authors":"K. M. Sherepo","doi":"10.17816/vto97927","DOIUrl":"https://doi.org/10.17816/vto97927","url":null,"abstract":"On February 23, 1999, Professor K.M. Sivash. He hasn't been with us for 10 years. It is known that often even the most significant scientific achievements receive a true assessment only after a long time, sometimes after the death of a scientist. Konstantin Mitrofanovich won wide recognition and fame during his lifetime. However, over time, his contribution to science seems to be more significant.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":"8 1","pages":"82"},"PeriodicalIF":0.0,"publicationDate":"1999-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74260250","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}