Pub Date : 2024-04-14DOI: 10.15674/0030-59872024196-97
The article is devoted to Ashukina N. O.
这篇文章专门介绍了 Ashukina N. O.O.
{"title":"Natalija Oleksandrivna Ashukina","authors":"","doi":"10.15674/0030-59872024196-97","DOIUrl":"https://doi.org/10.15674/0030-59872024196-97","url":null,"abstract":"The article is devoted to Ashukina N. O.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"183 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706285","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}
Pub Date : 2024-04-14DOI: 10.15674/0030-5987202415-12
Stanislav Bondarenko, Oleksandr Fomin, Iurii Lazarenko
As a result of large-scale war in Ukraine, the frequency of gunshot wounds of the upper extremities has increased dramatically, accompanied by massive damage to soft tissue, neurovascular plexuses, and significant bone deficiency, so their treatment with traditional methods is risky. This leads to the development of new treatment methods, in particular, techniques for shoulder arthrodesis. Objective. To investigate the effectiveness of shoulder arthrodesis using an individual 3D-titanium implant and or a locked compression plate (LCP) with bone autoplasty for the treatment of severe combat trauma of the upper extremity. Methods. In 2022–2023, 19 men aged 36.2 (24–52) years with severe combat trauma of the upper extremity underwent shoulder arthrodesis using individual 3D-titanium implants (n = 9) or LCP with bone autoplasty (n = 10). The follow-up period was 18 months. Individual 3D-implants were created in the CAD program Autodesk Fusion 360 and made of Ti6AI4V alloy by three- dimensional metal 3D-printing. The functional status of the shoulder joint was assessed by the Oxford Shoulder Score, VAS at 6 and 12 months after surgery. Fusion was checked radiographically at 1, 3, 6 and 12 months. Results. The average follow-up period was 12 months. Ankylosis of the shoulder joint was formed in 18 (95 %) patients, and clinical consolidation without final restructuring with a positive tendency to bone fusion was detected in one patient (5 %). Radiologically confirmed fusion in 8.5 months (6–12). After 12 months, a decrease in pain (VAS: 5 to 1 points; p < 0.001) and improvement in the condition of the shoulder (Oxford Shoulder Score: 25 to 40 points, p < 0.001) were found compared with 6 months. Conclusions. Treatment of severe combat trauma of the upper extremity by shoulder arthrodesis allows to eliminate pain and restore sufficient function to perform daily tasks one year after surgery. The combination of shoulder arthrodesis with individual 3D-implants resulted in the restoration of upper limb function in all 9 patients with massive bone and muscle defects.
{"title":"EARLY RESULTS OF SHOULDER ARTHRODESIS WITH 3D-TITANIUM IMPLANTS FOR TREATMENT OF SEVERE GUNSHOT WOUNDS OF THE SHOULDER GIRDLE","authors":"Stanislav Bondarenko, Oleksandr Fomin, Iurii Lazarenko","doi":"10.15674/0030-5987202415-12","DOIUrl":"https://doi.org/10.15674/0030-5987202415-12","url":null,"abstract":"As a result of large-scale war in Ukraine, the frequency of gunshot wounds of the upper extremities has increased dramatically, accompanied by massive damage to soft tissue, neurovascular plexuses, and significant bone deficiency, so their treatment with traditional methods is risky. This leads to the development of new treatment methods, in particular, techniques for shoulder arthrodesis. Objective. To investigate the effectiveness of shoulder arthrodesis using an individual 3D-titanium implant and or a locked compression plate (LCP) with bone autoplasty for the treatment of severe combat trauma of the upper extremity. Methods. In 2022–2023, 19 men aged 36.2 (24–52) years with severe combat trauma of the upper extremity underwent shoulder arthrodesis using individual 3D-titanium implants (n = 9) or LCP with bone autoplasty (n = 10). The follow-up period was 18 months. Individual 3D-implants were created in the CAD program Autodesk Fusion 360 and made of Ti6AI4V alloy by three- dimensional metal 3D-printing. The functional status of the shoulder joint was assessed by the Oxford Shoulder Score, VAS at 6 and 12 months after surgery. Fusion was checked radiographically at 1, 3, 6 and 12 months. Results. The average follow-up period was 12 months. Ankylosis of the shoulder joint was formed in 18 (95 %) patients, and clinical consolidation without final restructuring with a positive tendency to bone fusion was detected in one patient (5 %). Radiologically confirmed fusion in 8.5 months (6–12). After 12 months, a decrease in pain (VAS: 5 to 1 points; p < 0.001) and improvement in the condition of the shoulder (Oxford Shoulder Score: 25 to 40 points, p < 0.001) were found compared with 6 months. Conclusions. Treatment of severe combat trauma of the upper extremity by shoulder arthrodesis allows to eliminate pain and restore sufficient function to perform daily tasks one year after surgery. The combination of shoulder arthrodesis with individual 3D-implants resulted in the restoration of upper limb function in all 9 patients with massive bone and muscle defects.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"64 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140704848","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}
Pub Date : 2024-04-14DOI: 10.15674/0030-59872024159-63
I. Trutyak, Oleksandr Korolkov, Nazar Hnateiko, Vitalij Ivashchenko, Vasyl Trunkvalter
Objective. To analyze changes in the nosological structure of patients, treatment technologies, to outline the peculiarities of surgical interventions in the trauma profile of a civilian clinical hospital during the war period and to emphasize the need for relevant knowledge and skills of specialists in the treatment of combat trauma and its consequences.Methods. A comparative analysis of the clinical and nosological structure of 2,475 patients were treated during the year before the war and 3,838 patients during the full-scale war year. Among them, 83.1 % were civilians, 7.7 % were temporarily resettled, and 9.2 % were military personnel. The study utilized bibliosemantic, medical-statistical, and clinical methods. Results. During the active phase of the war, the Orthopedics Department of the civilian clinical hospital provided specialized medical assistance to both civilian populations and military personnel injured during hostilities. The relative number of hospitalized men increased by 4.83 %, and although the absolute number of those urgently hospitalized decreased. Despite the overall increase in the number of operations per patient, surgical activity in the Orthopedics Department decreased from 86 to 80 %. The intensification of inpatient treatment organization, patient preparation for subsequent stages of surgical interventions in the Rehabilitation Department, and outpatient medicine work collectively reduced the average bed-day in the Orthopedics Department by 12.3 %. Conclusions. Thus, during the war, the structure of patients in the Orthopedics Department of the civilian medical clinical institution changed, with an increase in the relative number of male patients and those with multiple and combined injuries. A notable feature of the treatment process organization during hostilities is the phasing of the treatment of the wounded not only at the levels of medical evacuation but also within the clinical hospital. The intensification of the organizational component and the outpatient link of the treatment process allowed for a reduction in bed-days and the provision of inpatient treatment to a larger number of patients.
{"title":"Comparative Characteristics of Patients Structure in the Orthopedics Department of a Clinical Hospital in a Region Remote from the Front Line during Peacetime and the First Year of a Full-Scale War in Ukraine","authors":"I. Trutyak, Oleksandr Korolkov, Nazar Hnateiko, Vitalij Ivashchenko, Vasyl Trunkvalter","doi":"10.15674/0030-59872024159-63","DOIUrl":"https://doi.org/10.15674/0030-59872024159-63","url":null,"abstract":"Objective. To analyze changes in the nosological structure of patients, treatment technologies, to outline the peculiarities of surgical interventions in the trauma profile of a civilian clinical hospital during the war period and to emphasize the need for relevant knowledge and skills of specialists in the treatment of combat trauma and its consequences.Methods. A comparative analysis of the clinical and nosological structure of 2,475 patients were treated during the year before the war and 3,838 patients during the full-scale war year. Among them, 83.1 % were civilians, 7.7 % were temporarily resettled, and 9.2 % were military personnel. The study utilized bibliosemantic, medical-statistical, and clinical methods. Results. During the active phase of the war, the Orthopedics Department of the civilian clinical hospital provided specialized medical assistance to both civilian populations and military personnel injured during hostilities. The relative number of hospitalized men increased by 4.83 %, and although the absolute number of those urgently hospitalized decreased. Despite the overall increase in the number of operations per patient, surgical activity in the Orthopedics Department decreased from 86 to 80 %. The intensification of inpatient treatment organization, patient preparation for subsequent stages of surgical interventions in the Rehabilitation Department, and outpatient medicine work collectively reduced the average bed-day in the Orthopedics Department by 12.3 %. Conclusions. Thus, during the war, the structure of patients in the Orthopedics Department of the civilian medical clinical institution changed, with an increase in the relative number of male patients and those with multiple and combined injuries. A notable feature of the treatment process organization during hostilities is the phasing of the treatment of the wounded not only at the levels of medical evacuation but also within the clinical hospital. The intensification of the organizational component and the outpatient link of the treatment process allowed for a reduction in bed-days and the provision of inpatient treatment to a larger number of patients.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"15 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706372","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}
Objective. To prove the possibility of using non-invasive diagnostics of the volemic state of postoperative patients using ultrasound assessment of inferior vena cava collapsibility index. Methods. The study included 67 patients who underwent transpedicular fixation of the spine with laminectomy. Volemiс status was determined for all participants in two ways: by catheterization of the central vein and determination of central venous pressure, as well as by ultrasound examination of the inferior vena cava and calculation of inferior vena cava collapsibility index. Results. According to the results of the invasive assessment of central venous pressure, patients were divided into 3 groups: group I (patients in hypovolemic state, n = 31), group II (patients in euvolemic state, n = 25) and group III (patients in hypervolemic state, n = 11 ). The average values of central venous pressure indicators in patients of these groups were statistically significantly different from each other (p < 0.01). The difference between the mean values of the inferior vena cava collapse index in the respective groups was statistically significant (p < 0.01). A reliable inverse correlation of very high strength was found between the indicators of inferior vena cava collapsibility index and central venous pressure (p < 0.05). Conclusions. Determination of the patient's volemic state is an extremely important tool for the correct selection of the fluid volume management. Ultrasound assessment of volemic status has a number of advantages, such as the non-invasiveness of the method, wide availability, low price and speed of execution. According to the results of our study, the possibility of using inferior vena cava collapsibility index to assess the volemic status of patients has been demonstrated.
{"title":"INFERIOR VENA CAVA COLLAPSIBILITY INDEX AS A NON-INVASIVE METHOD OF ASSESSING THE VOLEMIC STATUS OF PATIENTS DURING SPINE INTERVENTIONS","authors":"Mykhailo Ivachevskij, Andriy Rusyn, Vitalina Ivachevska","doi":"10.15674/0030-59872024133-37","DOIUrl":"https://doi.org/10.15674/0030-59872024133-37","url":null,"abstract":"Objective. To prove the possibility of using non-invasive diagnostics of the volemic state of postoperative patients using ultrasound assessment of inferior vena cava collapsibility index. Methods. The study included 67 patients who underwent transpedicular fixation of the spine with laminectomy. Volemiс status was determined for all participants in two ways: by catheterization of the central vein and determination of central venous pressure, as well as by ultrasound examination of the inferior vena cava and calculation of inferior vena cava collapsibility index. Results. According to the results of the invasive assessment of central venous pressure, patients were divided into 3 groups: group I (patients in hypovolemic state, n = 31), group II (patients in euvolemic state, n = 25) and group III (patients in hypervolemic state, n = 11 ). The average values of central venous pressure indicators in patients of these groups were statistically significantly different from each other (p < 0.01). The difference between the mean values of the inferior vena cava collapse index in the respective groups was statistically significant (p < 0.01). A reliable inverse correlation of very high strength was found between the indicators of inferior vena cava collapsibility index and central venous pressure (p < 0.05). Conclusions. Determination of the patient's volemic state is an extremely important tool for the correct selection of the fluid volume management. Ultrasound assessment of volemic status has a number of advantages, such as the non-invasiveness of the method, wide availability, low price and speed of execution. According to the results of our study, the possibility of using inferior vena cava collapsibility index to assess the volemic status of patients has been demonstrated.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"224 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140704591","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}
Prostate cancer is the second most common cause of malignancy in men, with bone metastases being a significant source of morbidity and mortality in advanced cases. Objective. To give a clinical example of a patient with a pathological transtrochanteric fracture of the right femur with displacement of fragments, the presence of metastasis at the fracture site, to emphasize the importance of 3D-training before surgery. Methods. A clinical example with a significant impairment of the function of the right lower extremity against the background of a significant pain syndrome is given. The diagnosis was established: pathological transtrochanteric fracture of the right femur with displacement of fragments, the presence of metastasis at the fracture site. Pre-surgical training was carried out using a 3D-model and total endoprosthetics of the right hip joint with a revision individual implant of the cement fixation type was carried out. The patient fully recovered the function of the right lower limb and hip joint, the pain syndrome was eliminated, and sleep normalized. The use of a 3D-model for preoperative training of surgeons made it possible to rationally limit traumatization of healthy tissues during tumor removal, prevent possible complications and optimize the time of surgical intervention and thus minimize blood loss. Conclusions. The use of a training 3D-model before surgery followed by prosthetics with a special oncological endoprosthesis provided satisfactory functional results and restoration of the patient's quality of life in the given clinical case. The use of a 3D-model is the key to careful preparation for surgical intervention, taking into account the individual anatomical features of the pathological process and adjacent tissues, which allows you to significantly optimize the terms of the operation and reduce blood loss, and also provides valuable experience for further surgical practice.
{"title":"THE USE OF A TRAINING 3D-MODEL IN THE TREATMENT OF A PATIENT WITH A PATHOLOGICAL FRACTURE OF THE PROXIMAL PART OF THE FEMUR (CASE FROM PRACTICE)","authors":"Oleg Drobotun, Sergii Konovalenko, Mykola Ternovyi","doi":"10.15674/0030-59872024153-58","DOIUrl":"https://doi.org/10.15674/0030-59872024153-58","url":null,"abstract":"Prostate cancer is the second most common cause of malignancy in men, with bone metastases being a significant source of morbidity and mortality in advanced cases. Objective. To give a clinical example of a patient with a pathological transtrochanteric fracture of the right femur with displacement of fragments, the presence of metastasis at the fracture site, to emphasize the importance of 3D-training before surgery. Methods. A clinical example with a significant impairment of the function of the right lower extremity against the background of a significant pain syndrome is given. The diagnosis was established: pathological transtrochanteric fracture of the right femur with displacement of fragments, the presence of metastasis at the fracture site. Pre-surgical training was carried out using a 3D-model and total endoprosthetics of the right hip joint with a revision individual implant of the cement fixation type was carried out. The patient fully recovered the function of the right lower limb and hip joint, the pain syndrome was eliminated, and sleep normalized. The use of a 3D-model for preoperative training of surgeons made it possible to rationally limit traumatization of healthy tissues during tumor removal, prevent possible complications and optimize the time of surgical intervention and thus minimize blood loss. Conclusions. The use of a training 3D-model before surgery followed by prosthetics with a special oncological endoprosthesis provided satisfactory functional results and restoration of the patient's quality of life in the given clinical case. The use of a 3D-model is the key to careful preparation for surgical intervention, taking into account the individual anatomical features of the pathological process and adjacent tissues, which allows you to significantly optimize the terms of the operation and reduce blood loss, and also provides valuable experience for further surgical practice.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"127 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706829","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}
Pub Date : 2024-04-14DOI: 10.15674/0030-59872024113-18
Andrii Popov, Mykyta Moloduk
It is well known that the most frequent complication of osteoporosis is compression fractures of vertebral bodies. In addition to brittleness of the bones and mechanical stress, more and more evidence approving that compression fractures of vertebral bodies are related to many risk factors, such as aging, sex, concomitant morbidities of cardiovascular and cerebrovascular diseases and lifestyle (chronic smoking and alcohol consumption) are collected. Objective. Analyzing the condition of spines of the patients suffering from compression fractures of vertebral bodies on the background of osteoporosis after the performed Percutaneous vertebroplasty (PV). Methods. 553 patients who underwent hospital treatment at the spine pathology clinic of the Sytenko Institute of Spine and Joint Pathology (2005–2022) and underwent PV were examined. Results. The patients were divided into three groups depending on the number of damaged vertebrae. The 1st group included the patients with compression fractures of one vertebra (185 — 33.4 %); the 2nd group included the patients having 2 or 3 deformed vertebrae (216 — 39 %); and the 3rd group included the patients with 4–5 damaged vertebrae (152 — 27.4 %). Stages of compression of vertebral bodies during the X-ray morphometry was as follows before the surgery: I — 349 (24 %) vertebrae; II — 494 (34 %); III — 552 (38 %); and IV — 58 (4 %). We achieved the reduction of the level of compression of vertebral bodies as a result of PV in 20 % of cases (patients who noticed the manifestation of the pain syndrome within 2 weeks mostly suffered from these deformations). Conclusions. The results of analysis of PV of 553 patients with composite material and bone cement in the near and far future provide us an opportunity to state that this surgical treatment is an efficient and safe treatment method (despite the materials used). 40 (24 %) patients out of 165 patients of the group I, 52 (33 %) patients out of 157 patients of the group II and 54 (44 %) patients our of 133 patients of the group III were diagnosed with repeated compression fractures. Summarizing all the above, we should note that the more compression fractures the patient has, the higher the risk of further augmentation of other deformations of vertebral bodies is.
{"title":"ANALYSIS OF THE RESULTS OF PERCUTANEOUS VERTEBROPLASTY OF COMPRESSION FRACTURES OF BODIES OF CHEST AND LUMBAR VERTEBRAE ON THE BACKGROUND OF OSTEOPOROSIS","authors":"Andrii Popov, Mykyta Moloduk","doi":"10.15674/0030-59872024113-18","DOIUrl":"https://doi.org/10.15674/0030-59872024113-18","url":null,"abstract":"It is well known that the most frequent complication of osteoporosis is compression fractures of vertebral bodies. In addition to brittleness of the bones and mechanical stress, more and more evidence approving that compression fractures of vertebral bodies are related to many risk factors, such as aging, sex, concomitant morbidities of cardiovascular and cerebrovascular diseases and lifestyle (chronic smoking and alcohol consumption) are collected. Objective. Analyzing the condition of spines of the patients suffering from compression fractures of vertebral bodies on the background of osteoporosis after the performed Percutaneous vertebroplasty (PV). Methods. 553 patients who underwent hospital treatment at the spine pathology clinic of the Sytenko Institute of Spine and Joint Pathology (2005–2022) and underwent PV were examined. Results. The patients were divided into three groups depending on the number of damaged vertebrae. The 1st group included the patients with compression fractures of one vertebra (185 — 33.4 %); the 2nd group included the patients having 2 or 3 deformed vertebrae (216 — 39 %); and the 3rd group included the patients with 4–5 damaged vertebrae (152 — 27.4 %). Stages of compression of vertebral bodies during the X-ray morphometry was as follows before the surgery: I — 349 (24 %) vertebrae; II — 494 (34 %); III — 552 (38 %); and IV — 58 (4 %). We achieved the reduction of the level of compression of vertebral bodies as a result of PV in 20 % of cases (patients who noticed the manifestation of the pain syndrome within 2 weeks mostly suffered from these deformations). Conclusions. The results of analysis of PV of 553 patients with composite material and bone cement in the near and far future provide us an opportunity to state that this surgical treatment is an efficient and safe treatment method (despite the materials used). 40 (24 %) patients out of 165 patients of the group I, 52 (33 %) patients out of 157 patients of the group II and 54 (44 %) patients our of 133 patients of the group III were diagnosed with repeated compression fractures. Summarizing all the above, we should note that the more compression fractures the patient has, the higher the risk of further augmentation of other deformations of vertebral bodies is.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"237 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703880","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}
Pub Date : 2024-04-14DOI: 10.15674/0030-59872024127-32
M. Golovakha, Weniamin Orljanski, Tomas Braunsteiner, M. Lisunov, Volodymir Pertsov
Femoral head fractures are a rare injury with limited information in the literature. Recent studies have been based on small case series, indicating that the incidence of fractures in hip dislocation varies from 7 to 18 %. Fractures of the femoral head are classified according to Pipkin. Treatment is often accompanied by significant complications, and the choice of the optimal treatment method remains a matter of debate. The choice of treatment tactics affects the duration of treatment and functional outcome. The article presents the results of treatment of patients whose treatment tactics were based on the Pipkin classification. Objective. To substantiate the use of the Pipkin classification of femoral head fractures in the selection of treatment and diagnostic tactics. Methods. The study was performed by evaluating the results of treatment in 44 patients. The Pipkin classification was used to determine the treatment tactics. The results were evaluated according to the HHS scale. The results were statistically analysed by comparing the median scores for different groups using the Mann-Whitney U test. Results. The worst prognosis was for patients with Pipkin III and Pipkin IV fractures. HHS scores for patients with complicated outcomes are worse than for patients with uncomplicated outcomes. Treatment outcomes for Pipkin type III fractures are statistically significantly lower than for other types. Conclusions. Pipkin fractures are a rare and severe injury that can cause significant limb dysfunction with proper treatment. Treatment of Pipkin type I and type II includes immediate reduction of the dislocation and conservative treatment in case of satisfactory fragmentation or open reduction with metal osteosynthesis for displaced fractures; for type III and IV, open reduction and osteosynthesis are possible for young patients, and primary arthroplasty is recommended for patients over 60 years of age or with concomitant metabolic diseases.
股骨头骨折是一种罕见的损伤，文献资料有限。最近的研究以小型病例系列为基础，表明髋关节脱位的骨折发生率在7%至18%之间。股骨头骨折根据皮普金分类法进行分类。治疗往往伴随着严重的并发症，而最佳治疗方法的选择仍是一个争论不休的问题。治疗策略的选择会影响治疗时间和功能结果。本文介绍了根据皮普金分类法对患者进行治疗的结果。目的证实在选择治疗和诊断策略时使用股骨头骨折 Pipkin 分类法。方法。该研究通过评估 44 例患者的治疗效果来进行。采用皮普金分类法确定治疗策略。根据 HHS 量表对结果进行评估。使用 Mann-Whitney U 检验比较不同组别的中位数得分，对结果进行统计分析。结果皮普金 III 型和皮普金 IV 型骨折患者的预后最差。结果复杂的患者的 HHS 评分比结果不复杂的患者差。从统计学角度看，Pipkin III 型骨折的治疗效果明显低于其他类型。结论。皮普金骨折是一种罕见的严重损伤，如果治疗得当，可导致严重的肢体功能障碍。I 型和 II 型皮普金骨折的治疗方法包括立即进行脱位复位，在碎裂满意的情况下进行保守治疗，或对移位的骨折进行切开复位和金属骨合成术；对于 III 型和 IV 型，年轻患者可进行切开复位和骨合成术，对于 60 岁以上或合并代谢性疾病的患者，建议进行初次关节置换术。
{"title":"USING THE PIPKIN CLASSIFICATION IN DETERMINING THE TREATMENT TACTICS OF FEMORAL HEAD FRACTURES","authors":"M. Golovakha, Weniamin Orljanski, Tomas Braunsteiner, M. Lisunov, Volodymir Pertsov","doi":"10.15674/0030-59872024127-32","DOIUrl":"https://doi.org/10.15674/0030-59872024127-32","url":null,"abstract":"Femoral head fractures are a rare injury with limited information in the literature. Recent studies have been based on small case series, indicating that the incidence of fractures in hip dislocation varies from 7 to 18 %. Fractures of the femoral head are classified according to Pipkin. Treatment is often accompanied by significant complications, and the choice of the optimal treatment method remains a matter of debate. The choice of treatment tactics affects the duration of treatment and functional outcome. The article presents the results of treatment of patients whose treatment tactics were based on the Pipkin classification. Objective. To substantiate the use of the Pipkin classification of femoral head fractures in the selection of treatment and diagnostic tactics. Methods. The study was performed by evaluating the results of treatment in 44 patients. The Pipkin classification was used to determine the treatment tactics. The results were evaluated according to the HHS scale. The results were statistically analysed by comparing the median scores for different groups using the Mann-Whitney U test. Results. The worst prognosis was for patients with Pipkin III and Pipkin IV fractures. HHS scores for patients with complicated outcomes are worse than for patients with uncomplicated outcomes. Treatment outcomes for Pipkin type III fractures are statistically significantly lower than for other types. Conclusions. Pipkin fractures are a rare and severe injury that can cause significant limb dysfunction with proper treatment. Treatment of Pipkin type I and type II includes immediate reduction of the dislocation and conservative treatment in case of satisfactory fragmentation or open reduction with metal osteosynthesis for displaced fractures; for type III and IV, open reduction and osteosynthesis are possible for young patients, and primary arthroplasty is recommended for patients over 60 years of age or with concomitant metabolic diseases.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706080","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}
Pub Date : 2024-04-14DOI: 10.15674/0030-59872024149-52
Kumar Sahu Dr. Santosh, Kar Dr. Dattatreya
Lumbar disc herniation is a common disease. There is severe pain in the buttock and leg, which may persist for more than 6 weeks even after conservative treatment. Currently, there are several surgical techniques for the treatment of lumbar disc herniation, ranging from laminectomy to microdiscectomy. The main advantages of endoscopic discectomy include: cosmetic appeal, minimally invasive nature, better visualization, shorter hospital stay and faster recovery. Objective. This article reviews discusses the management of patients with degenerative diseases of the lumbar spine by Destandau Endospine system. The authors shares his experience of the surgical technique and the results of percutaneous endoscopic discectomy using the Destandau system during the treatment of 51 patients with herniated disc and canal stenosis in the lumbar spine. The main advantages of the Destandau endoscopic system are a small skin incision and minimal damage to soft tissues. This is a minimally invasive intervention, which is applied through a skin incision 1.5–2 cm long. In order to ensure the accuracy and safety of the patient both before and during the operation, fluoroscopy is used. Under the control of an endoscope, the herniated intervertebral disc, free fragments of the disc are removed and the pinched nerve is released. Thus, rapid recovery is achieved during postoperative rehabilitation. Conclusions. The endoscopic system can be used to treat all types of intervertebral disc herniations and associated canal stenosis. It is a relatively safe procedure, provided proper preoperative planning and an experienced team of doctors. Most lumbar pathologies that are not related to instability can be successfully resolved with its help. The two main advantages of the Destandau endospinal system include minimally invasive surgery with minimal iatrogenic damage and excellent efficacy. In the case of its successful application, the recovery process is significantly shortened, without any restrictions for returning to everyday life.
{"title":"ПОПЕРЕКОВА ДИСКЕКТОМІЯ З ДЕКОМПРЕСІЄЮ КАНАЛУ ЗА СИСТЕМОЮ DESTANDAU ENDOSPINE","authors":"Kumar Sahu Dr. Santosh, Kar Dr. Dattatreya","doi":"10.15674/0030-59872024149-52","DOIUrl":"https://doi.org/10.15674/0030-59872024149-52","url":null,"abstract":"Lumbar disc herniation is a common disease. There is severe pain in the buttock and leg, which may persist for more than 6 weeks even after conservative treatment. Currently, there are several surgical techniques for the treatment of lumbar disc herniation, ranging from laminectomy to microdiscectomy. The main advantages of endoscopic discectomy include: cosmetic appeal, minimally invasive nature, better visualization, shorter hospital stay and faster recovery. Objective. This article reviews discusses the management of patients with degenerative diseases of the lumbar spine by Destandau Endospine system. The authors shares his experience of the surgical technique and the results of percutaneous endoscopic discectomy using the Destandau system during the treatment of 51 patients with herniated disc and canal stenosis in the lumbar spine. The main advantages of the Destandau endoscopic system are a small skin incision and minimal damage to soft tissues. This is a minimally invasive intervention, which is applied through a skin incision 1.5–2 cm long. In order to ensure the accuracy and safety of the patient both before and during the operation, fluoroscopy is used. Under the control of an endoscope, the herniated intervertebral disc, free fragments of the disc are removed and the pinched nerve is released. Thus, rapid recovery is achieved during postoperative rehabilitation. Conclusions. The endoscopic system can be used to treat all types of intervertebral disc herniations and associated canal stenosis. It is a relatively safe procedure, provided proper preoperative planning and an experienced team of doctors. Most lumbar pathologies that are not related to instability can be successfully resolved with its help. The two main advantages of the Destandau endospinal system include minimally invasive surgery with minimal iatrogenic damage and excellent efficacy. In the case of its successful application, the recovery process is significantly shortened, without any restrictions for returning to everyday life.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"179 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706309","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}
Pub Date : 2024-04-14DOI: 10.15674/0030-59872024193-95
The article is devoted to Khvysuk M. I.
这篇文章专门介绍赫维苏克-M. I.
{"title":"Mykola Ivanovych Khvysuk","authors":"","doi":"10.15674/0030-59872024193-95","DOIUrl":"https://doi.org/10.15674/0030-59872024193-95","url":null,"abstract":"The article is devoted to Khvysuk M. I.","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"5 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706407","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}
Pub Date : 2024-04-14DOI: 10.15674/0030-59872024143-48
Borys Pustovoit, Pustovoit Pustovoit, V. Staude, Mykola Tokhtamyshev
Objective. Determining the effectiveness of physical therapy in the surgical treatment of valgus deformity of the first toe. Methods. The clinical material of the conducted study includes 38 observations, 34 patients (38 operative interventions, 4 patients — on 2 feet. In the control group (CG) there were 16 patients (16 interventions), and in the main group (MG) — 18 patients (22 interventions). All patients who participated in the study had the same diagnosis — hallux valgus II–III degree. All patients received the same type of surgical intervention — a variant Z-shaped osteotomy of the first metatarsal bone according to the Scarf method or Chevron, which was supplemented with osteotomy of proximal phalanges of the I finger to Akin method. Patients were examined with the Visual-Analogue Scale (VAS), the Physiotherapy Clinical Outcome Variables (COVS) Motor Skills Testing Scale, and the American Orthopedic Foot and Ankle Society (AOFAS) Scale (module 2) for the Clinical Evaluation of Foot and Ankle Diseases of the American Foot and Ankle Association. Rehabilitation of MG patients consisted of developed physical therapy (PT) program, which included 4 periods. Rehabilitation included not only massage and exercises for the muscles of the front part of the foot, but also a complex of rehabilitation methods aimed to restore the function of the muscles of both lower limbs, hips and buttocks. PT program for KG consisted only of morning hygienic gymnastics, classical massage and therapeutic exercises to restore function of muscles of the foot and lower leg. Results. Assessment of the condition of patients after the end of PT on the COVS scale helped to conclude that the patients of MG have significantly better indicators of general physical activity than patients of CG. Analysis of the obtained results according to the (AOFAS) Scale confirmed that patients of MG after using developed PT program have statistically better results. Conclusions. The developed PT program significantly accelerate the clinical recovery of function not only the front part of the foot, but also general working capacity of patients.
{"title":"PHYSICAL THERAPY IS AN INTEGRAL PART OF THE SURGICAL TREATMENT OF VALGUS DEFORMITY OF THE FIRST TOE","authors":"Borys Pustovoit, Pustovoit Pustovoit, V. Staude, Mykola Tokhtamyshev","doi":"10.15674/0030-59872024143-48","DOIUrl":"https://doi.org/10.15674/0030-59872024143-48","url":null,"abstract":"Objective. Determining the effectiveness of physical therapy in the surgical treatment of valgus deformity of the first toe. Methods. The clinical material of the conducted study includes 38 observations, 34 patients (38 operative interventions, 4 patients — on 2 feet. In the control group (CG) there were 16 patients (16 interventions), and in the main group (MG) — 18 patients (22 interventions). All patients who participated in the study had the same diagnosis — hallux valgus II–III degree. All patients received the same type of surgical intervention — a variant Z-shaped osteotomy of the first metatarsal bone according to the Scarf method or Chevron, which was supplemented with osteotomy of proximal phalanges of the I finger to Akin method. Patients were examined with the Visual-Analogue Scale (VAS), the Physiotherapy Clinical Outcome Variables (COVS) Motor Skills Testing Scale, and the American Orthopedic Foot and Ankle Society (AOFAS) Scale (module 2) for the Clinical Evaluation of Foot and Ankle Diseases of the American Foot and Ankle Association. Rehabilitation of MG patients consisted of developed physical therapy (PT) program, which included 4 periods. Rehabilitation included not only massage and exercises for the muscles of the front part of the foot, but also a complex of rehabilitation methods aimed to restore the function of the muscles of both lower limbs, hips and buttocks. PT program for KG consisted only of morning hygienic gymnastics, classical massage and therapeutic exercises to restore function of muscles of the foot and lower leg. Results. Assessment of the condition of patients after the end of PT on the COVS scale helped to conclude that the patients of MG have significantly better indicators of general physical activity than patients of CG. Analysis of the obtained results according to the (AOFAS) Scale confirmed that patients of MG after using developed PT program have statistically better results. Conclusions. The developed PT program significantly accelerate the clinical recovery of function not only the front part of the foot, but also general working capacity of patients. ","PeriodicalId":137495,"journal":{"name":"ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706474","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}
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