Vol 74, No 2 (1993)

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.