Pub Date : 2023-10-18DOI: 10.15674/0030-59872023369-78
Sergij Khmyzov, Anastasiia Hrytsenko, Genadii Kykosh, Anton Hrytsenko
Obstetric practice dates back thousands of years, providing assistance to women in labor is often complicated by the rapid course of labor, pelvic presentation of the fetus, shoulder dystocia with a possible clavicle fracture. Damage to CV–CVI roots, classic Duchenne–Erb palsy, accounts for 46 % of the total number of obstetric palsies. Objective. To analyze the scientific and medical literature in order to identify historical scientific and practical information about the study of childbirth injuries, and, in particular, Duchenne–Erb's obstetric palsy. Methods. To study and analyze sources of scientific and medical information, publications from Google search engines, electronic databases PubMed, Google Scholar, archival medical journals. Results. The first data on obstetric paralysis were provided by Duchesne in 1872, highlighting thorough reports on upper extremity muscle damage. Subsequently, in 1874, Erb performed electrical stimulation of the affected muscles, finding out the zone of neurological damage. The history of the development and formation of this scientific issue is quite ambiguous, because it borders on two medical fields: neurosurgery and orthopedics. According to literary sources, it is obvious that the pathohistology and pathophysiology of the direct injury zone (roots CV–CVI), delayed changes in the function of the upper limb, and the latest diagnostic technologies simplify the understanding of the presentation. The existing methods of operative interventions allow physicians to improve the child's life. However, the question remains open regarding the use of certain operative interventions in relation to the child's age and further rehabilitation. Conclusions. Despite a significant stratum of scientific and practical research on Duchenne–Erb's obstetric palsy, there are still a number of questions regarding the diagnosis and treatment of children with this abnormality. The search for improving the functional state of the upper limb in children should continue.
{"title":"BIRTH INJURY, DUCHENNE-ERBʼS OBSTETRIC PALSY. DIAGNOSIS AND TREATMENT (LITERATURE REVIEW)","authors":"Sergij Khmyzov, Anastasiia Hrytsenko, Genadii Kykosh, Anton Hrytsenko","doi":"10.15674/0030-59872023369-78","DOIUrl":"https://doi.org/10.15674/0030-59872023369-78","url":null,"abstract":"Obstetric practice dates back thousands of years, providing assistance to women in labor is often complicated by the rapid course of labor, pelvic presentation of the fetus, shoulder dystocia with a possible clavicle fracture. Damage to CV–CVI roots, classic Duchenne–Erb palsy, accounts for 46 % of the total number of obstetric palsies. Objective. To analyze the scientific and medical literature in order to identify historical scientific and practical information about the study of childbirth injuries, and, in particular, Duchenne–Erb's obstetric palsy. Methods. To study and analyze sources of scientific and medical information, publications from Google search engines, electronic databases PubMed, Google Scholar, archival medical journals. Results. The first data on obstetric paralysis were provided by Duchesne in 1872, highlighting thorough reports on upper extremity muscle damage. Subsequently, in 1874, Erb performed electrical stimulation of the affected muscles, finding out the zone of neurological damage. The history of the development and formation of this scientific issue is quite ambiguous, because it borders on two medical fields: neurosurgery and orthopedics. According to literary sources, it is obvious that the pathohistology and pathophysiology of the direct injury zone (roots CV–CVI), delayed changes in the function of the upper limb, and the latest diagnostic technologies simplify the understanding of the presentation. The existing methods of operative interventions allow physicians to improve the child's life. However, the question remains open regarding the use of certain operative interventions in relation to the child's age and further rehabilitation. Conclusions. Despite a significant stratum of scientific and practical research on Duchenne–Erb's obstetric palsy, there are still a number of questions regarding the diagnosis and treatment of children with this abnormality. The search for improving the functional state of the upper limb in children should continue.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135943769","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 : 2023-10-18DOI: 10.15674/0030-59872023336-42
Mykola Korzh, Vasyl Makarov, Marcin Chilik, Serhii Zdanevych, Maksym Smoliar
Objective. To conduct a finite element analysis of the stress-strain state (STS) of the elements of the shoulder joint after implantation reverse shoulder endoprostheses. Material and methods. After 3Dscanning of the composite model of the scapula and humerus, geometric models of the shoulder joint were built in the SolidWorks 2019 SP 1.0 program, followed by mathematical modeling and FEA. For the comparative analysis of the STS of the «bone – reverse endoprosthesis» s ystem, t hree-dimensional m odels o f two types of reverse shoulder endoprostheses were created, which were then transformed into a finite-element model and implanted into the developed three-dimensional mathematical model of the shoulder joint without cement. The STS calculations of the elements of endoprostheses were carried out for two positions: abduction 90° and flexion 90° with a load of 5 kg. Results. Compared to the healthy shoulder joint, models with reverse shoulder endoprosthesis have significantly different contact stresses and contact areas. It was established that the maximum stress in the details of the contact parts of the endoprosthesis when retracted at an angle of 90° did not exceed +1.78 MPa, when bending +5.8 MPa. The maximum stresses on the liner during shoulder abduction are +8.6 MPa, the minimum –7.38 MPa, during flexion +2.3 MPa and –2.45 MPa, respectively. It has been proven that the contact areas of the hemisphere and inserts of both reverse endoprostheses during abduction and flexion of the limb by 90° are significantly larger (573 mm2 vs. 1809–2081 mm2) when compared with a healthy shoulder joint, while changes in the area between the endoprostheses are insignificant and equal to 2...3 %. Conclusions. Analysis of the STS load of elements of reverse shoulder endoprosthesis showed that the greatest stresses occur in the contact zones. It has been proven that the maximum stresses on the contact structures of endoprostheses are less than on the head of a healthy joint, but the contact area during implantation of a reversible endoprosthesis of the shoulder joint increases significantly (more than 3 times).
{"title":"FINITE ELEMENT ANALYSIS OF THE STRESS-STRAIN STATE OF 3D COMPUTER GENERATED IMAGING OF REVERSE TOTAL SHOULDER ENDOPROSTHESES","authors":"Mykola Korzh, Vasyl Makarov, Marcin Chilik, Serhii Zdanevych, Maksym Smoliar","doi":"10.15674/0030-59872023336-42","DOIUrl":"https://doi.org/10.15674/0030-59872023336-42","url":null,"abstract":"Objective. To conduct a finite element analysis of the stress-strain state (STS) of the elements of the shoulder joint after implantation reverse shoulder endoprostheses. Material and methods. After 3Dscanning of the composite model of the scapula and humerus, geometric models of the shoulder joint were built in the SolidWorks 2019 SP 1.0 program, followed by mathematical modeling and FEA. For the comparative analysis of the STS of the «bone – reverse endoprosthesis» s ystem, t hree-dimensional m odels o f two types of reverse shoulder endoprostheses were created, which were then transformed into a finite-element model and implanted into the developed three-dimensional mathematical model of the shoulder joint without cement. The STS calculations of the elements of endoprostheses were carried out for two positions: abduction 90° and flexion 90° with a load of 5 kg. Results. Compared to the healthy shoulder joint, models with reverse shoulder endoprosthesis have significantly different contact stresses and contact areas. It was established that the maximum stress in the details of the contact parts of the endoprosthesis when retracted at an angle of 90° did not exceed +1.78 MPa, when bending +5.8 MPa. The maximum stresses on the liner during shoulder abduction are +8.6 MPa, the minimum –7.38 MPa, during flexion +2.3 MPa and –2.45 MPa, respectively. It has been proven that the contact areas of the hemisphere and inserts of both reverse endoprostheses during abduction and flexion of the limb by 90° are significantly larger (573 mm2 vs. 1809–2081 mm2) when compared with a healthy shoulder joint, while changes in the area between the endoprostheses are insignificant and equal to 2...3 %. Conclusions. Analysis of the STS load of elements of reverse shoulder endoprosthesis showed that the greatest stresses occur in the contact zones. It has been proven that the maximum stresses on the contact structures of endoprostheses are less than on the head of a healthy joint, but the contact area during implantation of a reversible endoprosthesis of the shoulder joint increases significantly (more than 3 times).","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135943770","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 : 2023-10-18DOI: 10.15674/0030-59872023357-61
Yevgen Matelenok
Neglected complex dislocations of the elbow joint are not often pathology, bat its treatment is serious problem and demand an individual tactic of treatment. Objective. To present a clinical case of consecutive treatment the neglected complex dislocations of the elbow. Methods. The clinical case of neglected complex dislocations to the back with coronoid process fracture II type (by Regan, Morrey) with displacement to a 60-year old man, who could not get medical care within 6 months. At the moment of examination patient had formed steadfast interrelations of displaced elbow joint structures with loosing of limb functionality. At the first stage, the forearm was distracted by using an external fixation device end redaction in the shoulder-elbow joint was achieved. At another stage arthrolysis, open redaction of the radial head, restoration of the lateral ligamentous apparatus was complected. In three weeks restoration of movements in the elbow joint has begun, ensuring movements close to the natural axis of the forearm rotation, which was provided by the external fixation device. Results. In 6 months the patient noted moderate pain only after intense physical load, hi doesn’t take painkillers, volume o f rotational m ovements: 2 0/0/25 (45°), e xtension-flexion movements: 0/15/118 (103°). The patient actively uses the limb for self-care and in work activities. According to the Mayo Elbow Performance Score the sum of points is 75, this means — the result is good. Conclusions. In cases of neglected complex dislocations for significant periods of existence (more than 3–4 months) staged treatment tactics is appropriate with using external fixation devices, by perforce perform open and closed manipulations, which depends on the specific clinical situation.
{"title":"TREATMENT OF NEGLECTED COMPLEX DISLOCATIONS IN THE ELBOW JOINT (CLINICAL CASE)","authors":"Yevgen Matelenok","doi":"10.15674/0030-59872023357-61","DOIUrl":"https://doi.org/10.15674/0030-59872023357-61","url":null,"abstract":"Neglected complex dislocations of the elbow joint are not often pathology, bat its treatment is serious problem and demand an individual tactic of treatment. Objective. To present a clinical case of consecutive treatment the neglected complex dislocations of the elbow. Methods. The clinical case of neglected complex dislocations to the back with coronoid process fracture II type (by Regan, Morrey) with displacement to a 60-year old man, who could not get medical care within 6 months. At the moment of examination patient had formed steadfast interrelations of displaced elbow joint structures with loosing of limb functionality. At the first stage, the forearm was distracted by using an external fixation device end redaction in the shoulder-elbow joint was achieved. At another stage arthrolysis, open redaction of the radial head, restoration of the lateral ligamentous apparatus was complected. In three weeks restoration of movements in the elbow joint has begun, ensuring movements close to the natural axis of the forearm rotation, which was provided by the external fixation device. Results. In 6 months the patient noted moderate pain only after intense physical load, hi doesn’t take painkillers, volume o f rotational m ovements: 2 0/0/25 (45°), e xtension-flexion movements: 0/15/118 (103°). The patient actively uses the limb for self-care and in work activities. According to the Mayo Elbow Performance Score the sum of points is 75, this means — the result is good. Conclusions. In cases of neglected complex dislocations for significant periods of existence (more than 3–4 months) staged treatment tactics is appropriate with using external fixation devices, by perforce perform open and closed manipulations, which depends on the specific clinical situation.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135943771","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}
In the modern world, despite the increased availability of hightech orthopedic care, the number of patients with gonarthrosis does not decrease, and thanks to public awareness, more and more people turn to orthopedists for surgical help. Due to its high efficiency, the leading role in the treatment of terminal gonarthrosis has been firmly occupied by total knee arthroplasty for more than four decades. Unicondylar knee arthroplasty in patients with unilateral arthrosis allows to largely preserve physiological kinematics, to achieve minimal bone and soft tissue traumatization during surgery and, as a result, to obtain a higher functional result. The objective of the work is to analyze the data of the world literature regarding unicondylar knee arthroplasty, its advantages and disadvantages. Material and methods. The authors analyzed the publications devoted to single-condylar knee arthroplasty from the Google search engine, scientific and metric electronic databases PubMed, Medline and other relevant sources of scientific and medical information. Correct patient selection is vital to ensure a successful outcome with OEKS. The main indication for OEKS is deforming arthrosis of the II–III century. with a predominant lesion of the internal part of the knee joint and varus deformation of the lower limb or with a more pronounced pathology of the external part of the knee joint and valgus deformation of the lower limb. Results. The authors analyzed the literature sources on single-condylar endoprosthesis of the knee joint. Indications, contraindications, biomechanical features, type of endoprosthesis fixation, type of endoprosthesis platform, features of lateral gonarthrosis, and complications of single-condylar knee arthroplasty are determined. Conclusions. The analysis of selected literary sources showed that single-condylar arthroplasty of the knee joint is an effective means of preserving the bone. However, careful patient selection and precision of surgical technique remain the key to a successful outcome.
{"title":"UNICONDYLAR KNEE ARTHROPLASTY — PROS AND CONS (LITERATURE REVIEW)","authors":"Olena Baburkina, Oleg Ovchynnikov, Maryna Bludova, Anatoliy Zhygun","doi":"10.15674/0030-59872023379-90","DOIUrl":"https://doi.org/10.15674/0030-59872023379-90","url":null,"abstract":"In the modern world, despite the increased availability of hightech orthopedic care, the number of patients with gonarthrosis does not decrease, and thanks to public awareness, more and more people turn to orthopedists for surgical help. Due to its high efficiency, the leading role in the treatment of terminal gonarthrosis has been firmly occupied by total knee arthroplasty for more than four decades. Unicondylar knee arthroplasty in patients with unilateral arthrosis allows to largely preserve physiological kinematics, to achieve minimal bone and soft tissue traumatization during surgery and, as a result, to obtain a higher functional result. The objective of the work is to analyze the data of the world literature regarding unicondylar knee arthroplasty, its advantages and disadvantages. Material and methods. The authors analyzed the publications devoted to single-condylar knee arthroplasty from the Google search engine, scientific and metric electronic databases PubMed, Medline and other relevant sources of scientific and medical information. Correct patient selection is vital to ensure a successful outcome with OEKS. The main indication for OEKS is deforming arthrosis of the II–III century. with a predominant lesion of the internal part of the knee joint and varus deformation of the lower limb or with a more pronounced pathology of the external part of the knee joint and valgus deformation of the lower limb. Results. The authors analyzed the literature sources on single-condylar endoprosthesis of the knee joint. Indications, contraindications, biomechanical features, type of endoprosthesis fixation, type of endoprosthesis platform, features of lateral gonarthrosis, and complications of single-condylar knee arthroplasty are determined. Conclusions. The analysis of selected literary sources showed that single-condylar arthroplasty of the knee joint is an effective means of preserving the bone. However, careful patient selection and precision of surgical technique remain the key to a successful outcome.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135943774","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 : 2023-10-18DOI: 10.15674/0030-59872023362-68
Andrej Trampuz, Olga Pidgaiska, Volodymyr Filipenko, Kostiantyn Romanenko, Olexii Marushchak
Fracture-related infection following orthopedic surgery, especially in cases of war-related trauma, represents a grave complication. The injuries sustained in war often entail severe damage to soft tissues, including significant impairment of vessels, nerves, tendons, muscles, and result in substantial bone defects. Complicating matters further, these infections often involve multidrug-resistant pathogens, making effective treatment a significant challenge. Optimal management of patients with combat-related trauma and signs of infection necessitates specialized care in dedicated centers. The approach to treatment should be guided by a well-defined algorithm that incorporates appropriate surgical interventions alongside systemic and localized antibiotic administration. In instances where chronic infection manifests after war-related injuries and specific causative agents are not definitively identified, initiating empiric therapy is advisable. A combination of meropenem, colistin, and vancomycin can be a suitable choice for initial treatment. Subsequently, once the causative microbes are identified, targeted treatment can be prescribed based on the susceptibility patterns. This article delves into the primary pathogens commonly found in war-related wounds and provides effective antibiotic regimens based on the specific microorganisms. One promising approach for managing severe war injuries is suppressive antibiotic therapy, which enhances the prospects of successful treatment. The comprehensive strategy outlinedhere aims to mitigate the serious risks posed by fracture-related infections in the context of war-induced trauma, ultimately improving patient outcomes and prognosis.
{"title":"Approaches to surgical treatment and antibacterial therapy in patients with chronic infection after war injuries","authors":"Andrej Trampuz, Olga Pidgaiska, Volodymyr Filipenko, Kostiantyn Romanenko, Olexii Marushchak","doi":"10.15674/0030-59872023362-68","DOIUrl":"https://doi.org/10.15674/0030-59872023362-68","url":null,"abstract":"Fracture-related infection following orthopedic surgery, especially in cases of war-related trauma, represents a grave complication. The injuries sustained in war often entail severe damage to soft tissues, including significant impairment of vessels, nerves, tendons, muscles, and result in substantial bone defects. Complicating matters further, these infections often involve multidrug-resistant pathogens, making effective treatment a significant challenge. Optimal management of patients with combat-related trauma and signs of infection necessitates specialized care in dedicated centers. The approach to treatment should be guided by a well-defined algorithm that incorporates appropriate surgical interventions alongside systemic and localized antibiotic administration. In instances where chronic infection manifests after war-related injuries and specific causative agents are not definitively identified, initiating empiric therapy is advisable. A combination of meropenem, colistin, and vancomycin can be a suitable choice for initial treatment. Subsequently, once the causative microbes are identified, targeted treatment can be prescribed based on the susceptibility patterns. This article delves into the primary pathogens commonly found in war-related wounds and provides effective antibiotic regimens based on the specific microorganisms. One promising approach for managing severe war injuries is suppressive antibiotic therapy, which enhances the prospects of successful treatment. The comprehensive strategy outlinedhere aims to mitigate the serious risks posed by fracture-related infections in the context of war-induced trauma, ultimately improving patient outcomes and prognosis.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135943645","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}
The use of regenerative technologies is widespread in modern medicine. Adipose-derived stem cells (ADSCs) in the stromalvascular fraction (SVF) appear to be most attractive for use in cell therapy. The objective of this study is to identify morphological differences in the stromal-vascular fraction from the subcutaneous tissue and infrapatelar fat pad (IFP). Material and methods. Data analysis of 15 patients was carried out. The average age of the patients was (44.0 ± 3.8) years with a body mass index of (20.1 ± 1.6) kg/m2 . Aspirates of subcutaneous adipose tissue were obtained from the anterior abdominal wall of 8 women without signs of obesity and comorbid metabolic diseases, as well as the resected IFP from 7 patients during therapeutic and diagnostic arthroscopy, also without signs of obesity. We conducted a comparative characterization of the composition of the obtained histological samples. Morphometric measurements of the diameter of adipocytes were performed. Parametric and non-parametric criteria of statistical analysis were applied. Parametric criteria were used to determine the average diameter of adipocytes and the standard deviation. Nonparametric ones were used to test the hypothesis about the normality of the distribution of the studied indicators according to the Shapiro–Wilk test. The results. SVF, which were obtained in our study from subcutaneous adipose tissue and from IFP, differ in composition, namely, the amount of the stromal component, which is visually much more pronounced in the SVF of IFP, the size of adipocytes, which in SVF from subcutaneous adipose tissue of a statistically larger diameter. Conclusions. It was morphologically proven that SVF of IFP is a promising source of adipose mesenchymal stem cells for regenerative medicine, especially for cartilage regeneration.
{"title":"MORPHOLOGICAL COMPARISON OF THE STROMAL-VASCULAR FRACTION OF THE SUBCUTANEOUS FAT CELL AND INFRAPATELLAR FAT PAD","authors":"Serhiy Maslenikov, Yulia Avramenko, Maxim Golovakha","doi":"10.15674/0030-59872023351-56","DOIUrl":"https://doi.org/10.15674/0030-59872023351-56","url":null,"abstract":"The use of regenerative technologies is widespread in modern medicine. Adipose-derived stem cells (ADSCs) in the stromalvascular fraction (SVF) appear to be most attractive for use in cell therapy. The objective of this study is to identify morphological differences in the stromal-vascular fraction from the subcutaneous tissue and infrapatelar fat pad (IFP). Material and methods. Data analysis of 15 patients was carried out. The average age of the patients was (44.0 ± 3.8) years with a body mass index of (20.1 ± 1.6) kg/m2 . Aspirates of subcutaneous adipose tissue were obtained from the anterior abdominal wall of 8 women without signs of obesity and comorbid metabolic diseases, as well as the resected IFP from 7 patients during therapeutic and diagnostic arthroscopy, also without signs of obesity. We conducted a comparative characterization of the composition of the obtained histological samples. Morphometric measurements of the diameter of adipocytes were performed. Parametric and non-parametric criteria of statistical analysis were applied. Parametric criteria were used to determine the average diameter of adipocytes and the standard deviation. Nonparametric ones were used to test the hypothesis about the normality of the distribution of the studied indicators according to the Shapiro–Wilk test. The results. SVF, which were obtained in our study from subcutaneous adipose tissue and from IFP, differ in composition, namely, the amount of the stromal component, which is visually much more pronounced in the SVF of IFP, the size of adipocytes, which in SVF from subcutaneous adipose tissue of a statistically larger diameter. Conclusions. It was morphologically proven that SVF of IFP is a promising source of adipose mesenchymal stem cells for regenerative medicine, especially for cartilage regeneration.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135943765","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}
115-YEARS ANNIVERSARY SYTENKO INSTITUTE OF SPINE AND JOINT PATHOLOGY, NATIONAL UKRAINIAN ACADEMY OF MEDICAL SCIENCE
乌克兰国家医学科学院sytenko脊柱和关节病理学研究所成立115周年
{"title":"115-YEARS ANNIVERSARY SYTENKO INSTITUTE OF SPINE AND JOINT PATHOLOGY, NATIONAL UKRAINIAN ACADEMY OF MEDICAL SCIENCE","authors":"Mykola Korzh, Volodymyr Tankut, Hanna Demianenko, Inna Golubeva, Kostyantyn Berenov, Viktoria Androsenkova","doi":"10.15674/0030-59872023391-99","DOIUrl":"https://doi.org/10.15674/0030-59872023391-99","url":null,"abstract":"115-YEARS ANNIVERSARY SYTENKO INSTITUTE OF SPINE AND JOINT PATHOLOGY, NATIONAL UKRAINIAN ACADEMY OF MEDICAL SCIENCE","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":"145 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135942894","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}
Deformations of the front part of the foot with valgus deformity of the first toe lead to a redistribution of the body weight load during walking between the heads of the metatarsal bones. At the same time, the load on the head of II and III, and sometimes IV metatarsal bones increases significantly. Objective. To substantiate the choice of the most correct distal metatarsal osteotomy for the treatment of patients with metatarsalgia. Materials and methods. Three variants of distal metatarsal osteotomy were simulated: Weil, Helal, and distal wedge-shaped metatarsal osteotomy. Result. Weil osteotomy allows you to raise the support point of the metatarsal head above the support surface from 2 to 7 mm, depending on the amount of displacement of the head in the proximal direction and the angle of inclination of the metatarsal bone relative to the plane of the support surface, which effectively reduces the load on the metatarsal head during walking, but under conditions of magnitude the angle of inclination of the axis of the metatarsal bone is more than 20°. Helal osteotomy with the subsequent displacement of the separated part proximally, ensures the lifting of the head above the conventional plane of support from 1 to 4 mm, contributes to the effective unloading of the head while standing and while walking. They are used only for severe metatarsalgia. The range of correction of the standing height of the support surface of the metatarsal head for performing a distal wedgeshaped osteotomy is determined to be from 0.6 to 2.9 mm. Its advantage is the independence of the amount of correction from the presence or absence of a decrease in the longitudinal arch of the foot. Conclusions. Weil osteotomy has the worst corrective possibilities of raising the head of the metatarsal bone, but is very easy to perform, so its use is advisable in the absence of reduction of the longitudinal arch of the foot. A wedge-shaped distal osteotomy has a range of correction of the metatarsal headelevation up to 3 mm, but it depends on its diameter, so it is used in the case of a head diameter of at least 10 mm. Helal osteotomy provides the widest range of elevation of the metatarsal head, which does not depend on the presence of any degree of flat feet, but has some technical limitations.
{"title":"BIOMECHANICAL SUBSTANTIATION OF THE ALGORITHM FOR CHOOSING THE OPTION OF DISTAL CORRECTIVE OSTEOTOMY OF THE II–IV METATARSAL BONES IN THE TREATMENT OF METATARSALGIA","authors":"Dmytro Prozorovskiy, Mykhailo Karpinsky, Olena Karpinska","doi":"10.15674/0030-59872023319-27","DOIUrl":"https://doi.org/10.15674/0030-59872023319-27","url":null,"abstract":"Deformations of the front part of the foot with valgus deformity of the first toe lead to a redistribution of the body weight load during walking between the heads of the metatarsal bones. At the same time, the load on the head of II and III, and sometimes IV metatarsal bones increases significantly. Objective. To substantiate the choice of the most correct distal metatarsal osteotomy for the treatment of patients with metatarsalgia. Materials and methods. Three variants of distal metatarsal osteotomy were simulated: Weil, Helal, and distal wedge-shaped metatarsal osteotomy. Result. Weil osteotomy allows you to raise the support point of the metatarsal head above the support surface from 2 to 7 mm, depending on the amount of displacement of the head in the proximal direction and the angle of inclination of the metatarsal bone relative to the plane of the support surface, which effectively reduces the load on the metatarsal head during walking, but under conditions of magnitude the angle of inclination of the axis of the metatarsal bone is more than 20°. Helal osteotomy with the subsequent displacement of the separated part proximally, ensures the lifting of the head above the conventional plane of support from 1 to 4 mm, contributes to the effective unloading of the head while standing and while walking. They are used only for severe metatarsalgia. The range of correction of the standing height of the support surface of the metatarsal head for performing a distal wedgeshaped osteotomy is determined to be from 0.6 to 2.9 mm. Its advantage is the independence of the amount of correction from the presence or absence of a decrease in the longitudinal arch of the foot. Conclusions. Weil osteotomy has the worst corrective possibilities of raising the head of the metatarsal bone, but is very easy to perform, so its use is advisable in the absence of reduction of the longitudinal arch of the foot. A wedge-shaped distal osteotomy has a range of correction of the metatarsal headelevation up to 3 mm, but it depends on its diameter, so it is used in the case of a head diameter of at least 10 mm. Helal osteotomy provides the widest range of elevation of the metatarsal head, which does not depend on the presence of any degree of flat feet, but has some technical limitations.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135943773","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 : 2023-10-18DOI: 10.15674/0030-5987202335-12
Maxim Golovakha, Stanislav Bondarenko
Objective. On the basis of comparative radiometric analysis, before and after surgery, to assess the accuracy of the knee arthroplasty with an individual instrument. Methods. The analysis of knee arthroplasty of 26 patients operated with a special instrument was performed. Age: 50–59 years — 6, 0–69 — 12, 70–79 — 5, 80 and older — 3 patients. Men — 3, women — 18. Before the operation performed a computed tomography of the lower extremities, and after operation radiography of the lower extremities completely with the vertical positions of the feet. Patient specific instrument made according to the original method. The results of the analysis were performed by comparing X-ray parameters before and after operations: 1) position of the mechanical axis in the frontal plane on the plateau of the tibia in percent; 2) medial tibial resection angle to the mechanical axis; 3) the size of the components of the endoprosthesis (femoral, tibial and liner height). Results. Deviations in the values of the medial tibial and of the lateral femoral angles between the planned and actually obtained value was an average of 0.7 %, which can be considered a high indicator of the accuracy of the implant position. The position of the mechanical axis of the limb after the operation differed from the planned by a little more than 0.9 %. The dimensions of the endoprosthesis components and the height of the tibial insert fitted to the patients matched the planning results in 100 % of the cases, with the tibial insert height being 9 mm in all cases. The use of an individual tool made it possible to reduce the time of the operation, not to open the bone marrow canal of the thigh Conclusions. The use of the original individual tool for knee arthroplasty provided a high precision to install the components of the arthroplasty.
{"title":"ASSESSMENT OF THE USE OF AN INDIVIDUAL TOOL FOR KNEE ARTHROPLASTY","authors":"Maxim Golovakha, Stanislav Bondarenko","doi":"10.15674/0030-5987202335-12","DOIUrl":"https://doi.org/10.15674/0030-5987202335-12","url":null,"abstract":"Objective. On the basis of comparative radiometric analysis, before and after surgery, to assess the accuracy of the knee arthroplasty with an individual instrument. Methods. The analysis of knee arthroplasty of 26 patients operated with a special instrument was performed. Age: 50–59 years — 6, 0–69 — 12, 70–79 — 5, 80 and older — 3 patients. Men — 3, women — 18. Before the operation performed a computed tomography of the lower extremities, and after operation radiography of the lower extremities completely with the vertical positions of the feet. Patient specific instrument made according to the original method. The results of the analysis were performed by comparing X-ray parameters before and after operations: 1) position of the mechanical axis in the frontal plane on the plateau of the tibia in percent; 2) medial tibial resection angle to the mechanical axis; 3) the size of the components of the endoprosthesis (femoral, tibial and liner height). Results. Deviations in the values of the medial tibial and of the lateral femoral angles between the planned and actually obtained value was an average of 0.7 %, which can be considered a high indicator of the accuracy of the implant position. The position of the mechanical axis of the limb after the operation differed from the planned by a little more than 0.9 %. The dimensions of the endoprosthesis components and the height of the tibial insert fitted to the patients matched the planning results in 100 % of the cases, with the tibial insert height being 9 mm in all cases. The use of an individual tool made it possible to reduce the time of the operation, not to open the bone marrow canal of the thigh Conclusions. The use of the original individual tool for knee arthroplasty provided a high precision to install the components of the arthroplasty.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135943776","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 : 2023-10-18DOI: 10.15674/0030-59872023333-18
Oleksandr Barkov, Roman Malyk, Olena Karpinska
One of the risk factors for complications in the spinal motion segments of the thoracic and lumbar regions, as well as in the adjacent segments with spinal fusion ones, is changes in the sagittal vertebral-pelvic balance. Purpose. To determine the effect of muscle changes that occur during the performance of two-segment LIV–SI spinal fusion on the load of adjacent motion segments. Material and methods. The spinal fusion of two spinal motion segments of the lumbar spine was simulated at the LIV–LV and LV–SI levels at different angles of segment fixation in the OpenSim programme. Five models were analysed: 1 (basic) — without changes; 2 — changes in the points of attachment and muscle strength; 3 — normo-lordotic fixation; 4 — hypolordotic; 5 —hyperlordotic. The load on the zone of interest was measured as the magnitude of the projection of the force vector depending on the angle of inclination of the torso as a percentage of the body weight. Results. Simulation of the above configurations of the instrumental spinal fusion (intact, normo-lordotic, hyperlordotic, hypolordotic positions due to a change in the angle of the LIV–SI spinal fusion) showed that the load force of the adjacent segments when bent forward depended on the angle of the instrumental spinal fusion performed. Conclusions. As a result of study of the kinematic model of the lumbar spine using bisegmental spinal fusion of LIV–SI, it was proved that the load force of the adjacent segments when bent forward depended on the angle of the instrumental spinal fusion performed. It was determined that the upper adjacent vertebra of the fixation zone had a relatively insignificant increase in load in the case of fixation in the hyperlordotic position; in the hypolordotic position, the load on the upper segment led to an increase in loads on the upper adjacent segment, and in the hypolordic position, it led to a slight decrease compared to the normo-lordotic fixation. According to the results of the study, minimal muscle damage is expected during the surgical intervention, so the reliability of the model is closer to minimally invasive surgery. The developed kinematic models can be useful in the planning of the transpedicular fixation surgery to prevent complications.
{"title":"STUDY OF THE LIV VERTEBRAL BODY LOAD DURING DYNAMIC SIMULATION OF MOVEMENTS IN THE LUMBAR SPINE USING MUSCULOSKELETAL MODELS AFTER POSTERIOR BISEGMENTAL SPINE FUSION PERFORMANCE","authors":"Oleksandr Barkov, Roman Malyk, Olena Karpinska","doi":"10.15674/0030-59872023333-18","DOIUrl":"https://doi.org/10.15674/0030-59872023333-18","url":null,"abstract":"One of the risk factors for complications in the spinal motion segments of the thoracic and lumbar regions, as well as in the adjacent segments with spinal fusion ones, is changes in the sagittal vertebral-pelvic balance. Purpose. To determine the effect of muscle changes that occur during the performance of two-segment LIV–SI spinal fusion on the load of adjacent motion segments. Material and methods. The spinal fusion of two spinal motion segments of the lumbar spine was simulated at the LIV–LV and LV–SI levels at different angles of segment fixation in the OpenSim programme. Five models were analysed: 1 (basic) — without changes; 2 — changes in the points of attachment and muscle strength; 3 — normo-lordotic fixation; 4 — hypolordotic; 5 —hyperlordotic. The load on the zone of interest was measured as the magnitude of the projection of the force vector depending on the angle of inclination of the torso as a percentage of the body weight. Results. Simulation of the above configurations of the instrumental spinal fusion (intact, normo-lordotic, hyperlordotic, hypolordotic positions due to a change in the angle of the LIV–SI spinal fusion) showed that the load force of the adjacent segments when bent forward depended on the angle of the instrumental spinal fusion performed. Conclusions. As a result of study of the kinematic model of the lumbar spine using bisegmental spinal fusion of LIV–SI, it was proved that the load force of the adjacent segments when bent forward depended on the angle of the instrumental spinal fusion performed. It was determined that the upper adjacent vertebra of the fixation zone had a relatively insignificant increase in load in the case of fixation in the hyperlordotic position; in the hypolordotic position, the load on the upper segment led to an increase in loads on the upper adjacent segment, and in the hypolordic position, it led to a slight decrease compared to the normo-lordotic fixation. According to the results of the study, minimal muscle damage is expected during the surgical intervention, so the reliability of the model is closer to minimally invasive surgery. The developed kinematic models can be useful in the planning of the transpedicular fixation surgery to prevent complications.","PeriodicalId":76291,"journal":{"name":"Ortopediia travmatologiia i protezirovanie","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135942728","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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