Reconstruction of Deltoid Ligament Using Low Invasive Surgical Technique at Treatment of Ankle Joint Fractures

Comparative analysis of treatment results of 68 patients with malleolus fractures and injury of deltoid ligament was performed. Depending on the treatment technique all patients were subdivided into four groups. Main group - surgical treatment of fractures and reconstruction of deltoid ligament with Twinflix screw (n=30), comparative groups - surgical treatment of fractures with transcutaneous suturing of deltoid ligament (n=10) and ligament plasty with Р -shaped sutures (n=8); control group - conservative treatment of fractures and deltoid ligament injury (n=20). Follow-up time made up 6 months - 2 years. Evaluation of treatment results was performed by adopted scale of American Orthopaedic Foot and Ankle Society. Patients were examined using clinical and roentgenologic methods as well as ultrasound and rheovasography. In the main group excellent result was achieved in 23.1%, good result - in 65.3%, satisfactory - in 11.6% of patients. In control group they made up 16.8%, 61.2% and 19.5%, respectively, with poor result in 2.5% of patients. It was demonstrated that application of low invasive osteosynthesis in combination with reconstruction of deltoid ligament using Twinfix screw reduced considerably the probability of posttraumatic arthrosis development as well as provided for complete restoration of the ligament with preservation of its elastic properties and joint stability.

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Standard open operative interventions in surgical treatment of patients, suffering an acute complicated pancreatitis

Klinicheskaia khirurgiia ◽

10.26779/2522-1396.2018.07.27 ◽

2018 ◽

Vol 85 (7) ◽

pp. 27-29

Author(s):

V. P. Аndriushchenko ◽

D. V. Аndriushchenko ◽

Yu. S. Lysiuk

Keyword(s):

Surgical Treatment ◽

Comparison Group ◽

Surgical Intervention ◽

Main Group ◽

Control Group ◽

Treatment Results ◽

Surgical Interventions ◽

Second Stage ◽

Standard Operations

Objective. To determine the character and optimal volume of standard open surgical interventions in an acute complicated pancreatitis (ACP) with elaboration of the main technical elements of the operations. Маterials and methods. There were operated 96 patients, suffering ACP. The main group consisted of 47 patients, in whom open interventions were performed primarily in 19, and as the second-stage procedure after application of miniinvasive interventional technologies (МIТ) – in 28. The comparison group consisted of 49 patients, in whom standard operations were done only. Results. Application of MIТ have promoted the indications narrowing for performance of primary open operations more than twice. In the main group the arcuate-like subcostal access was applied predominantly - in 26 (55%) observations (χ²=14.287; р=002), while in a control one – a median upper laparotomy – in 37 (76%) observations (χ²=38.43, р < 0.001). The method of closed draining in accordance to procedure of Beger was used predominantly in the main group of patients – in 43% of observations, comparing with a control group - 9% of observations (χ²=12.965; р=0.003). In 23% patients of the main group and in 26% patients of a control one (χ²=0.0013; р=0.05), when the extended purulent-necrotic inflammation process have presented, a staged sanation was applied, using programmed relaparotomies. Some technical elements of the surgical intervention were improved. Conclusion. Application of standard open operations in accordance to elaborated principle is accompanied by improvement of the treatment results in patients, suffering ACP.

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NON-INVASIVE METHODS FOR DAMAGE DIAGNOSIS OF MENISUS OF THE KNEE JOINT

Vestnik ◽

10.53065/kaznmu.2021.38.15.031 ◽

2021 ◽

pp. 162-165

Author(s):

Е.Н. Набиев ◽

А.Р. Байзаков ◽

У.А. Абдуразаков ◽

Р.А. Аскеров ◽

И.М. Лиров ◽

...

Keyword(s):

Surgical Treatment ◽

Knee Joint ◽

Exercise Therapy ◽

Main Group ◽

New Method ◽

Control Group ◽

Treatment Results ◽

Non Invasive ◽

Meniscus Suture ◽

Early Passive

Цель исследования: оптимизация результатов хирургического лечения пациентов с повреждениями менисков коленного суставас использованием малоинвазивной органосохраняющей технологии «сшивания мениска». В статье приведены результаты хирургического лечения 70 больных с повреждениями менисков коленного сустава, лечившийся ГКП на ПХВ ГКБ № 7 г. Алматы за период с 2017 по 2020 гг. Все больные были распределены на контрольную и основную гроуппу. В контрольную группу вошли 40 (57,2%) больных. Им выполнена артроскопическая резекция мениска. Коленный сустав не иммобилизовали, больные получали физиолечение, ЛФК и массаж. 30 (42,8%) больных отнесены к основной группе, которым выполнен шов менисков под астроскопом по новому способу (свидетельство на авторское право № 9602 от 04.05.2020.). Коленный сустав иммобилизовали на 4 недель, больтные получали также физиолечение, ЛФК и массаж конечности. Комплексное лечение больных с использованием нового способа артроскопического сшивание мениска (свидетельство на авторское право № 9602 от 04.05.2020.), ранние активные движения в здоровых суставах нижней конечности (голеностопных и тазобедренных со второго дня) и ранние пассивные и активные движения в оперированном коленном суставе (со второго дня), поздняя нагрузка на оперированную конечность (через 4 недель), способствовало в 96,7% случаях получить хороших и удовлетворительных результатов лечения у пациентов основной группы. Частота неудовлетворительных исходов лечения в основной группе встречается на 6,2% реже в сравнении с пациентами контрольной группы. Objective of the study: to optimize the results of surgical treatment of patients with injuries of the knee menisci using the minimally invasive organ-preserving technology of "stitching the meniscus". The article presents the results of surgical treatment of 70 patients with injuries of the knee menisci, who were treated by the MCP at the PCV City Clinical Hospital № 7 in Almaty for the period from 2017 to 2020. All patients were divided into control and main groups. The control group included 40 (57.2%) patients. He performed arthroscopic resection of the meniscus. The knee joint was not immobilized, the patients received physiotherapy, exercise therapy and massage. Thirty (42.8%) patients were referred to the main group, who had meniscus suture performed under an astroscopic technique using a new method (copyright certificate № 9602 dated 05/04/2020). The knee joint was immobilized for 4 weeks, the patients also received physiotherapy, exercise therapy and limb massage. Complex treatment of patients using a new method of arthroscopic suturing of the meniscus (copyright certificate № 9602 dated 05/04/2020), early active movements in healthy joints of the lower limb (ankle and hip from the second day) and early passive and active movements in the operated knee joint (from the second day), late loading on the operated limb (after 4 weeks), contributed in 96.7% of cases to obtain good and satisfactory treatment results in patients of the main group. The incidence of unsatisfactory treatment outcomes in the main group is 6.2% less common in comparison with patients in the control group.

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The benefits of early surgical treatment of deep cervical burns in children

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors16298 ◽

2020 ◽

Vol 8 (1) ◽

pp. 25-34

Author(s):

Pavel A. Gnipov ◽

Alexey G. Baindurashvili ◽

Marina A. Brazol ◽

Ekaterina V. Mitrofanova ◽

Maxim R. Melnikov ◽

...

Keyword(s):

Surgical Treatment ◽

Main Group ◽

Control Group ◽

Surgical Removal ◽

Treatment Results ◽

The Third ◽

Graft Success ◽

The Moment ◽

Early Surgical Treatment

Background. The frequency of deep cervical burns in children is four times higher than that of deep face burns. Currently, there is no consensus on the methods for surgical treatment of deep burns in cervical areas; meshed skin autografts continue to be used. Aim. To evaluate the benefits of early surgical treatment of deep сervical burns in children between the third and fifth days from the moment of injury. Materials and methods. Case-control study. Surgical treatment was performed in 81 children with deep cervical burns. The main group with early surgical treatment included 46 children and underwent surgical treatment at 3.37 0.14 days from the moment of injury; the control group received autograft during stage treatment for 35 children at 27.17 0.18 days. The treatment results were evaluated by the following indicators: the number of dressing changes, the period of skin restoration, and the area of graft success. In the long term, functional and cosmetic treatment results were evaluated. Results. In the study and control groups, 7.93 0.45 and 18.75 0.61 dressings were required to complete the treatment, respectively (p 0.001). The skin restoration periods were 16.54 0.68 and 36.94 0.89 days, respectively (p 0.001). The graft success areas were 99.50% 0.13% in the main group and 93.91% 2.68% in the control (p 0.001). During the staged surgical treatment, one patient showed a loss of 90% of the graft, which required regrafting. Other complications in the treatment process have not been noted. When assessing long-term cosmetic results using the Vancouver Scar Scale, the average score was 4.0 0.26 points in the main group and 7 0.28 points in the control (p 0.001). The presence of post-burn cicatricial contracture in the main group was noted in 12 (26%) people and the absence in 34 (74%) children. In the control group, 20 (57%) patients required surgical removal of post-burn deformity, and 15 (43%) children did not need further surgical interventions. Conclusions. Early surgical treatment of deep cervical burns in children on the third and fifth days from injury allows not only to accelerate the process of restoration of the skin but also to directly affect the cosmetic and functional results in a better way.

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Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto20111843-10 ◽

2011 ◽

Vol 18 (4) ◽

pp. 3-10

Author(s):

A V Krut'ko ◽

Shamil' Al'firovich Akhmet'yanov ◽

D M Kozlov ◽

A V Peleganchuk ◽

A V Bulatov ◽

...

Keyword(s):

Surgical Treatment ◽

Lumbar Spine ◽

Surgical Techniques ◽

Pain Syndrome ◽

Early Postoperative Period ◽

Main Group ◽

Control Group ◽

Surgical Interventions ◽

Comparative Group ◽

Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

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THE EFFECT OF NUTRITIONAL THERAPY ON QUALITY OF LIFE INDICATORS FOR PATIENTS WITH GASTRIC CANCER AT THE STAGE OF SURGICAL TREATMENT

Research n Practical Medicine Journal ◽

10.17709/2409-2231-2019-6-3-10 ◽

2019 ◽

Vol 6 (3) ◽

pp. 108-114 ◽

Cited By ~ 1

Author(s):

A. D. Sergienko ◽

V. E. Khoronenko ◽

E. V. Gameeva ◽

A. B. Ryabov ◽

V. M. Khomyakov

Keyword(s):

Quality Of Life ◽

Gastric Cancer ◽

Surgical Treatment ◽

Nutritional Therapy ◽

Main Group ◽

Control Group ◽

Quality Of Life Indicators ◽

Eortc Qlq C30 ◽

Eortc Qlq

Purpose of the study. To determine the effect of nutritional deficiency and nutritional therapy on the quality of life of patients with gastric cancer at the stage of surgical treatment. Patients and methods. In Thoracoabdominal Department of P. Herzen Moscow Oncology Research Institute within 2017– 2019 the quality of life at the stage of surgical treatment of gastric malignant neoplasms was evaluated in 62 patients (36 men and 26 women) aged 34 to 79 years (mean age 61.9 ± 9.55). At the outpatient stage, patients were divided into 2 groups: in the 1st (main) group, patients received nutritive support with specialized mixtures for 10 days before hospitalization, in the 2nd (control) group, patients were asked to follow a high-protein diet without adding specialized mixtures. The quality of life assessment was carried out on the basis of the EORTC-QLQ-C30 Questionnaire, which patients received on the day of hospitalization. Patients repeatedly filled in EORTC-QLQ-C30 Questionnaire before discharge from the hospital, which allowed to assess the dynamics of the quality of life indicators of the studied patients. The study groups were comparable in social and medical indicators. Results. The analysis of the survey results showed that the “general state of health” in the studied groups at the stage of hospitalization is estimated �bove average. Also, in both groups there is a positive dynamics in the values of the above indicator before discharge. Patients of the 1st group who received specialized nutritional mixtures, developed the statistical significance of the differences in the assessment of the quality of life upon admission and before discharge. Thus, it can be argued that nutritional therapy had a significant positive impact on the quality of life in terms of “general health”, in contrast to the control group of patients who did not receive specialized nutritional therapy. There was a general tendency toward an increase in the quality of life indicators at admission and before discharge on all scores of the questionnaire in groups. Thisis a positive assessment by patients of their condition after providing them with medical services. In this case, the discomfort from the symptoms accompanying the disease is reduced, which is confirmed by the scoring results. Statistically significant differences in the assessment of symptoms occur in the study group. Patients having received nutritional therapy noted a decrease in pain, an improvement in the processes of assimilation of food, as well as an improvement in well-being, physical condition, an increase in general tone and energy, a surge of strength and a sense of vitality. In “decreased appetite”score the indices of patients in the main group decreased by more than 3 times, i. e. their appetite improved significantly under treatment. Improving appetite in patients of the main group led to an improvement in the functioning of the gastrointestinal tract as a whole. Patients in this group noted an improvement in digestion and bowel movements. Conclusion The study showed that the quality of life of patients with gastric cancer largely depends on their nutritional deficiency, and nutritional therapy at the stages of surgical treatment, in turn, can significantly improve its results, including in the aspect of their perception by patients. Using the general EORTC QLQ-C30 questionnaire is one of the available methods for assessing the quality of life in patients with gastric cancer.

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Efficiency of minimally invasive surgery for liver echinococcosis and its complications

Annaly khirurgicheskoy gepatologii = Annals of HPB surgery ◽

10.16931/1995-5464.2021184-91 ◽

2021 ◽

Vol 26 (1) ◽

pp. 84-91

Author(s):

Z. A. Azizzoda ◽

K. M. Kurbonov ◽

K. R. Ruziboyzoda ◽

S. G. Ali-Zade

Keyword(s):

Minimally Invasive Surgery ◽

Comparative Analysis ◽

Surgical Treatment ◽

Liver Resection ◽

Minimally Invasive ◽

Postoperative Mortality ◽

Main Group ◽

Control Group ◽

Surgical Methods ◽

Access Surgery

Aim. Improving outcomes of diagnosis and treatment of patients with liver echinococcosis and its complications. Materials and methods. A comparative analysis of the results of surgical treatment of liver echinococcosis and its complications with traditional laparotomy access surgery (control group) and minimally invasive interventions (main group) was performed.Results. The study included 300 patients (170 in the control and 130 in the main group). In the main group, 37 (28.4%) cases performed open echinococcectomy from various mini-accesses, and 27 (20.7%) performed twostage operations using minimally invasive technology. Laparoscopic echinococcectomy was performed in 23 (17.7%) patients, laparoscopic pericystectomy 12 (9.2%) and laparoscopic liver resection in 10 (7.7%) patients. The frequency of postoperative complications in the main group was 17.7%, in the control 51.8%, postoperative mortality decreased from 2.3% to 0.8%.Conclusion. Minimally invasive technologies in the surgical treatment of liver echinococcosis show the better immediate results compared to traditional open surgical methods.

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Treatment Methods for Different Variations Syndrome Mirizzi

INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH AND ANALYSIS ◽

10.47191/ijmra/v4-i4-20 ◽

2021 ◽

Vol 04 (04) ◽

Author(s):

Omarov N.B., Aimagambetov M. Zh. ◽

◽

Keyword(s):

Surgical Treatment ◽

Bile Ducts ◽

Gallstone Disease ◽

Main Group ◽

Mirizzi Syndrome ◽

Long Term Results ◽

Control Group ◽

Type Iii ◽

Type Iv ◽

Number Of Patients

The number of patients with complicated forms of cholelithiasis of cholelithiasis is progressively growing. One of the complications of gallstone disease is Mirizzi syndrome (SM). The reason for the development of which is the spread of the inflammatory - destructive process from the gallbladder to the bile ducts with the formation of pressure ulcers in the common bile duct, as a result of which the formation of a cholecystobiliary fistula occurs, through which stones from the gallbladder enter the main bile ducts. The analysis of the surgical treatment of patients with cholelithiasis (GSD) treated in the UH NJSC "MUS" was carried out. There were 3842 patients in total, Patients were in the period from January 2012. to July 2018 The analysis revealed that of all these patients with gallstones, Mirizzi SM type III and IV syndrome was diagnosed in 25 (0.7%). In 14 (56%) patients with type III SM and type IV SM, 11 (44%). The main group consisted of 10 (40%) patients and 15 (60%) patients included in the control group. The main group completed: 1) In type III SM (only 4 (40%) patients). One patient underwent hepaticojejunostomy according to the clinic method (2017/0423.1). In 3 patients, cholecystohepaticocholedochoplasty was performed with U-shaped interrupted sutures on the drainage according to Vishnevsky (2017 / 0980.1); 2) In type IV SM (a total of 6 (60%) patients). 4 patients underwent hepaticojejunostomy according to the clinic method (2017/0423.1). In 2 patients, cholecystohepaticocholedochoplasty was performed with U-shaped interrupted sutures on the drainage according to Vishnevsky (2017 / 0980.1). The developed and tested methods of surgical treatment of Mirizzi syndrome of types III and IV make it possible to improve the immediate and long-term results of surgical treatment of patients with this pathology. These methods of surgical treatment allow preserving the physiology of the bile outflow without postoperative complications typical for traditional hepaticojejunostomy (incompetence of the anastomotic sutures, stricture of hepaticojejunostomy).

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New Approaches to Systematization and Treatment of Impression Monocondylar Tibial Plateau Fractures

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto201623316-22 ◽

2016 ◽

Vol 23 (3) ◽

pp. 16-22

Author(s):

M. V Gilev ◽

E. A Volokitina ◽

Yu. V Antoniadi ◽

S. M Kutepov

Keyword(s):

Tibial Plateau ◽

Main Group ◽

Tibial Plateau Fractures ◽

Control Group ◽

Treatment Results ◽

Operational Classification ◽

Knee Contracture ◽

Secondary Displacement ◽

Ct Data

Treatment results for 109 patients (mean age 56 ± 1.7 years) with monocondylar impression tibial plateau fractures (ITPF) are presented. Patients from the control group (n=63) were operated on during the period from 2008 to 1010, patients from the main group (n=46) - from 2011 to 2013. Patients from the main group were treated with regard for injury localization relative to plateau center according to proposed operational classification of impression fractures (by CT data) and algorithm to choose the osteosynthesis technique depending on the anatomic and morphologic peculiarities of the intra-articular injury. In patients from the main group the evaluation by Rasmussen scale 36 months after intervention showed excellent results in 15 (38.4%), good - in 22 (56.4%), satisfactory - in 5 (12.8%) of patients, no poor results were recorded, and in patients from the control group - in 6 (11.5%), 8 (15.3%), 36 (69.3%) and 3 (5,8%) patients, respectively. Three (7.6%) complications (secondary displacement of fragments (2), knee contracture (1)) were observed in the main group, and 11 (20.9%) in the control group (20.9%) - local infectious inflammatory process (4), secondary displacement of plateau fragments (6), condylar sag (1). Perfected tactics of treatment of patients with ITPF enabled to achieve 3.48 times more excellent and good results (p

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Laboratory Tests in Assessing the Risk of Heterotopic Ossification

Medicina ◽

10.29234/2308-9113-2020-8-3-1-10 ◽

2020 ◽

pp. 1-10

Author(s):

M. V. Stogov ◽

◽

Y. P. Soldatov ◽

G. M. Chibirov ◽

E. A. Kireeva ◽

...

Keyword(s):

Surgical Treatment ◽

Heterotopic Ossification ◽

Laboratory Tests ◽

Bone Fractures ◽

Length Of Hospital Stay ◽

Main Group ◽

Control Group ◽

Cut Point ◽

Elbow Fractures ◽

Degree Of Risk

Heterotopic ossification (HO) is a common complication after injuries and orthopedic interventions. The aim of the study is to assess the feasibility of using laboratory tests to predict and determine the degree of risk of developing heterotopic ossification in patients after surgical treatment of bone fractures. Materials and methods. The results of surgical treatment of the effects of a humeral fracture in 25 patients were analyzed. In retrospect, all patients were divided into two groups: the main group included patients (n=9), who after surgery of the elbow fractures developed complications in the form of HO elbow para-articular tissues. The control group (n=16) consisted of patients who in the year after elbow fractures surgery developed no complications in the form of HO. Blood tests were performed in all patients prior to treatment, 7 days after surgery and at discharge from the hospital. The two groups of comparison (main and control) were comparable in age, time elapsed from the injury, the type of surgery performed, and length of hospital stay. Results. As a result of the study three potential predictors of HO were distinguished by laboratory tests in patients of the main group at the time of discharge: 1) high values of lactate (cut point with 100% sensitivity of the test – 2.32 mmol/l); 2) high values of hemoglobin (cut point with 100% sensitivity of the test – 130 g/l); 3) decreased activity of bone isoenzyme of acid phosphatase (cut point with 100% sensitivity of the test – 4.4 U/l). The odds ratio for a positive result of all three tests for predicting heterotopic ossification is 15.0. Conclusion. The identified laboratory tests allow to predict and determine the degree of risk of heterotopic ossification in patients after treatment of the effects of bone fractures.

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Surgical treatment of acetabular fractures

TRAUMA ◽

10.22141/1608-1706.4.22.2021.239709 ◽

2021 ◽

Vol 22 (4) ◽

pp. 46-51

Author(s):

I.I. Trufanov

Keyword(s):

Surgical Treatment ◽

Road Traffic ◽

Platelet Rich Plasma ◽

Clinical Effectiveness ◽

Postoperative Management ◽

Main Group ◽

The Body ◽

Social Adaptation ◽

Acetabular Fractures ◽

Control Group

Background. Acetabular fractures are severe intra-articular injuries that require anatomical reposition and early function, but they are often complicated by degenerative changes in both the acetabulum and the femoral head, leading to the development of post-traumatic coxarthrosis. The purpose was to study the clinical effectiveness of surgical treatment and postoperative management of patients using autologous platelet-rich plasma in patients with fractures of the acetabulum. Materials and methods. Twenty-eight patients with acetabular fractures of various degrees were operated at the City Emergency Hospital of Zaporizhzhia and the Municipal Clinical Hospital No 9 from 2017 to 2019. Gender composition: 22 men (78.57 %), 6 women (21.43 %), average age 46.64 ± 2.21 years, with a 95% confidence interval 42.31–50.96. Nineteen victims (67.86 %) had road traffic injuries, 7 (25 %) domestic injuries, and 2 (7.14 %) had industrial injuries. Results. In the main group of patients treated with platelet-rich plasma, radiologically visible adhesion of the injured area after 8 weeks occurred in 10 people (83.4 %). In one person (8.3 %), the adhesion occurred after 12, and in another (8.3 %) — 16 weeks after surgery. In the control group, adhesions at 8th week were registered in 14 patients (60.87 %), in 8 (34.78 %) — at 16th week. Given the general recovery of the body in the main group, the activation and social adaptation of patients occurred 2–3 weeks earlier. The assessment was performed radiologically and by the criteria of functional recovery.

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