Pub Date : 2024-04-21DOI: 10.18019/1028-4427-2024-30-2-245-254
V. Golnik, V. A. Peleganchuk, D. A. Dzhukhaev, Yu.M. Batrak, V. V. Pavlov
Introduction Reconstruction of the acetabulum during revision arthroplasty is a challenging task in the setting of massive bone defects. Often the only effective method is impaction bone grafting (IBG). The purpose is to demonstrate the capabilities of the X-Change impaction bone grafting technology in replacing acetabular defects as a method of choice for revision hip arthroplasty.Materials and methods In the presented series of cases, the use (IBG) turned out to be the method of choice, allowing for high-quality reconstruction. In each presented case, revision hip arthroplasty was performed with augmentation with a reconstructive mesh or trabecular metal augment to create support and contain the defect to retain the osteoplastic material.Results During follow-up periods of 4.8 to 6.5 years there were no signs of resorption or loosening. According to the Harris hip score the results were 96, 97 and 89 points respectively.Discussion Impaction bone grafting technology is quite versatile. It can be used in various coditions of revision arthroplasty with contained defects of the acetabulum. In contrast to the use of modular revision augmentation systems and additive technologies it makes possible to achieve dense filling of the smallest defects and profile a bed congruent with the acetabular component. The use of cemented fixation makes it possible to further stabilize the impacted bone chips and use mechanotransduction mechanisms that stimulate the bone remodeling. The use of IBG has proven to be an effective technique for the reconstruction of medium-sized acetabular defects in combination with mesh and cement cup, as well as in combination with trabecular metal augments.Conclusion The use of IBG during revision hip arthroplasty can be especially effective for small acetabulum sizes. Combining IBG with trabecular metal augments significantly expands the application of this technology. The use of IBG makes it possible to create a bone reserve, which creates more favorable conditions for inevitable repeated revision interventions.
{"title":"Impaction bone grafting as a method of choice in bone defect management in the revision hip arthroplasty: a cases series","authors":"V. Golnik, V. A. Peleganchuk, D. A. Dzhukhaev, Yu.M. Batrak, V. V. Pavlov","doi":"10.18019/1028-4427-2024-30-2-245-254","DOIUrl":"https://doi.org/10.18019/1028-4427-2024-30-2-245-254","url":null,"abstract":"Introduction Reconstruction of the acetabulum during revision arthroplasty is a challenging task in the setting of massive bone defects. Often the only effective method is impaction bone grafting (IBG). The purpose is to demonstrate the capabilities of the X-Change impaction bone grafting technology in replacing acetabular defects as a method of choice for revision hip arthroplasty.Materials and methods In the presented series of cases, the use (IBG) turned out to be the method of choice, allowing for high-quality reconstruction. In each presented case, revision hip arthroplasty was performed with augmentation with a reconstructive mesh or trabecular metal augment to create support and contain the defect to retain the osteoplastic material.Results During follow-up periods of 4.8 to 6.5 years there were no signs of resorption or loosening. According to the Harris hip score the results were 96, 97 and 89 points respectively.Discussion Impaction bone grafting technology is quite versatile. It can be used in various coditions of revision arthroplasty with contained defects of the acetabulum. In contrast to the use of modular revision augmentation systems and additive technologies it makes possible to achieve dense filling of the smallest defects and profile a bed congruent with the acetabular component. The use of cemented fixation makes it possible to further stabilize the impacted bone chips and use mechanotransduction mechanisms that stimulate the bone remodeling. The use of IBG has proven to be an effective technique for the reconstruction of medium-sized acetabular defects in combination with mesh and cement cup, as well as in combination with trabecular metal augments.Conclusion The use of IBG during revision hip arthroplasty can be especially effective for small acetabulum sizes. Combining IBG with trabecular metal augments significantly expands the application of this technology. The use of IBG makes it possible to create a bone reserve, which creates more favorable conditions for inevitable repeated revision interventions.","PeriodicalId":37426,"journal":{"name":"Genij Ortopedii","volume":"118 50","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140678494","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 : 2024-04-19DOI: 10.18019/1028-4427-2024-30-2-171-181
E. Belyak, R. K. Sagdiev, F. L. Lazko, A. A. Sufianov, D. L. Paskhin, A. Prizov, M. Lazko, N. V. Zagorodniy
Introduction As reported, brachioplexopathy is a relevant polyetiological disease with an annual incidence from 0.17 to 1.6 per 100,000. There are two basic endoscopic methods of brachial plexus decompression: an endoscopically-assisted mini-invasive transaxillary approach and fully endoscopic decompression in association with shoulder arthroscopy.Purpose Compare the two main endoscopic methods of brachial plexus decompression.Material and methods Twenty-two patients diagnosed with post-traumatic brachioplexopathy were included in the study. There were 8 patients in group 1 and 14 patients in group 2. All patients passed clinical and instrumental examination. Statistical analysis was performed with non-parametric U-criteria of Mann – Whitney. Differences were considered significant at p < 0.05. Patients of group 1 underwent shoulder joint arthroscopy and fully endoscopic brachial plexus decompression. Patients of group 2 had revision and transaxillary mini-invasive decompression of brachial plexus with video endoscopic assistance.Results In the first group, upper limb dysfunction according to DASH scale decreased from 52.3 ± 2.2 to 28.8 ± 3.8 points (p < 0.05). In the second group, upper limb dysfunction according to DASH scale decreased from 47.9 ± 4.4 to 26.6 ± 4.3 points (p < 0.05). Discrepancy according to DASH scale before and after surgery in the first group was 23.5 ± 3.6 points and in the second group it was 19.4 ± 5.4 points; the difference between the groups was statistically insignificant (p > 0.05).Discussion The results of our study are similar to the results of endoscopic brachial plexus decompression in the previously published studies.Conclusion The methods of endoscopic brachial plexus decompression in association with shoulder joint arthroscopy and isoolated mini-invasive neurolysis and decompression of brachial plexus under videoendoscopic assistance are equally effective in the treatment of brachialplexopathy.
{"title":"Comparative analysis of the methods of an all-endoscopic brachial plexus decompression and a mini-invasive endoscopically-assisted technique for management of patients with traumatic brachioplexopathy","authors":"E. Belyak, R. K. Sagdiev, F. L. Lazko, A. A. Sufianov, D. L. Paskhin, A. Prizov, M. Lazko, N. V. Zagorodniy","doi":"10.18019/1028-4427-2024-30-2-171-181","DOIUrl":"https://doi.org/10.18019/1028-4427-2024-30-2-171-181","url":null,"abstract":"Introduction As reported, brachioplexopathy is a relevant polyetiological disease with an annual incidence from 0.17 to 1.6 per 100,000. There are two basic endoscopic methods of brachial plexus decompression: an endoscopically-assisted mini-invasive transaxillary approach and fully endoscopic decompression in association with shoulder arthroscopy.Purpose Compare the two main endoscopic methods of brachial plexus decompression.Material and methods Twenty-two patients diagnosed with post-traumatic brachioplexopathy were included in the study. There were 8 patients in group 1 and 14 patients in group 2. All patients passed clinical and instrumental examination. Statistical analysis was performed with non-parametric U-criteria of Mann – Whitney. Differences were considered significant at p < 0.05. Patients of group 1 underwent shoulder joint arthroscopy and fully endoscopic brachial plexus decompression. Patients of group 2 had revision and transaxillary mini-invasive decompression of brachial plexus with video endoscopic assistance.Results In the first group, upper limb dysfunction according to DASH scale decreased from 52.3 ± 2.2 to 28.8 ± 3.8 points (p < 0.05). In the second group, upper limb dysfunction according to DASH scale decreased from 47.9 ± 4.4 to 26.6 ± 4.3 points (p < 0.05). Discrepancy according to DASH scale before and after surgery in the first group was 23.5 ± 3.6 points and in the second group it was 19.4 ± 5.4 points; the difference between the groups was statistically insignificant (p > 0.05).Discussion The results of our study are similar to the results of endoscopic brachial plexus decompression in the previously published studies.Conclusion The methods of endoscopic brachial plexus decompression in association with shoulder joint arthroscopy and isoolated mini-invasive neurolysis and decompression of brachial plexus under videoendoscopic assistance are equally effective in the treatment of brachialplexopathy.","PeriodicalId":37426,"journal":{"name":"Genij Ortopedii","volume":" 70","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140683653","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 : 2024-04-19DOI: 10.18019/1028-4427-2024-30-2-182-190
Yulia A. Fedorova, S. V. Vissarionov, Y. Proshchenko, V. Zorin
Introduction The upper limb functional limitations in congenital radioulnar synostosis may significantly affect the daily activities of patients. Classifications of the condition are descriptive and have limited practical application.Purpose Determine a functionally significant quantitative criterion for anatomical changes in the forearm.Material and methods 92 children (136 forearms) with congenital radioulnar synostosis were examined for limitations in activities of daily living (ADL), health-related quality of life measured with PedsQL questionnaire; pronation of the forearm and radiographic parameters. A comparative and correlation analysis, ROC analysis were performed to determine the relationship between the forearm pronation and limitations of ADL.Results Statistically significant correlations were revealed between symptoms and the forearm alignment (p < 0.01, rxy = 0.5); subluxation of the ulnar head and forearm alignment (p < 0.001, rxy = 0.6); bowing deformity of the radius, forearm alignment and subluxation of the ulnar head and between the length of the forearm bones and bowing deformity of the radius (p < 0.05, rxy = 0.4 and rxy = 0.5). A statistically significant inverse correlation was revealed between symptoms and PedsQL scores (p = 0.038, rxy = –0.4). Pronation of 45° was the threshold value of the forearm alignment with a high risk of ADL limitation. The area under the ROC curve corresponding to the relationship between symptoms and the forearm alignment was 0.955 ± 0.021 (95 % CI: 0.915–0.995). There was a statistically significant (p < 0.01) decrease in the lumen of the medullary canal in the middle third of the ulnar shaft with the radius lumen being unchanged. Dorsal subluxation of the ulnar head was detected In 30 % of cases.Discussion The characteristics identified demonstrated changes in the forearm bones with functional impairments being correlated with the forearm pronation.Conclusion The correlation between the patient’s symptoms and the forearm alignment must be taken into account in the classification and when determining indications for surgical treatment distinguishing between functional (< 45° pronation) and dysfunctional (≥ 45° pronation) options.
{"title":"Clinical and radiological aspects of the forearm in children with congenital radioulnar synostosis: a cohort study","authors":"Yulia A. Fedorova, S. V. Vissarionov, Y. Proshchenko, V. Zorin","doi":"10.18019/1028-4427-2024-30-2-182-190","DOIUrl":"https://doi.org/10.18019/1028-4427-2024-30-2-182-190","url":null,"abstract":"Introduction The upper limb functional limitations in congenital radioulnar synostosis may significantly affect the daily activities of patients. Classifications of the condition are descriptive and have limited practical application.Purpose Determine a functionally significant quantitative criterion for anatomical changes in the forearm.Material and methods 92 children (136 forearms) with congenital radioulnar synostosis were examined for limitations in activities of daily living (ADL), health-related quality of life measured with PedsQL questionnaire; pronation of the forearm and radiographic parameters. A comparative and correlation analysis, ROC analysis were performed to determine the relationship between the forearm pronation and limitations of ADL.Results Statistically significant correlations were revealed between symptoms and the forearm alignment (p < 0.01, rxy = 0.5); subluxation of the ulnar head and forearm alignment (p < 0.001, rxy = 0.6); bowing deformity of the radius, forearm alignment and subluxation of the ulnar head and between the length of the forearm bones and bowing deformity of the radius (p < 0.05, rxy = 0.4 and rxy = 0.5). A statistically significant inverse correlation was revealed between symptoms and PedsQL scores (p = 0.038, rxy = –0.4). Pronation of 45° was the threshold value of the forearm alignment with a high risk of ADL limitation. The area under the ROC curve corresponding to the relationship between symptoms and the forearm alignment was 0.955 ± 0.021 (95 % CI: 0.915–0.995). There was a statistically significant (p < 0.01) decrease in the lumen of the medullary canal in the middle third of the ulnar shaft with the radius lumen being unchanged. Dorsal subluxation of the ulnar head was detected In 30 % of cases.Discussion The characteristics identified demonstrated changes in the forearm bones with functional impairments being correlated with the forearm pronation.Conclusion The correlation between the patient’s symptoms and the forearm alignment must be taken into account in the classification and when determining indications for surgical treatment distinguishing between functional (< 45° pronation) and dysfunctional (≥ 45° pronation) options.","PeriodicalId":37426,"journal":{"name":"Genij Ortopedii","volume":" 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140684689","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 : 2024-04-19DOI: 10.18019/1028-4427-2024-30-2-191-199
P. V. Fedotov, D. V. Kovalev, S. N. Rybakov
Introduction Small joints replacement is a valid treatment for deforming osteoarthritis and traumatic injuries to the phalangeal joints of the hand to restore motor hand functions. Various types of implants differing in shape, biomechanics and material composition have been developed.The purpose of the study was to evaluate long-term results of the proximal interphalangeal joint arthroplasty of the hand using various implants and identify their advantages.Material and methods We retrospectively reviewed 78 cases of proximal interphalangeal joint replacement in 64 patients. Outcomes were assessed at 6 months and at follow-up stages with preoperative and postoperative measurements of the range of motion in the joint evaluating pain, radiographs and outcomes measures using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.Results The range of motion in the prosthetic joint increased significantly at different follow-up periods with all types of implants. The pain syndrome decreased. Radiographs revealed 10 cases of aseptic instability in the group of constrained prostheses. The DASH assessment showed high subjective satisfaction with the treatment.Discussion We could not find papers reporting PIP joint arthroplasty using SBI D.G.T. implant system. A retrospective study of RM Finger arthroplasty of the PIP joint indicated restored joint stability with AROM improvement and with low pain, although it had a high rate of complications. We recorded no complications with this implant model. Some authors would not recommend the RM Finger implant (Mathys) for PIP joint replacement. Arthroplasty of small joints of the hand with MOJE kermik-implantate showed satisfactory outcomes for 82 % of patients at a long term.Conclusion Arthroplasty of the PIP joint of the hand using various implant designs resulted in greater mobility of the upper limbs, a lower pain due to subjective improvement in the functionality at a long term. Although the procedures were effective with all implant designs the reliability of changes in the parameters was more evident with nonconstrained implants.
{"title":"The long-term results of proximal interphalangeal joint arthroplasty of the hand","authors":"P. V. Fedotov, D. V. Kovalev, S. N. Rybakov","doi":"10.18019/1028-4427-2024-30-2-191-199","DOIUrl":"https://doi.org/10.18019/1028-4427-2024-30-2-191-199","url":null,"abstract":"Introduction Small joints replacement is a valid treatment for deforming osteoarthritis and traumatic injuries to the phalangeal joints of the hand to restore motor hand functions. Various types of implants differing in shape, biomechanics and material composition have been developed.The purpose of the study was to evaluate long-term results of the proximal interphalangeal joint arthroplasty of the hand using various implants and identify their advantages.Material and methods We retrospectively reviewed 78 cases of proximal interphalangeal joint replacement in 64 patients. Outcomes were assessed at 6 months and at follow-up stages with preoperative and postoperative measurements of the range of motion in the joint evaluating pain, radiographs and outcomes measures using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.Results The range of motion in the prosthetic joint increased significantly at different follow-up periods with all types of implants. The pain syndrome decreased. Radiographs revealed 10 cases of aseptic instability in the group of constrained prostheses. The DASH assessment showed high subjective satisfaction with the treatment.Discussion We could not find papers reporting PIP joint arthroplasty using SBI D.G.T. implant system. A retrospective study of RM Finger arthroplasty of the PIP joint indicated restored joint stability with AROM improvement and with low pain, although it had a high rate of complications. We recorded no complications with this implant model. Some authors would not recommend the RM Finger implant (Mathys) for PIP joint replacement. Arthroplasty of small joints of the hand with MOJE kermik-implantate showed satisfactory outcomes for 82 % of patients at a long term.Conclusion Arthroplasty of the PIP joint of the hand using various implant designs resulted in greater mobility of the upper limbs, a lower pain due to subjective improvement in the functionality at a long term. Although the procedures were effective with all implant designs the reliability of changes in the parameters was more evident with nonconstrained implants.","PeriodicalId":37426,"journal":{"name":"Genij Ortopedii","volume":" 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140683264","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 : 2024-04-19DOI: 10.18019/1028-4427-2024-30-2-200-209
M. R. Jasim, M. A. M. Saeed
Background The thoracic spine pathology can lead to severe disability and discomfort.This study aims to identify determinant characteristics in patients with thoracic spine pathologies who present with non-regional complaints such as lumbar/cervical pain and others.Methods A prospective observational descriptive study was conducted at Basrah Teaching Hospital from March 2020 to December 2021, enrolling 114 patients categorized into two groups. Group A included patients with thoracic spine pathology and thoracic pain, while Group B consisted of patients with thoracic spine pathology and non-local symptoms (such as lower lumbar pain, pain in extremities, etc.). Comprehensive clinical evaluations were performed using a specially designed questionnaire.Results The majority of patients were in the 60-79 age group, with females comprising 55 % in Group A and 60 % in Group B. Smoking was observed in 28.98 % of Group A and 26.66 % of Group B. Symptomatic patients with solitary back pain commonly exhibited dorsal root compression symptoms (49.27 %), lower limb weakness (18.84 %), and sphincter dysfunction (7.24 %). Patients with thoracic plus lower and/or neck pain frequently reported paraesthesia (42.22 %) and cervical root symptoms (48.38 %). Kyphotic deformity was present in 20.28 % of Group A and 11.11 % of Group B, while tenderness was observed in 23.18 % of Group A and 13.33 % of Group B. Plain radiograph changes, including disk space narrowing (44.44 %), subchondral sclerosis (29.63 %), curve alterations (29.63 %), and facet arthropathy (25.9 %), were more prevalent in those with symptomatic thoracic back pain (Group A).Conclusion Non-local symptoms in thoracic spine pathologies are common, with complicated and multi-site low back pain being more prevalent than isolated back or thoracic pain. Elderly individuals, females, obesity, and comorbidities appear to be predictive risk factors for low back pain development. Paraesthesia emerges as the most common neurological manifestation, while kyphosis and scoliosis are primary presentations of thoracic pathologies. Multi-modalities of imaging, including plain radiographs, MRI, CT scan, and DEXA scan, can aid in detecting back pathologies. The mainstay of managing symptomatic thoracic pathologies is surgical intervention.
方法 2020 年 3 月至 2021 年 12 月在巴士拉教学医院开展了一项前瞻性观察描述性研究，共纳入 114 名患者，分为两组。A 组包括胸椎病变和胸痛患者，B 组包括胸椎病变和非局部症状（如下腰痛、四肢疼痛等）患者。大多数患者年龄在 60-79 岁之间，女性在 A 组和 B 组中分别占 55% 和 60%。A 组和 B 组中分别有 28.98% 和 26.66% 的患者吸烟。胸痛加下肢和/或颈部疼痛的患者通常会出现麻痹（42.22%）和颈根症状（48.38%）。A 组和 B 组分别有 20.28% 和 11.11% 的患者出现駝背畸形，而 A 组和 B 组分别有 23.18% 和 13.33% 的患者出现压痛。平片变化包括椎间盘间隙变窄（44.44%）、软骨下硬化（29.63%）、曲线改变（29.结论 胸椎病变中的非局部症状很常见，复杂和多部位腰痛比孤立的腰痛或胸痛更常见。老年人、女性、肥胖和合并症似乎是导致腰背痛的风险因素。麻痹是最常见的神经系统表现，而脊柱侧弯和脊柱侧凸则是胸廓病变的主要表现。包括普通X光片、核磁共振成像、CT扫描和DEXA扫描在内的多种成像方式都有助于检测背部病变。治疗有症状的胸部病变的主要方法是手术干预。
{"title":"Non-obvious and obvious signs of the thoracic spine pathology: a clinical study","authors":"M. R. Jasim, M. A. M. Saeed","doi":"10.18019/1028-4427-2024-30-2-200-209","DOIUrl":"https://doi.org/10.18019/1028-4427-2024-30-2-200-209","url":null,"abstract":"Background The thoracic spine pathology can lead to severe disability and discomfort.This study aims to identify determinant characteristics in patients with thoracic spine pathologies who present with non-regional complaints such as lumbar/cervical pain and others.Methods A prospective observational descriptive study was conducted at Basrah Teaching Hospital from March 2020 to December 2021, enrolling 114 patients categorized into two groups. Group A included patients with thoracic spine pathology and thoracic pain, while Group B consisted of patients with thoracic spine pathology and non-local symptoms (such as lower lumbar pain, pain in extremities, etc.). Comprehensive clinical evaluations were performed using a specially designed questionnaire.Results The majority of patients were in the 60-79 age group, with females comprising 55 % in Group A and 60 % in Group B. Smoking was observed in 28.98 % of Group A and 26.66 % of Group B. Symptomatic patients with solitary back pain commonly exhibited dorsal root compression symptoms (49.27 %), lower limb weakness (18.84 %), and sphincter dysfunction (7.24 %). Patients with thoracic plus lower and/or neck pain frequently reported paraesthesia (42.22 %) and cervical root symptoms (48.38 %). Kyphotic deformity was present in 20.28 % of Group A and 11.11 % of Group B, while tenderness was observed in 23.18 % of Group A and 13.33 % of Group B. Plain radiograph changes, including disk space narrowing (44.44 %), subchondral sclerosis (29.63 %), curve alterations (29.63 %), and facet arthropathy (25.9 %), were more prevalent in those with symptomatic thoracic back pain (Group A).Conclusion Non-local symptoms in thoracic spine pathologies are common, with complicated and multi-site low back pain being more prevalent than isolated back or thoracic pain. Elderly individuals, females, obesity, and comorbidities appear to be predictive risk factors for low back pain development. Paraesthesia emerges as the most common neurological manifestation, while kyphosis and scoliosis are primary presentations of thoracic pathologies. Multi-modalities of imaging, including plain radiographs, MRI, CT scan, and DEXA scan, can aid in detecting back pathologies. The mainstay of managing symptomatic thoracic pathologies is surgical intervention.","PeriodicalId":37426,"journal":{"name":"Genij Ortopedii","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140684828","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 : 2024-02-21DOI: 10.18019/1028-4427-2024-30-1-107-113
E. M. Biktasheva, B. Minasov, M. M. Valeev, R. Yakupov, T. Minasov, T. Mavlyutov
Introduction Thermal injury to the palmar surface of the hand is usually complicated by flexion desmogenic contracture of the finger joints. This condition is more complicated with significant wound areas and depths of soft tissue destruction. Conventional surgical methods and soft tissue reconstructions may fail to provide full restoration of the hand function.The objective was to present the optimal treatment strategy for patients with scar flexion contractures of the fingers after thermal injury to the palmar surface of both hands using a pediatric case report.Material and methods A child aged 2 years and 4 months underwent surgical treatment to include excision of scars, skin grafting of both hands with a vascularized fasciocutaneous flap raised with the radial artery.Result The patient could regain all types of hand grip on both sides 12 years after surgical treatment. Both hands were aesthetically acceptable.Discussion Treatment of patients with thermal injury and substantial soft tissue damage is a complex disease process. Conservative treatment and surgical procedures using non-vascularized skin flaps are normally used for the condition. These approaches are associated with cicatricial and arthrogenic flexion contracture of the finger joints. The radical treatment includes thorough wound debridement and early flap coverage and wound closure using a flap with an axial-pattern blood supply, free flaps and reverse-flow flaps. The surgical approach helps to avoid flexion contracture of the fingers initiating early restoration of professional, social stereotypes and stereotypes in everyday life.Conclusion The clinical observation has shown the possibility of one-stage organ-preserving surgical treatment using flaps with an axial blood supply.
{"title":"Bilateral reconstruction of palmar soft tissues defects of the hands after thermal injury","authors":"E. M. Biktasheva, B. Minasov, M. M. Valeev, R. Yakupov, T. Minasov, T. Mavlyutov","doi":"10.18019/1028-4427-2024-30-1-107-113","DOIUrl":"https://doi.org/10.18019/1028-4427-2024-30-1-107-113","url":null,"abstract":"Introduction Thermal injury to the palmar surface of the hand is usually complicated by flexion desmogenic contracture of the finger joints. This condition is more complicated with significant wound areas and depths of soft tissue destruction. Conventional surgical methods and soft tissue reconstructions may fail to provide full restoration of the hand function.The objective was to present the optimal treatment strategy for patients with scar flexion contractures of the fingers after thermal injury to the palmar surface of both hands using a pediatric case report.Material and methods A child aged 2 years and 4 months underwent surgical treatment to include excision of scars, skin grafting of both hands with a vascularized fasciocutaneous flap raised with the radial artery.Result The patient could regain all types of hand grip on both sides 12 years after surgical treatment. Both hands were aesthetically acceptable.Discussion Treatment of patients with thermal injury and substantial soft tissue damage is a complex disease process. Conservative treatment and surgical procedures using non-vascularized skin flaps are normally used for the condition. These approaches are associated with cicatricial and arthrogenic flexion contracture of the finger joints. The radical treatment includes thorough wound debridement and early flap coverage and wound closure using a flap with an axial-pattern blood supply, free flaps and reverse-flow flaps. The surgical approach helps to avoid flexion contracture of the fingers initiating early restoration of professional, social stereotypes and stereotypes in everyday life.Conclusion The clinical observation has shown the possibility of one-stage organ-preserving surgical treatment using flaps with an axial blood supply.","PeriodicalId":37426,"journal":{"name":"Genij Ortopedii","volume":"17 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140442604","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 : 2024-02-21DOI: 10.18019/1028-4427-2024-30-1-142-152
F. A. Gafurov, I. Y. Khodzhanov, D. Mansurov, Sh. N. Eranov
Introduction The optimal surgical approach for malleolar fractures and distal tibiofibular syndesmotic (DTFS) disruption remains controversial. There is no uniform treatment protocol for this type of injury.The objective was to review modern surgical treatments of the pathology and determine the optimal option.Material and methods Articles of French, English, Uzbek, Kazakh, German, Danish, Japanese and Chinese authors were retrospectively reviewed. An internet search of MedLine; PubMed; Scopus; Web of Science, CINAHL, the Cochrane Central Register of Controlled Trials databases was performed.Results Comparative studies of dynamic fixation and static fixation of the DTFS showed advantages of the dynamic methods enabling precise, anatomical syndesmotic fixation and faster healing. Dynamic fixation methods would require no implant removal, while syndesmotic screw woul be taken off to reduce compression in the ankle joint and minimize a risk of malreduction facilitating mobility of the ankle joint. Dynamic methods are associated with greater stability and less complication rate. However, static methods have the advantages of being more accessible and less expensive, which can be an important factor choosing a treatment method. Static methods are a wide application and can be used in a wide range of clinical cases. Long-term results show no statistically significant differences between dynamic fixation and static fixation.Discussion Literature review indicates the dynamic method with suture-button, a combined method and titanium cable isotonic annular fixation system as the preferred technique for surgical stabilization of distal syndesmosis associated with ankle fractures with a lower risk of postoperative complications and the possibility of short-term rehabilitation.Conclusion The choice between dynamic and static methods of distal syndesmosis fixation depends on many factors, including the complexity of the injury, the availability and cost of implants and the experience of the surgeon.
引言 踝骨骨折和胫腓骨远端联合（DTFS）断裂的最佳手术方法仍存在争议。材料和方法 回顾性研究了法国、英国、乌兹别克斯坦、哈萨克斯坦、德国、丹麦、日本和中国作者的文章。对 MedLine、PubMed、Scopus、Web of Science、CINAHL 和 Cochrane Central Register of Controlled Trials 等数据库进行了网络检索。动态固定方法不需要移除植入物，而巩膜螺钉则需要取下，以减少对踝关节的压迫，并最大限度地降低畸形风险，促进踝关节的活动度。动态方法具有更高的稳定性和更低的并发症发生率。然而，静态方法具有更容易获得、费用更低的优点，这可能是选择治疗方法的一个重要因素。静态方法应用广泛，可用于多种临床病例。讨论 文献综述表明，缝合-钮扣动态法、联合法和钛索等张环形固定系统是与踝关节骨折相关的远端巩膜手术稳定的首选技术，术后并发症风险较低，且可进行短期康复。
{"title":"Intramedullary osteosynthesis for ankle fractures and distal tibiofibular syndesmotic disruption","authors":"F. A. Gafurov, I. Y. Khodzhanov, D. Mansurov, Sh. N. Eranov","doi":"10.18019/1028-4427-2024-30-1-142-152","DOIUrl":"https://doi.org/10.18019/1028-4427-2024-30-1-142-152","url":null,"abstract":"Introduction The optimal surgical approach for malleolar fractures and distal tibiofibular syndesmotic (DTFS) disruption remains controversial. There is no uniform treatment protocol for this type of injury.The objective was to review modern surgical treatments of the pathology and determine the optimal option.Material and methods Articles of French, English, Uzbek, Kazakh, German, Danish, Japanese and Chinese authors were retrospectively reviewed. An internet search of MedLine; PubMed; Scopus; Web of Science, CINAHL, the Cochrane Central Register of Controlled Trials databases was performed.Results Comparative studies of dynamic fixation and static fixation of the DTFS showed advantages of the dynamic methods enabling precise, anatomical syndesmotic fixation and faster healing. Dynamic fixation methods would require no implant removal, while syndesmotic screw woul be taken off to reduce compression in the ankle joint and minimize a risk of malreduction facilitating mobility of the ankle joint. Dynamic methods are associated with greater stability and less complication rate. However, static methods have the advantages of being more accessible and less expensive, which can be an important factor choosing a treatment method. Static methods are a wide application and can be used in a wide range of clinical cases. Long-term results show no statistically significant differences between dynamic fixation and static fixation.Discussion Literature review indicates the dynamic method with suture-button, a combined method and titanium cable isotonic annular fixation system as the preferred technique for surgical stabilization of distal syndesmosis associated with ankle fractures with a lower risk of postoperative complications and the possibility of short-term rehabilitation.Conclusion The choice between dynamic and static methods of distal syndesmosis fixation depends on many factors, including the complexity of the injury, the availability and cost of implants and the experience of the surgeon.","PeriodicalId":37426,"journal":{"name":"Genij Ortopedii","volume":"14 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140444577","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 : 2024-02-21DOI: 10.18019/1028-4427-2024-30-1-153-162
N. N. Grigoryeva, G. Airapetov
Introduction A coronavirus, SARS-CoV-2, called COVID-19 by the WHO has caused a pandemic of respiratory illness killed more than 6 million people. The severe infection has a significant negative impact on the entire musculoskeletal system.The objective was to summarize literature data on the mechanisms of the condition and identify musculoskeletal symptoms of COVID-19.Material and methods An internet search of PubMed, MedLine and eLIBRARY library databases using the search terms: COVID-19, aseptic osteonecrosis, post-COVID-19 syndrome, arthropathy, musculoskeletal system, spondylitis, osteoporosis was performed.Results and discussion Musculoskeletal symptoms of COVID-19 are reported in 31-59% of cases. Mechanisms of musculoskeletal involvement of coronavirus infection include cytotoxic effect of the virus on osteogenesis cells, vascular inflammation and coagulopathy, “cytokine storm”, side effects of drug therapy and hypoxia. According to an etiological factor, musculoskeletal manifestations of SARS-CoV-2 include autoimmune (reactive arthritis, sacroiliitis, ankylosing spondylitis, axial spondyloarthritis, psoriatic arthritis) conditions caused by impaired circulation of bone tissue (aseptic osteonecrosis), infectious (septic arthritis, spondylitis, spondylodiscitis) and metabolic (osteopenia, osteoporosis) conditions.Conclusion It has been established that COVID-19 infection has a negative impact on the musculoskeletal, endocrine and immune systems increasing the risk of degenerative diseases of the musculoskeletal system and infectious complications in orthopaedic patients early post surgery.
{"title":"Mechanisms of musculoskeletal consequences of COVID-19","authors":"N. N. Grigoryeva, G. Airapetov","doi":"10.18019/1028-4427-2024-30-1-153-162","DOIUrl":"https://doi.org/10.18019/1028-4427-2024-30-1-153-162","url":null,"abstract":"Introduction A coronavirus, SARS-CoV-2, called COVID-19 by the WHO has caused a pandemic of respiratory illness killed more than 6 million people. The severe infection has a significant negative impact on the entire musculoskeletal system.The objective was to summarize literature data on the mechanisms of the condition and identify musculoskeletal symptoms of COVID-19.Material and methods An internet search of PubMed, MedLine and eLIBRARY library databases using the search terms: COVID-19, aseptic osteonecrosis, post-COVID-19 syndrome, arthropathy, musculoskeletal system, spondylitis, osteoporosis was performed.Results and discussion Musculoskeletal symptoms of COVID-19 are reported in 31-59% of cases. Mechanisms of musculoskeletal involvement of coronavirus infection include cytotoxic effect of the virus on osteogenesis cells, vascular inflammation and coagulopathy, “cytokine storm”, side effects of drug therapy and hypoxia. According to an etiological factor, musculoskeletal manifestations of SARS-CoV-2 include autoimmune (reactive arthritis, sacroiliitis, ankylosing spondylitis, axial spondyloarthritis, psoriatic arthritis) conditions caused by impaired circulation of bone tissue (aseptic osteonecrosis), infectious (septic arthritis, spondylitis, spondylodiscitis) and metabolic (osteopenia, osteoporosis) conditions.Conclusion It has been established that COVID-19 infection has a negative impact on the musculoskeletal, endocrine and immune systems increasing the risk of degenerative diseases of the musculoskeletal system and infectious complications in orthopaedic patients early post surgery.","PeriodicalId":37426,"journal":{"name":"Genij Ortopedii","volume":"52 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140444962","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 : 2024-02-21DOI: 10.18019/1028-4427-2024-30-1-124-133
A. I. Greben, P. Eremin, E. Y. Kostromina, P. A. Markov, I. Gilmutdinova
Introduction Bone defect management is a critical stage of treatment and rehabilitation that still remains a challenging problem for traumatologists and orthopaedists. The need for tissue engineering techniques is due to limited abilities of the human body to correct bone tissue autoregeneration, especially in comorbid and elderly patients with osteoporosis. Bone autografts is a gold standard in those cases but is associated with certain restrictions. Regenerative medicine and stem cell biology development opened up capabilities to employ new methods for enhancement of bone tissue repair. A special interest of researchers is focused on mesenchymal stem cells and extracellular vesicles for bone tissue regeneration optimization.Purpose of this review was to show mesenchymal stem cells and exosomes effeciency in bone defect treatment.Materials and methods Open electronic databases of scientific literature, PubMed and e-Library, were used. The literature data search was carried out using the keywords: regenerative medicine, bone defects, exosomes, mesenchymal stem cells.Results and discussion The review presents current ideas about mesenchymal stem cells, their microenvironment and exosomes influence on bone tissue repair. Clinical need in effective bone regeneration is still high. Mesenchymal stem cells and acellular regenerative treatments have shown good results in bone defects repair and are perspective directions. Productive use of mesenchymal stem cells and exosomes in bone defects treatment requires further study of their mechanisms of action, the regenerative techniques efficacy and safety evaluation in preclinical and clinical studies.Conclusion The use of mesenchymal stem cells and cell-free regenerative approaches has demonstrated good results in the restoration of bone tissue defects and is a promising direction.
{"title":"Mesenchymal stem cells and exosomes in bone defects treatment","authors":"A. I. Greben, P. Eremin, E. Y. Kostromina, P. A. Markov, I. Gilmutdinova","doi":"10.18019/1028-4427-2024-30-1-124-133","DOIUrl":"https://doi.org/10.18019/1028-4427-2024-30-1-124-133","url":null,"abstract":"Introduction Bone defect management is a critical stage of treatment and rehabilitation that still remains a challenging problem for traumatologists and orthopaedists. The need for tissue engineering techniques is due to limited abilities of the human body to correct bone tissue autoregeneration, especially in comorbid and elderly patients with osteoporosis. Bone autografts is a gold standard in those cases but is associated with certain restrictions. Regenerative medicine and stem cell biology development opened up capabilities to employ new methods for enhancement of bone tissue repair. A special interest of researchers is focused on mesenchymal stem cells and extracellular vesicles for bone tissue regeneration optimization.Purpose of this review was to show mesenchymal stem cells and exosomes effeciency in bone defect treatment.Materials and methods Open electronic databases of scientific literature, PubMed and e-Library, were used. The literature data search was carried out using the keywords: regenerative medicine, bone defects, exosomes, mesenchymal stem cells.Results and discussion The review presents current ideas about mesenchymal stem cells, their microenvironment and exosomes influence on bone tissue repair. Clinical need in effective bone regeneration is still high. Mesenchymal stem cells and acellular regenerative treatments have shown good results in bone defects repair and are perspective directions. Productive use of mesenchymal stem cells and exosomes in bone defects treatment requires further study of their mechanisms of action, the regenerative techniques efficacy and safety evaluation in preclinical and clinical studies.Conclusion The use of mesenchymal stem cells and cell-free regenerative approaches has demonstrated good results in the restoration of bone tissue defects and is a promising direction.","PeriodicalId":37426,"journal":{"name":"Genij Ortopedii","volume":"6 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140445633","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 : 2024-02-21DOI: 10.18019/1028-4427-2024-30-1-114-123
E. A. Volokitina, I. Antropova, K. A. Timofeev, R. A. Trufanenko
Background Ceramic materials are currently in wide demand in various fields of medicine. Zirconium ceramics demonstrate exceptional mechanical properties and biocompatibility and do not cause cytotoxic effects or allergic reactions in surrounding tissues.The objective was to present an analysis of current literature data on the use of zirconium ceramics as a bone replacement material in traumatology and orthopaedics.Materials and methods The search for publications was conducted using the databases of Scopus, PubMed and the electronic scientific library eLIBRARY in the Russian and English languages using the keywords: bioceramics, bone, bone defect, zirconate, zirconium ceramics, bone tissue engineering, implant, scaffold, augment, biointegration, bioactivity. Depth of search for scientific papers was from 2000 to 2023.Results and discussion Zirconium dioxide is the main ceramic bioinert material. The study presents the characteristics of ZrO2 as a bone replacement material and its comparison with titanium implants. Data are presented on various strategies for improving zirconium bioceramics: improving the surface of the material by physical and chemical methods, obtaining volumetric porosity, including using additive technologies, creating composite materials, and developing bioactive coatings. New methods of creating zirconium ceramics compatible with living tissues containing bioactive ions that promote both osseointegration and bone tissue regeneration have been actively studied.Conclusions Zirconium dioxide ceramics appear to be a promising alternative to titanium implants in terms of mechanical strength, biological functionality, chemical stability, osseointegration, and antibacterial properties. Future experimental and clinical studies will further improve zirconium ceramics.
{"title":"Current state and perspectives on the use of zirconium ceramic implants in traumatology and orthopaedics","authors":"E. A. Volokitina, I. Antropova, K. A. Timofeev, R. A. Trufanenko","doi":"10.18019/1028-4427-2024-30-1-114-123","DOIUrl":"https://doi.org/10.18019/1028-4427-2024-30-1-114-123","url":null,"abstract":"Background Ceramic materials are currently in wide demand in various fields of medicine. Zirconium ceramics demonstrate exceptional mechanical properties and biocompatibility and do not cause cytotoxic effects or allergic reactions in surrounding tissues.The objective was to present an analysis of current literature data on the use of zirconium ceramics as a bone replacement material in traumatology and orthopaedics.Materials and methods The search for publications was conducted using the databases of Scopus, PubMed and the electronic scientific library eLIBRARY in the Russian and English languages using the keywords: bioceramics, bone, bone defect, zirconate, zirconium ceramics, bone tissue engineering, implant, scaffold, augment, biointegration, bioactivity. Depth of search for scientific papers was from 2000 to 2023.Results and discussion Zirconium dioxide is the main ceramic bioinert material. The study presents the characteristics of ZrO2 as a bone replacement material and its comparison with titanium implants. Data are presented on various strategies for improving zirconium bioceramics: improving the surface of the material by physical and chemical methods, obtaining volumetric porosity, including using additive technologies, creating composite materials, and developing bioactive coatings. New methods of creating zirconium ceramics compatible with living tissues containing bioactive ions that promote both osseointegration and bone tissue regeneration have been actively studied.Conclusions Zirconium dioxide ceramics appear to be a promising alternative to titanium implants in terms of mechanical strength, biological functionality, chemical stability, osseointegration, and antibacterial properties. Future experimental and clinical studies will further improve zirconium ceramics.","PeriodicalId":37426,"journal":{"name":"Genij Ortopedii","volume":"11 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140442093","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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