


Vol 74, No 2 (1993)
Indications and tactics of operative treatment of patients with congenital dislocation of the femur
Abstract
The problem of the treatment of congenital dislocation of the femur is actual currently. The main attention of the orthopedists is paid to the correction of deformation elements of proximal part of the femur and cotyloid cavity tectum. The paper is concerned with the tactics of operative treatment of children with congenital dislocation of the femur depending on the form of the disease and age of patients. Some methods of the treatment are developed on the basis of the recovery of right biomechanics of paraarticular muscles and joint elements. These methods are the basis of the suggested approach to the treatment of pathology. The efficacy of the treatment is confirmed by a large number of observations and twenty years of the treatment of congenital dislocation of the femur in children.



Analysis of the variations of the fixation of proximal part of the femur in the treatment of hip joint diseases in children using the apparatus
Abstract
On the basis of a numerical experiment using the mathematical apparatus of finite element method on the computer IBM PC by means of program package «Microcomputeraided design of structures» modified for design of structures, applied in traumatology and orthopedics, a new method of the apparatus fixation if proximal part of the femur is developed. The arranging of Elizarov’s apparatus suggested provides the needle — rod fixation of the femur. The method is used in the treatment of 84 patients with hip joint diseases, positive results are obtained in 96,4% of the cases. The efficacy of the method allows recommending it for the treatment of patients with congenital dislocations of the femur, aseptic necrosis of the head of the femur and coxa-vara in specialized hospitals.



New methods of the correction of cotyloid cavity dysplasia
Abstract
New developments in surgery of displastic processes of cotyloid cavity tectum are presenj ted. Based on the progressive correction of pelvic component of the joint by the external fixation apparatus, these methods are sufficiently efficient and appropriate in children of school age. The variations of the correction of cotyloid cavity tectum are tested in the infantile department of the research center «The recovery traumatology and orthopedics» of Tatarstan and are found to be good. This paper is concerned with the detailed description of the operative interventions.



Apophysial trochanteric plasty in the treatment of children with destructive dislocations of the femur in the absence of the head and neck
Abstract
A distingishing feature of the newly developed method of the treatment of destructive dislocation of the femur in children is a possibility to use autotransplant on the feeding muscular limb for the plasty of proximal part of the femur with the recovery of cartilaginous integument of the joint surface of femoral component. The method shows the high efficacy. The positive result is obtained in 8 cases out of 9. The use of Ilizarov’s apparatus significantly promotes the realization of the method and provides a possibility to make the patient more active in the process of the treatment.



Electroneuromyographic investigations in patients with deforming arthrosis of the hip and knee joints
Abstract
The changes of the functional state of spinal centers and muscles (musculus quadriceps femoris and musculus triceps surae) are detected, when observing 8 healthy subjects and 16 patients with gonand coxarthrosis. Centers or center-controlled muscles suffer to a large extent depending on the occurrence of the joint affections.



Some biomechanical aspects of contractures in coxarthrosis
Abstract
On the basis of the clinical analysis (225 patients suffering from coxarthrosis with the affection of 295 joints and three-plane mathematical modelling of different types of contractures in hip joint, the genesis of contractures is described and biomechanical peculiarities of each type are given. The elimination of contractures in various surgical interventions is considered as a necessary component of the pathogenetic treatment of coxarthrosis, beneficially affecting the course of degenerative dystrophic process.



Combined treatment of coxarthrosis
Abstract
Based on the examinations perfomed in 80 patients with coxarthrosis complicated by contractures, it is concluded that the pain is one of the most important pathogenetic factors of the contracture formation. A combined method of the treatment of coxarthrosis is developed, including laser therapy, acupuncture and intertrochanteric osteotomy using Ilizarov’s apparatus. As many as 186 patients are operated. Positive results are obtained in 92% of the cases.



On the problem of pathogenesis of closed fracture of the femur
Abstract
The data concerning the relationship between generalized functional changes of homeostasis and local pathology of the traumatic disease before hospitalization are obtained. The pathogenetic therapy preventing the initiation of the compensated forms of homeostasis disorders is developed.



Experience of perosseous osteosynthesis by means of Ilizarov’s apparatus in fractures of distal epimetaphysis of the crus bones and subluxations of the foot medially
Abstract
The results of the treatment of 6 patients with grave fractures of distal epimetaphysis of the crus bones and subluxation of the loot medially are analyzed. The indications for the use of perosseous osteosynthesis by means of Elizarov’s apparatus are formulated. The procedure of osteosynthesis and the peculiarities of the apparatus arranging for these fractures are described.



Clinico-morphologic parallels of vascular reactions reactions in heavy craniocerebral trauma
Abstract
The adaptational rearrangement of microcircular channel of the bulbar conjunctiva and the brain in heavy craniocerebral trauma experimentally and in clinic is studied in the dynamics. Simultaneous reaction of vessels of the ocular analyzer and the brain is established. The terms of the rearrangement of vascular channel are determined and the course and prediction of heavy craniocerebral trauma are well-founded. The therapeutic effect of vagosympathetic block on microcircular channel is confirmed.



Peculiarities of the shanges of characteristics of osteal regeneration in associated trauma
Abstract
The levels of inorganic phosphorus, calcium, free, connected and common oxyproline, alkaline phosphatase activity in blood are investigated in the experiment of standard craniocerebral trauma in connection wth the fracture of crus bones. The data obtained suggest the breaking of the coordination of hormonal regulation, manifesting itself simultaneously by the effect of parathormone and calcitonine in both phases of osteal regeneration. The disregulation of mineral metabolism, catabolism and anabolism processes of organic matrix causes the delay of reparative processes, intypicalness and development of fibrous tissue.



Pathogenetic basis of the effect of vagosympathetic novocainic block and its use in breast traumas
Abstract
The block favourably affects the exter-al respiration, decreases a degree of dyspnea, increases breathing volume, reduces pulmonary perfusion, preventing the progress of pulmonary edema, has a moderatelv pronounced lymptostimulating effect. At the same time after block the side effects are made possible in the form of a slight increase of arterial hypoxemia and hypertension of the lesser circle.



Functional state of the cardiorespiratory system in patients with funnel chest deformity
Abstract
Functional disorders of the cardiovascular and respiratory systems with pectus excavatum (CFD) have attracted close attention of specialists for a long time. Modern examination methods based on the use of new diagnostic equipment allow obtaining more and more objective criteria for assessing these disorders. However, there are still no clear relationships between the degree of deformity and the severity of cardiorespiratory disorders. Therefore, indications for thoracoplasty are made for cosmetic or other subjective reasons, which is unacceptable in relation to such a complex surgical intervention.



Gradual correction of severe forms of funnel chest deformity
Abstract
Funnel chest deformity (CFD) is a severe malformation, which, in addition to a cosmetic defect in the form of a depression of the sternum and ribs, is accompanied by various functional disorders in the cardiorespiratory system. The frequency of this defect, according to a number of domestic and foreign authors, varies depending on the region from 0.2% to 1.3%.



Postisometric relaxation and reflexotherapy in the treatment of pesttraumatic and immobilized contractures
Abstract
As many as 115 patients with posttraumatic and immobilized contractures of humeral and knee joints are treated using postisometric relaxation and acupuncture. The best results are obtained in the associated use of the given methods. The mechanisms of the therapeutic action of the given methods are dis cussed.



Treatment of preganglionic brachial plexus injuries
Abstract
Restoration of the function of the upper limb in the preganglionic level of damage to the brachial plexus trunks is a complex and multifaceted task that requires the surgeon to have knowledge of many specialties - peripheral nerve microsurgery, vascular surgery, micro-autotransplantology, orthopedics.



A new method of the substitution of the defects of peripheric nerves using Ilizarov’s apparatus
Abstract
A distractional method of the substitution of the defects of nerve trunks of a lower third of the forearm, using Elizarov’s apparatus is described. The nerve traction regime in the course of the treatment, using the apparatus is considered. The computer program allowing to colculate the hand extension rate according to the predetermined nerve traction regime is presented.



Microsurgical transplantation in the treatment of false joints and defects of long tubular bones
Abstract
The use of blood-supplying osteal transplants in the treatment of defects, false joints allows obtaining the odhesion of osteal fragments at a period from 2,5 to 4,5 months. Primary adhesion of transplants in obtained in 91% of the cases in 22 patients. The selection of one or other transplant depends principally on the revascularizetion and the place of osteosynthesis, the presense of infectious process in the zone of osteosynthesis, the size of osteal defect and associated traumas of surrounding tissues.



Heat-vision examination in traumas of nerves df the hand
Abstract
Twenty-six patients with traumas of peripheric nerves of the hand are observed using heat-vision. The follbwing treatment is performed by two ways — by epineural suture with gypseous immobilization and by taking out the hand from the forced position using the apparatus. Heat-vision is stated to be an objective method of the functional diagnosis and allows to perform the comparative esti4 mation of different treatment methods.



Caused responses of the short abductor of the first finger after operative recovery of nerves of the forearm
Abstract
The state of peripheric and central parts of neuromuscular system in patients with traumas of nerves of the forearm after the operations is examined by electrophysiologic methods. The changes of motor and central caused responces of the short abductor of the first finger are detected, pointing at the participation of median and ulnar nerves in the reinnervation of this muscle and the existence of functional shifts in the state of motor centers of the muscles of injured and uninjured limbs.



Treatment of nail felon
Abstract
Nail felon is the most common disease of the fingers. In terms of the number of cases, it is second only to subcutaneous panaritium and, according to a number of authors, is 26.1-37.3%. The specified disease is subdivided into paronychia, periungual and subungual felon. Some authors distinguish only two types - paronychia and subungual panaritium, although these are different types of nail panaritium, distinguishable both by localization and by the nature of inflammation. Paronychia - inflammation of only the nail fold; in women, it occurs 5 times more often, often gives relapses. Periungual felon - inflammation of the lateral part of the nail bed from one or both sides, occurs less often, and relapses are rare.



About pseudoinfarction hemorrhages in the lungs
Abstract
Thromboembolism or thrombosis of the pulmonary artery is often accompanied by the development of pseudoinfarction hemorrhage in the lungs. Pseudoinfarctions are usual stagnant hemorrhages or areas of catarrhal-hemorrhagic pneumonia. Pseudoinfarction hemorrhages, as well as simple hemorrhages in the lungs, are almost always perceived as an intravital pathology, therefore, the detection of infarction-like apoplexy of the lung tissue or hemorrhages on the section turns out to be an unexpected fact for the clinician.



Ray methods of investigation in the diagnosis of hepatopancreatoduodenal region and urinary system organs diseases
Abstract
Based on the examination of 617 patients, using current ray investigation methods — sonography, roentgenological methods, computer — aided tomograpgy, relaxative duodenography, the authors have determined their resolving capacity in the diagnosis of hepatopancreatoduodenal region and urinary system organs diseases. It is stated that their integral application allows to make a correct diagnosis in 98% of observations.



Hemosplenoperfusion in the complex treatment of diffuse purulent peritonitis
Abstract
Currently, some progress has been achieved in the treatment of diffuse purulent peritonitis (RP), associated with the use of new antibiotics and their routes of administration (intraperitoneal, endolymphatic, lymphotropic), as well as with the use of hemosorption and plasmapheresis. Nevertheless, mortality in this pathology is still quite high and, according to our observations, is 50-60%, which is largely due to pronounced endogenous intoxication. In turn, the latter leads to inhibition of the absorptive function of the liver and spleen, which may be associated with the functional state of macrophages of these organs and with a deficiency of opsonic factors due to their consumption.



Plasma fibronectin in patients with chronic active hepatitis and cirrhosis of the liver with signs of disseminated intravascular blood coagulation syndrome
Abstract
The plasma fibronectin level is determined in 39 patients with chronic active hepatitis and in 90 patients with cirrhosis of the liver by solid phase immunoenzyme method. All the patients with hepatitis and cirrhosis with signs of disseminated intravascular blood coagulability syndrome manifest a decrease of the fibronectin level, more pronounced in hypocoagulative phase of disseminated intravascular blood coagulability syndrome as a result of the consumption coagulopathy. A sharp decrease of the fibronection level (below 40% that of the norm) may suggest the possible prolongation of disseminated intravescular blood coagulability syndrome, the feasibility of the development of reticuloendothelial system block.



Modern aspects of the treatment of traumatic brachial plexus injury
Abstract
In the domestic literature, the issues of modern treatment of traumatic injury to the brachial plexus were not widely covered. Among peripheral nerve injuries, brachial plexus trauma ranks third in frequency, and first in terms of the degree and severity of disability. Due to the anatomical structure of the brachial plexus trunks, a variety of mechanisms and levels of damage, clinical forms of their manifestations, as well as various concomitant lesions create difficulties in the diagnosis of localization, the extent of the pathological process and its treatment. Modern diagnostic methods and the introduction of microsurgical techniques have significantly improved the results of the restoration of the functions of the upper limb.



Some results of a sociological survey on the health of the rural population of Tatarstan
Abstract
The study of the state of health of the population requires special attention due to the difficult socio-economic situation in which the entire national economy and, above all, the agricultural sector found itself. The labor intensity of workers in this industry directly depends on the season of the year, mechanized labor-intensive processes, labor supply. Of particular concern are the unfavorable tendencies that are now manifesting themselves more vividly. The agrarian sector of Tatarstan employs about 400 thousand people, of which almost 300 thousand are directly in agriculture.



Operational documentation of epidemiological surveillance for acute intestinal infections
Abstract
One of the main sections of the epidemiological surveillance of acute intestinal infections (AEI) is the operational epidemiological analysis of morbidity. For its implementation, a large array of information is accumulated, reflecting the results of collecting an epidemiological history in patients, the level of morbidity in microsections (regions), the etiological structure, pathways and factors of transmission of pathogens, the distribution of patients by age and social and professional groups, sanitary and hygienic background, etc. The received digital material must be quickly processed and in a compressed form to give a conclusion about the specific epidemiological situation.



Elimination of postoperative pain and swelling of the hand using special magnetophores
Abstract
It is known that the use of permanent magnets leads to a decrease in pain, acceleration of edema resorption and stimulation of reparative osteogenesis. To stimulate osteogenesis in non-fused fractures and pseudarthrosis of long tubular bones, a constant magnetic field (PMF) is used with an induction of 35 ± 5 mTl (millitesl) for 15 minutes (course — 20 sessions). However, these methods are effective only with prolonged (10–20 days) use.



Founder of the Kazan Dermatological School, Professor A.G. Ge (To the 150th anniversary of his birth)
Abstract



III National Congress on Respiratory Diseases (St. Petersburg, December 1-5, 1992)
Abstract
The Congress was attended by representatives of Russia, Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Moldova, Ukraine, Uzbekistan, as well as specialists from Austria, England, Germany, Holland, Canada, Poland, France, Finland, USA, Sweden.



Report on the work of the Society of Surgeons of the Republic of Tatarstan for 1992
Abstract
At the first meeting of the Society of Surgeons of the Republic of Tatarstan in the reporting year (30.01.1992), re-election of the board was held. Prof. I. A. Ibatullin, head. Department of Clinical Anatomy and Operative Surgery of the Kazan State Pedagogical University named after V.I. Lenin, Deputy - prof. V.N. Medvedev, head. Department of Surgical Diseases No. 2 KGMI named after S. V. Kurashov, Secretary - Cand. honey. Sciences A. Yu. Anisimov.


