Vol 64, No 6 (1983)

Tasks of the trauma and orthopedic service


The decisions of the November (1982) and June (1983) Plenums of the CPSU Central Committee, the provisions and conclusions arising from the speeches of the General Secretary of the CPSU Central Committee comrade. Yu. V. Andropov, demonstrated with renewed vigor their concern for Soviet people, their health, spiritual development, working and living conditions. A comprehensive program for the development of all health services in our country is determined by the decree of the Central Committee of the CPSU and the Council of Ministers of the USSR "On measures to further improve public health", adopted on September 22, 1977. All subsequent years, medical workers under the leadership and with direct participation of party and Soviet bodies, in In close cooperation with public organizations, we worked hard to implement the measures provided for by this decree.

Kazan medical journal. 1983;64(6):401-403
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Theoretical and clinical medicine

Etiology and pathogenesis of coxarthrosis and methods of its treatment

Akberdina D.L.


Coxarthrosis is one of the most common degenerative-dystrophic diseases of the musculoskeletal system and often leads to significant disability and even disability. The etiology and pathogenesis of coxarthrosis have not yet been clarified. The causes of this disease can be the following disorders: metabolic endocrine, static-dynamic and neurovascular.

Kazan medical journal. 1983;64(6):404-408
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The value of measurement of intraosseous blood pressure in the femoral neck for early diagnosis of perthes disease in children

Evseev V.I., Sharpar V.D.


We examined 41 patients aged 4 to 15 years with suspected Perthes disease. In all children, intraosseous blood pressure in the femoral neck was measured and transosseous phlebography was performed. A significant impairment of venous outflow was revealed, which is the cause of increased intraosseous blood pressure. It is concluded that it is advisable to measure intraosseous blood pressure in combination with other methods for early diagnosis of Perthes disease.

Kazan medical journal. 1983;64(6):408-410
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To the technique of periarticular osteotomy of the femur for coxarthrosis and aseptic necrosis of the femoral head

Prokhorov V.P.


The advantages of a more distal (through the level of the lesser trochanter) section of the bone in periarticular osteotomy performed for coxarthrosis and aseptic necrosis of the femoral head are shown. Some modification of this operation provides a lower risk of damage to the vessels supplying the hip joint, and better fixation of the proximal fragment (when using the Petukhova-Petrulis plate).

Kazan medical journal. 1983;64(6):410-412
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Medical rehabilitation and social adaptation of elderly and senile patients after hip arthroplasty

Vereshchagin A.P., Varvarin O.P., Zhdanov Y.D.


Endoprosthetics of the femoral head and neck was performed in 68 elderly and senile patients with medial fractures and their consequences. A gentle method of operation was used, which allows  early start of functional treatment in order to achieve early medical rehabilitation of patients. At the stage of rehabilitation treatment, the task is to compensate for the defect and prevent disability, at the stage of readaptation and rehabilitation, to optimally adapt the patient to life and create a favorable psychological environment, in a rational household device. The necessity of coordinating the efforts of the doctor and the patient with his environment for a speedy and full-fledged social adaptation is indicated.

Kazan medical journal. 1983;64(6):412-414
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On the origin and surgical treatment of solitary bone cysts in children

Grigoriev M.G., Abakarov A.A.


The results of treatment of 205 children with bone cysts were traced. It was revealed that osteoblastoclastoma can be the cause of cysts only in 15.6% of cases. The position on the possible genesis of solitary bone cysts due to dysplasia of the growth zone has been substantiated. In the surgical treatment of bone cysts, the method of choice is the marginal resection of the affected bone with replacement of the defect in the "bundle of brushwood" type. With active growth of the cyst, frequent pathological fractures, segmental bone resection with replacement of the defect with a massive allograft with longitudinal cuts is indicated.

Kazan medical journal. 1983;64(6):415-416
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Injection filling with mixed bone mixture of cystic bone cavities in children and adolescents

Murugov V.S.


Injection filling with a mixed bone mixture of cystic bone cavities in children and adolescents is proposed to restore the structure of bone tissue by stimulating the reparative process. The results of treatment of 10 children and adolescents aged 7 to 16 years with cystic diseases of the skeleton are presented. Analysis of clinical and X-ray photometric material showed that the proposed method allows achieving a positive effect in the shortest possible time without a wide surgical opening while maintaining function in the adjacent joint.

Kazan medical journal. 1983;64(6):416-418
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The choice of the method of surgery for chronic pancreatitis

Kuznetsov V.A., Mavrin M.I., Mavrin V.M.


The analysis of the surgical treatment of patients with primary chronic pancreatitis showed that the most justified operations are distal resection of the altered part of the pancreas, longitudinal pancreatojejunostomy with expansion and deformation of the Wirsung duct, cystectomy and cystojejunostomy with non-removable cysts of the gland. Adequate operations on the biliary tract in chronic cholecystopancreatitis restore the outflow of bile, pancreatic juice and pancreatic function.

Kazan medical journal. 1983;64(6):419-423
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Actual problems of perinatal neuroradiology

Mikhailov M.K., Akberov R.F., Basharova L.F., Mingazov R.G., Pukin M.A.


Perinatal neuroradiology is a poorly studied, complex section of general radiology. The X-ray method plays an important role in the early detection of symptoms of birth injuries of the nervous system, which is an important factor in the prevention and effective treatment of subsequent complications.

Kazan medical journal. 1983;64(6):423-426
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To the technique of double contrasting of the stomach

Abdulkhakova D.I.


A modification of the technique of double contrasting of the stomach is described. More than 2000 patients were examined by the method of stomach inflation. The technique is simple and easy to carry out in the conditions of both a polyclinic and a hospital. It has a fairly high information content in the diagnosis of various pathological conditions of the stomach.

Kazan medical journal. 1983;64(6):426-428
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To the use of a large-frame fluorograph for the diagnosis of gastric pathology

Utkov A.A.


The technique of gastrofluorography using a domestic large-frame fluorograph is described. A late-positional device was designed, which made it possible to perform polypositional fluorography in a horizontal position of the patient. With regard to gastrofluorography, a technique of double contrasting of the stomach has been developed, with the help of which gastric pathology is detected with minimal radiation exposure.

Kazan medical journal. 1983;64(6):428-430
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Removal of dental plaque with lithium chloride

Ovrutsky G.D., Yashkova T.N., Baganova S.I., Khairullin D.I.


In 46 patients with profuse dental deposits and inflammatory periodontal diseases, the effect of lithium chloride on the dissolution of dental calculus and the state of the marginal periodontium was studied. The property of lithium chloride has been shown to prevent and eliminate dental deposits, as well as to have an anti-inflammatory effect on the gums.

Kazan medical journal. 1983;64(6):430-432
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Odontogenic osteomyelitis of the jaws and their complications

Khamitov F.S., Epstein Y.Z., Ediger M.P.


The analysis of clinical observations in 63 patients with odontogenic osteomyelitis of the jaws and their complications was carried out. In 10 out of 38 patients, the inflammatory process proceeded with severe complications - deep phlegmon. In 4 of them, acute odontogenic infection was complicated by a septic process. Three of these patients, despite active complex treatment, died. The authors draw the attention of dentists to the need for timely referral of patients with acute odontogenic infection who need complex treatment to specialized hospitals.

Kazan medical journal. 1983;64(6):432-433
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The effectiveness of conservative treatment of pulpitis with Dimexide and lysozyme

Musharapova S.I.


The effectiveness of conservative treatment of acute serous limited and chronic fibrous pulpitis with the use of Dimexide and lysozyme, as well as their combination, has been studied. The high therapeutic efficacy of the studied treatment options for acute serous limited pulpitis has been shown.

Kazan medical journal. 1983;64(6):434-435
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Osteotomy of the proximal femur with coxarthrosis

Gimmelfarb A.L.


Osteotomy as a corrective orthopedic intervention was first performed by Barton more than a century and a half ago [22]. A hundred years later, it was still considered as a corrective operation, opposing it to medical operations [8]. Only in 1927, AA Kozlovsky discovered the beneficial effect of epimetaphyseal osteotomies on the course of articular, including dystrophic, processes and, on this basis, referred periarticular osteotomies to the category of therapeutic operations (osteotomia medicata). The mechanism of action of periarticular osteotomies remained unclear, but even then an opinion was expressed about their positive neurotrophic effect [18].

Kazan medical journal. 1983;64(6):435-438
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Dietary Fiber and Diabetes Mellitus

Vainshtein S.G., Masik A.M.


Prevention of diabetes mellitus includes a variety of measures, including making adjustments to the diet. In the 1970s and 1980s, the greatest attention was paid to the increase in the specific gravity of dietary fiber in the diet, which include polysaccharides (cellulose, hemicellulose, pectin substances, gums, mucus) and lignin [17]. It is believed that adding dietary fiber to the diet will prevent high levels of glycemia and insulinemia, thereby protecting the beta cells of the pancreas from overexertion [30]. The main research in this regard was carried out on healthy and diabetic patients; there are publications and experimental works. The purpose of the latter is to create adequate models for studying the protective effect of dietary fiber on hyperglycemia, as well as to elucidate the mechanisms of this action.

Kazan medical journal. 1983;64(6):438-441
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Clinical manifestations of impaired function of the apud system

Anchikova L.I., Kurshakova L.N., Maslov V.P., Khamidullin R.I., Zakirzyanov K.S.


In the human body, there is a neuroendocrine cell system, the main functional feature of which is the ability of cells to form biogenic amines and polypeptide hormones. The name "APUD-system" is made up of the initial letters of the main general properties of the cells included in this system [7]. Cells of the APUD-system (apudocytes) are found in the pituitary gland, hypothalamus, pineal gland, in the organs of the gastrointestinal tract, genitourinary system, respiration, in the heart, endocrine glands, etc. Apudocytes produce serotonin, melatonin, catecholamines, histamine, gastrin, glucagon , liberins and statins of the hypothalamus, etc. Overproduction or lack of certain hormones and biogenic amines due to disturbances in the structure and function of cells of the APUD-system lead to dysfunction of the system as a whole, which is expressed in a particular clinical syndrome. - apudopathy. I. M. Kvetnoy and H. T. Raikhlin (1978) proposed a working classification of apudopathies.

Kazan medical journal. 1983;64(6):441-444
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Clinical experiences

On the features of the clinical picture of traumatic brain injury during alcohol intoxication

Kutsenok I.K.


Examined 251 patients with traumatic brain injury in the acute period, received in a state of alcohol intoxication. In 109 victims, alcohol intoxication simulated a picture of traumatic brain damage. Observation in dynamics, additional examination using the methods of craniography, echoencephalography, carotid angiography, as well as lumbar puncture and examination of the fundus made it possible to exclude traumatic injuries of the skull and brain in patients of this group.

Kazan medical journal. 1983;64(6):444-445
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Cerebral complications in combined trauma of the skull and musculoskeletal system

Zakirov Y.A., Valeev E.K., Krylov V.E.


From 1972 to 1982, we observed 297 patients with concomitant trauma to the skull and musculoskeletal system. Of these, 9 were diagnosed with fat embolism, 3 with cerebral thromboembolism, 36 with intracranial subdural hematomas.

Kazan medical journal. 1983;64(6):445-446
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Outcomes of treatment of open fractures of long bones of non-firearms origin

Klyushkin I.V.


Under our supervision from 1976 to 1982, there were 206 patients with open injuries of long bones of non-firearms origin. Of these, an open hip fracture was in 29 (14.1%) patients, a leg fracture in 135 (65.5%), a humerus fracture in 10 (4.8%), forearm bones in 32 (15.6 %). The injuries that the patients had (according to the classification of A.V. Kaplan and O.N. Markova) were distributed as follows: ІА stage - in 33 (16%) victims, 1B - in 44 (21%), 2B - in 60 (30%), 2B-in 27 (13%), 3B-in 13 (6%), 3C- in 25 (12%), grade 4 in 4 (2%). As you can see, the patients we observed had mostly severe injuries. Before admission to the hospital, anti-shock measures were started in 22 patients, and primary surgical treatment was carried out in only 17 patients. In all other cases, the first medical aid was limited to the imposition of an aseptic dressing, the introduction of heart and painkillers, and transport immobilization.

Kazan medical journal. 1983;64(6):446-447
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Rehabilitation of people with disabilities with the consequences of fractures of long tubular bones

Belyakov A.A., Kapitansky I.S.


We conducted dispensary observation and rehabilitation treatment for 271 people (116 men and 105 women) with the consequences of long bones fractures. 184 (67.8%) people, that is, the predominant number of those surveyed, were of the most working age - from 20 to 50 years old. Most often, disability was established with the consequences of fractures of the shin bones (55.7%), femur (16.2%), forearm bones (14.4%) and humerus (13.7%).

Kazan medical journal. 1983;64(6):447-448
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Changes in plasma and platelet hemostasis in children with chronic hematogenous osteomyelitis before and after sequestrectomy

Barskaya M.A.


The study involved 42 people suffering from chronic hematogenous osteomyelitis (25 boys, 17 girls, age - from 5 to 14 years). Isolated bone lesions were noted in 29 patients, multiple - in 13. On admission, according to the X-ray examination, cortical sequesters were found in 20 children, central - in 15, penetrating - in 3, total - in 4. Among the complications, 2 patients were found to have fibrothorax (result transferred secondary destruction of the lungs), in one - acute diffuse nephritis and in one more - amyloid nephrosis. 35 of 42 children had fistulas on admission.

Kazan medical journal. 1983;64(6):449-450
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Fixation of the knee joint with a needle

Laktionov P.P., Anisimov A.B.


It is not easy to find a free bone-cartilaginous body in the cavity of the knee joint. Quite often, especially for a novice surgeon, the search for a "joint mouse" turns into a complex operation. In 5 patients, we used an injection needle to fix the free bone body found during the operation. Patients usually themselves, sitting on the operating table, grope for the "articular mouse" and try to hold it. After processing the operating field, the surgeon's assistant fixes the "articular mouse" with his fingers, and then pierces the body with a needle through the skin and the capsule of the joint and holds it. The surgeon makes an incision and, grasping the free body with a clamp, removes it. In this case, the incision of the skin and the joint capsule is no more than 5 cm, which is important for a favorable course of the postoperative period. We did not find information on the use of this technique for fixing a free body in the knee joint in the available literature.

Kazan medical journal. 1983;64(6):448-449
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About parasystole in children

Mamish A.M., Burba N.E.


In recent years, there has been an increase in interest in parasystole in children, since this form of arrhythmia is much more common than expected. Parasystole is an independent type of arrhythmia with the activity of the ectopic center. Diagnosis of parasystole is possible only with an electrocardiographic study. ECG signs of parasystole are characterized by a variation of pre-ectopic intervals, the presence of a common time divider for interectopic intervals and confluent complexes. Parasystole is combined with various arrhythmias, but most often with extrasystole. Electrocardiographic diagnosis of parasystole in children is complicated by the irregularity of sinus rhythm and physiological characteristics of the rhythm frequency according to age groups. In practice, the differential diagnosis between parasystole and extrasystole is especially difficult and in some cases is possible only with the help of functional tests.

Kazan medical journal. 1983;64(6):450-451
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The use of a CO2 laser in purulent surgery

Kipensky A.A., Saveliev S.V.


In recent years, the use of laser technology in surgery has found more and more widespread use. Low invasiveness, good hemostasis, antiseptic properties, non-contact, analgesic effect of the laser beam give it a significant advantage over traditional surgical instruments, including the electric knife. In 1981-1982. in the 1st surgical department of the hospital st. Kazan performed 91 opening of purulent cavities and treatment of purulent wounds with a laser beam in 80 patients who had various purulent-inflammatory and other diseases: abscesses, phlegmon (22), purulent wounds (13), osteomyelitis, gangrene of the fingers (11), carbuncles, boils (10), epithelial-coccygeal cysts (8), trophic ulcers (6), mastitis (5), burns (3), benign tumors (2). There were 46 men, 34 women, the patients' age was from 24 to 81 years.

Kazan medical journal. 1983;64(6):452-452
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Experience in the treatment of necrotizing ulcerative gingivostomatitis

Gasimov F.G., Khamidullina S.A.


Medicines proposed for the treatment of necrotic ulcerative lesions of the oral mucosa do not always allow to achieve a quick and stable result. Recently, proteolytic enzymes have been successfully used in the form of solutions for these purposes for application and electrophoresis. However, mixing with saliva, enzymes are quickly inactivated and their exposure in tissues is reduced. With this in mind, we used Iruxol ointment (Yugoslavia) containing the enzyme collagenase and chloramphenicol, which is a broad-spectrum antibiotic.

Kazan medical journal. 1983;64(6):452-453
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Large gastric leiomyoma

Khabibullin I.R.


Leiomyoma is a benign non-epithelial tumor originating from muscle tissue. In view of the rarity and complexity of its X-ray diagnostics, we present our observation. K-, 19 years old, was taken to the emergency department by an ambulance with complaints of acute epigastric pain, nausea and vomiting with blood.

Kazan medical journal. 1983;64(6):453-454
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Combined method of autoallodermoplasty

Izmailov G.A., Izmailov S.G.


In the treatment of extensive skin defects, when donor resources were insufficient for a one-step full replacement of the lost dermal cover, we used a new method of plastic surgery, which consists in combining the patient's skin and the donor's. A skin strip devoid of fatty tissue was cut out from a patient (its dimensions were calculated taking into account the area of ​​the wound surface), which was dissected with a scalpel, a straight razor or a special microdermatome into transverse auto-micrografts with a thickness of 0.1 to 0.5 mm. This significantly increased the area of ​​the main flap. The resulting grafts had two lateral surfaces capable of fusion with tissues. They contain all the elements of the skin, which allows us to call them full layer. The grafts were placed on the granulating surface with their lateral side with their moderate spreading at a distance of 4 mm from each other in a checkerboard pattern.

Kazan medical journal. 1983;64(6):454-455
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Prevention of re-obliteration after reconstructive surgery on the fallopian tubes

Osipov R.A.


In order to prevent infection and prevent sticking of the fallopian tubes from the first hours after the end of the operation, we used continuous irrigation of the tubes. To do this, immediately before the operation, a self-contained tip was introduced into the cervical canal, through which, after opening the abdominal cavity, a sterile saline solution stained with indigo carmine (chromohydzotubation) was injected, which made it possible during the operation to more accurately determine the state of the fallopian tubes, etc. control the degree of restoration of patency. After the end of the operation, the tip was left in the uterus for 5-7 days. A system for drip infusion of liquids was attached to it. The procaine-furacillin mixture (0.1 g of furacillin, 9 g of sodium chloride, 2.5 g of novocaine, 1000 g of distilled water) was poured dropwise. To the initial solution was added 250 mg of hydrocortisone and 1500 units. heparin, however, their dose was gradually reduced in the following days.

Kazan medical journal. 1983;64(6):455-455
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Healthcare mangement

The experience of the medical council in the examination of the results of treatment of trauma patients

Takhavieva D.G.


The experience of the Republican Medical Council on the examination of long-term results of treatment of traumatological patients in the TASSR is highlighted. The outcomes were studied and the analysis of the treatment of injuries was given. patients with isolated, multiple and combined fractures, treated in various medical institutions of the republic, both in inpatient and outpatient settings. Errors in diagnosis and treatment were identified, which, to one degree or another, adversely affected outcomes. The most common errors and complications, their causes are analyzed, recommendations for their prevention are given.

Kazan medical journal. 1983;64(6):455-458
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Epidemiology and healthcare management

Organizational aspects of prevention and control of staphylococcal infection in maternity hospitals

Khisamutdinov A.G., Grigoriev V.E., Mukhamedova R.U., Pigalova N.V., Shamsutdinova F.S., Petrovskaya V.P., Gubaidullina L.A.


A method of recording and registering pyoinflammatory diseases of staphylococcal etiology among newborns in maternity hospitals is proposed. The experience of epidemiological analysis is shown, which makes it possible to establish some features of the course of the epidemiological process and outline a set of preventive and anti-epidemic measures to combat this pathology.

Kazan medical journal. 1983;64(6):458-459
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Occupational hygiene

Physiological and hygienic assessment of working conditions and health status of workers - drillers of oil wells

Nabieva G.V.


A comprehensive study of the working conditions and health status of 622 oil drillers in the Kuibyshev region and the Bashkir Autonomous Soviet Socialist Republic was carried out. Using generally accepted hygienic research methods, measurements were made of noise, vibration, artificial light, temperature, speed, and air humidity. The severity and intensity of labor was assessed according to the results of complex hygienic, ergonomic, physiological studies and separately by the method of pulsometry, while we used a mathematical analysis of heart rate intervals. In the dynamics of the working day, the maximum strength and endurance of the hand muscles to static load were determined three times.

Kazan medical journal. 1983;64(6):459-462
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History of medicine

The fight against epidemic diseases of the population of the middle Volga region during the years of the civil war

Stegunin S.I., Palagin D.A.


In the first years of Soviet power, the working people of our country had not only to fight on the fronts against foreign invaders and internal counter-revolution, but also to wage a stubborn struggle against another dangerous enemy - epidemics. Lenin assigned the leading role in the fight against epidemics to prevention and sanitation. VD Bonch-Bruevich cites the following statement of VI Lenin: “... Sanitation is everything. This is the prevention of all diseases, otherwise we really love to treat the sick, we very much sympathize and regret the dead and do very little to prevent this morbidity and early, premature deaths. "

Kazan medical journal. 1983;64(6):462-465
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Assistance to the practicing physician

Bone transplantation method and device for its implementation

Gafarov K.Z., Tinchurina S.G., Sergeev V.M., Andreev P.S.


An original design for taking cylindrical bone grafts from allograft has been developed. Cylindrical grafts can be made from both cortical and cancellous bone. Cortical grafts in traumatology are used to connect bone fragments in the treatment of fractures. A spongy cylindrical bone graft in the form of a column is widely used for biostimulation of the femoral head during its aseptic necrosis, as well as for filling bone cavities after resection of benign tumors.

Kazan medical journal. 1983;64(6):466-467
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Equipment for a traumatologist

Zaripov Z.A.


Apparatus and devices for reposition of fragments of the forearm bones, for laying the forearm during operations, as well as for eliminating shoulder dislocation have been developed and are successfully used.

Kazan medical journal. 1983;64(6):467-468
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Anniversary of Abram Lvovich Yakobson


October 28, 1983 marks the 60th anniversary of the birth of the chief state sanitary doctor of the Tatar Autonomous Soviet Socialist Republic, Honored Doctor of the Tatar Autonomous Soviet Socialist Republic, Abram Lvovich Yakobson.

Kazan medical journal. 1983;64(6):468-468
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