Among the patients who for the first time called on MLEC for the evaluation of disablement group due to locomotor system pathology the patients with coxarthrosis were 35%. The results of clinical, X-ray, radionuclide examination as well as dynamics of medical social rehabilitation (by the data of capacity for work expertise) were analyzed in 200 patients with posttraumatic, idiopathic and dysplastic coxarthrosis. It was shown that existent methods of conservative and operative treatment gave efficient medical rehabilitation only in low percentage of cases, but the absense of clear medical social rehabilitation programme for those patients aggravated the matter. The best results were noted in patients operated for aseptic necrosis of the femur head. In all three forms of coxarthrosis the most efficient method of surgery was total replacement.

We have developed a technique for total en bloc spondylectomy through a posterior approch and now report our experience of 20 patients with a solitary or localised metastasis in the thoracic or lumbar vertebrae. There are two steps: an en bloc laminectomy, followed by en bloc resection of the vertebral body with an oncological wide margin and the insertion of a vertebral prosthesis. Pain was relieved in the 17 patients who could be assessed; 11 of the 15 patients with a neurological deficit were much improved, impending paralysis being prevented in 5 patients. There have been no local recurrences. Nine patients are at present alive with a mean follow up of 17,4 months.

One hundred six patients with benign tumors and tumor-like bone pathology underwent surgical treatment. Depending upon clinical pattern of pathologic process, tumor structure, its location, spreading degree, as well as with account of the tendency of one or the other tumor type to recurrence, different resections (marginal, parietal, segmental) were performed. For the replacement of defects, the alloplasty with demineralized bone grafts was used, in some cases it was associated with extrafocal osteosynthesis. In follow-up period (from 2 to 13 years) none of patients (106) had developed metastases. One hundred two patients did not show orthopaedic pathology, 4 patients had minor deformities and manifestations of deforming arthrosis with moderate disturbance of neighbouring joint function. The conclusion was made about the efficacy and perspectiveness of this method.

Three series of experiments in dogs were performed. In one series subtrochanteric osteotomy of the femur using compression osteosynthesis with Г-shape plate was carried out, in the other - osteotomy of the diaphysis of either the femur or tibia using osteosynthesis with straight plate, and in the third (control) series osteotomy was not performed and the plate was implanted under compression or without it. Bone tissue microcirculation was studied in the enlightened sections by authors’ method using Indian ink-gelatine mixture; morphologic examinations were carried out on eosin-hematoxylin stained specimens. Presice effect of osteogenesis induction in the place of plate contact with the metal fixative was observed and it was most pronounced around the screw thread, that was considered as a factor of the additional osteosynthesis fixation. During the formation of primary consolidation, the delay in angioarchitectonics retardation of the compact bone under the plate was noted. Microcirculatiry bed response was of universal addoptive pattern and showed the formation of extravascular microcirculation at early stages.

The results of treatment of 56 patients with femur neck pseudoarthrosis associated with different degree of degenerative dystrophic damage of femur head are presented. In femur neck pseudoarthrosis with coxa vara intra-articular extraosseous autoplasty by displacement of figured segment from intertrochanteric region under pseudoarthrosis zone is used. The method of intraosseous autoplasty consisted of subcortical cylingrical drilling of spongy neck bone through pseudoarthrosis zone with rotation of autograft by 180° is applied. The long-term results are retraced in 48 patients in the period up to 6 years. The preference is given methods of reconstruction of proximal femur end with combination of its autoplasty interchangeability.

During 1990-95 total knee joint replacement using endoprostheses of «Biomet», USA, «ESKA Medical», Germany, «Intermedics Orthopedics» were performed in 15 patients. Follow-up period was from 1 to 5 years, all results were favourable. Surgical technique and postoperative management are described. The case of success full bilateral knee joint replacement is presented.

In 86 patients with old injuries of flexor digitorum tendons in critical zone long-term results have been studied in postoperative period from 2,5 months to 1,5 years. All patients received rehabilitation by clinic’s method using early active mobilization and other types of treatment (drugs, stimulation, physiotherapy). Resulting index of wrist grasps was from 10,6 to 54%. Use of authors’ method for reconstructive treatment and postoperative rehabilitation allows to improve significantly the functional results and avoid the reoperation in most of cases.

The method of surgical treatment for fresh rupture of the anterior criciate ligament is presented. Surgical interventions have been performed in 148 patients (95 patients have been operated within the first week after injury, 36 - within the second week and 17 patients - during 3rd-4th week). In 109 patients, ligament reconstruction has been carried out using tractopexy and in 17 patients augmentation of the ligament by semitendinous muscle or central segment of the patellar ligament has been used. The choise of suture technique depended on the type of ligament injury. Tie long-term results have been studied in 104 patients.

The technique of three-point novocaine blockade for shoulder-scapularis periartheritis is described. It is based on the modern concepts of shoulder-scapularis periatheritis pathogenesis which assumes the impingement between greater tubercle of the humerus and anterior segment of acromion in upper expremity abduction (impingement syndrome). The aim of the blockade is the creation of subacromial decompression as a condition for free sliding of rotator cuff in abduction phase. The first point of novocaine injection is subacromial space, the second one — biceps sulcus, the third — the region of muscle teres minor of scapula. Addition of corticosteroids allows to cure the inflammation of periarticular soft tissues. Novocaine blockade is used in combination with exercise therapy. Complex treatment results are satisfactory. Only 18% of patients with persistent course of shoulder-scapularis periarthritis underwent the operation — anterior acromial- plasty by Neer.

The author used the model of intra- and supracondylar shoulder fracture in which all known types of the displacement of proximal fragments, i.e. rotative ones; the ones on the width inwards, outwards and anteriorly, were created. The criteria for rotation displacement estimation were determined. The table for the definition of the value of rotation angle of the proximal shoulder fragment was made up.

The purpose of this report is the determination of the diagnostic reliability of routine radiologic and CT examinations for pelvic injuries in children. The comparative analysis of these examinations and postmortem morphologic studies of pelvic spesimens was performed in 10 children, aged 2-12 years. It was shown that the X-ray method allowed to diagnose only 47.37% and CT method - 76.32% of all real pelvic injuries (by morphological data) in those children. However, the detectability of damage of the structures that formed the anterior pelvic semi-ring was 50% by radiologic examination, and 60% by CT examination, while for the structures forming posterior pelvic semi-ring it was 44.44% and 94.44%, respectively.

Radiologie examination of feet in axial plane was performed in 94 conscripts (188 feet) and 75 ambulant patients (115 feet). The main mechanism of transverse platypodia development was retraced in the séria roentgenograms of I metatarsosesamoid joint. Depending on the change of medial sesamoid articular surface position relative to the supportive plane 4 stages of transverse platypodia development were determined. The test for estimation of the value of I metatarsal osseous rotation based on the position of the articular surface of its head to the supportive plane was suggested.

The attempt of the objective evaluation of contracture stability using BIODEX System device was undertaken. A serues of tests waas performed to obtain the parameters defining the contracture. Twenty patients with knee contracture resulted from patella fracture (2), ligaments injury (8), after surgery on the ligamento-capsular system of the knee joint (10) were examined. The suggested method allows to obtain highly precise information on contracture flexibility and thus enables to assess more objectively the rehabilitation potential as well as the efficacy of the conservative treatment.

The method of total arthroplasty in dogs with hip joint dysplasia is suggested. The surgery includes 4 steps: resection of femur head, arthroxysis of acetabulum, implantation of artificial ligament and myoplasty of joint capsula. Resection degeneratively changed femur head excludes its fallacious insertion into acetabulum, arrests the pain syndrome. Implantation of artificial ligament as well as myoplasty of joint capsula prevents the instability development and external rotation in joint of distal segments of the extremity that could not be achieved by resection plasty.

The results of treatment of 41 severely burned patients with complication caused staphylococcic infection were presented. For complex treatment antistaphylococcic immunoglobulin elaborated at Kirov Scientific Institute of Hematology and Blood Transfusion was applied intravenously. High efficacy of immunoglobulin was found and it was determined that intravenous injection of antistaphylococcic immunoglobulin resulted not only immunoreplacement effect but in immunostimulation as well. The latter one was manifested by the activation of humoral antistaphylococcic immunity and positive changes in cellular immunity indices.

The article deals with the topical issues of the application of scanning magnetic fields in the treatment of patients with closed screw fractures of the tibia bones.

The article deals with current problems of endoprosthesis in tumours of the proximal humerus.

The article is devoted to current problems of tumour thrombosis of the unpaired and semi-unpaired veins in patients with chondrosarcoma of the pelvis.

This article describes an osteosynthesis device for treating vertebral fractures in children.

The article deals with the peculiarities of the universal tendon suture. 

The article is devoted to the current problems of comprehensive rehabilitation treatment of limb joint contractures.

The article is devoted to the agenda of the 681st meeting of the Society of Orthopedic Traumatologists and Prosthetists of Moscow and the Moscow region, which took place on 18 April 1996.