Restoration of Foot Shape and Function in Calcaneous Deformities and Defects

2009 ◽  
Vol 16 (4) ◽  
pp. 37-41
Author(s):  
Dmitriy Valer'evich Samusenko ◽  
Andrey Sergeevich Neretin ◽  
D V Samusenko ◽  
A S Neretin
Keyword(s):  
Bone Tissue ◽  
Blood Supply ◽  
Soft Tissues ◽  
Functional Results ◽  
Favorable Effect ◽  
Treatment Technique ◽  
Results Of Treatment ◽  
Distraction Osteosynthesis ◽  
Remission Phase ◽  
And Function

Methods and outcomes of treatment of calcaneous deformities and defects (102 patients, 112 feet) of different etiology are presented. Treatment technique was extrafocal compression-distraction osteosynthesis by Ilizarov. Condition of the foot was monitored using radioisotopic, biomechanical and radiologic examinations. Anatomic and functional results of treatment depended upon the severity of the initial pathologic changes in bone and soft tissues, presence of concomitant osteomyelitis in the remission phase as well as on gait stereotype and biomechanical relation of the overlying segments. Preference of transosseous osteosynthesis by Ilizarov for the treatment of calcaneous defects and deformities accounted for the possibility of dosed correction and functional loads as well as by the favorable effect on bone tissue blood supply.

BLOOD SUPPLY FEATURES OF SOFT TISSUE SARCOMAS OF THE EXTREMITIES

2017 ◽  
Vol 63 (5) ◽  
pp. 770-775
Author(s):  
Mikhail Khanevich ◽  
Georgiy Manikhas ◽  
Anton Khazov ◽  
M. Kukanov
Keyword(s):  
Soft Tissue ◽  
Blood Supply ◽  
Soft Tissues ◽  
Soft Tissue Sarcomas ◽  
Disease Free Survival ◽  
Long Term Results ◽  
Surgical Removal ◽  
Selective Embolization ◽  
Results Of Treatment

Surgical removal of tumor remains the only one radical treatment for patients with soft tissue sarcomas of the extremities. However, the parameters of total and disease-free survival after this type of treatment cannot be considered satisfactory. Currently the active search and introduction into clinical practice of additional impact methods that can improve the immediate and long-term results of treatment of such patients is being conducted. In the article there are presented results of the analysis of preoperative angiographic studies of 94 patients with primary and recurrent sarcomas of soft tissues of the extremities. The features of blood supply and internal angioarchitectonics of tumor were revealed depending on the size, histological type and localization. The features of blood supply of tumors in patients with primary and recurrent sarcomas of soft tissues of extremities were described in detail. The results of further surgical treatment of patients included in the study showed that information on the number and size of blood supply sources of the tumor zone, supplemented by selective embolization of vessels, made it possible to select the optimal plan and minimize trauma, reduce intraoperative hemorrhage, and perform organ-preserving and functionally beneficial operations.

RESULTS OF TREATMENT OF LOCALLY RECURRING SOFT TISSUES SARCOMAS OF EXTREMITIES

2018 ◽  
Vol 64 (3) ◽  
pp. 408-413
Author(s):  
Grigoriy Zinovev ◽  
Georgiy Gafton ◽  
Sergey Novikov ◽  
Ivan Gafton ◽  
Yekaterina Busko ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Soft Tissues ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Tumor Location ◽  
Long Term Results ◽  
Clinical Feature ◽  
National Medical ◽  
Results Of Treatment ◽  
Kaplan Meier

Background: The most striking clinical feature of soft tissues sarcomas (STS) is their ability to recur. At present disputes about the clinical and morphological factors of STS recurrence such as the degree of malignancy, size, location, depth of tumor location, patient’s age and the presence of previous relapses in the anamnesis do not subside. It also requires clarification of the effect of the volume of tissues removed on the long-term results of treatment of STS as well as indications for the application of various regimes of remote radiation therapy. Materials and methods: Of 1802 registered cases of STS of extremities at the N.N. Petrov National Medical Research Center of Oncology from 2004 to 2016 there were selected data on 213 patients who suffered from at least one relapse of the disease. There was performed an assessment of overall, non-metastatic and disease-free survival using a single-factor (the Kaplan-Meier method) and multivariate analysis (the Cox regression model). Conclusion: The detection of various prognostic factors of locally recurrent STS allows determining the necessary treatment tactics (the vastness and traumatism of surgery and the advisability of radiation therapy).

Biological Response to Wollastonite Doped α-Tricalcium Phosphate Implants in Hard and Soft Tissues in Rats

2008 ◽  
Vol 396-398 ◽  
pp. 7-10 ◽  
Author(s):  
Ana Maria Minarelli Gaspar ◽  
Sybele Saska ◽  
R. García Carrodeguas ◽  
A.H. De Aza ◽  
P. Pena ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Bone Formation ◽  
Bone Tissue ◽  
Tricalcium Phosphate ◽  
Rattus Norvegicus ◽  
Soft Tissues ◽  
Subcutaneous Tissue ◽  
Biological Response ◽  
New Bone Formation ◽  
Rat Bone

The biological response following subcutaneous and bone implantation of β-wollastonite(β-W)-doped α-tricalcium phosphate bioceramics in rats was evaluated. Tested materials were: tricalcium phosphate (TCP), consisting of a mixture of α- and β-polymorphs; TCP doped with 5 wt. % of β-W (TCP5W), composed of α-TCP as only crystalline phase; and TCP doped with 15 wt. % of β-W (TCP15), containing crystalline α-TCP and β-W. Cylinders of 2x1 mm were implanted in tibiae and backs of adult male Rattus norvegicus, Holtzman rats. After 7, 30 and 120 days, animals were sacrificed and the tissue blocks containing the implants were excised, fixed and processed for histological examination. TCP, TCP5W and TCP15W implants were biocompatible but neither bioactive nor biodegradable in rat subcutaneous tissue. They were not osteoinductive in connective tissue either. However, in rat bone tissue β-W-doped α-TCP implants (TCP5W and TCP15W) were bioactive, biodegradable and osteoconductive. The rates of biodegradation and new bone formation observed for TCP5W and TCP15W implants in rat bone tissue were greater than for non-doped TCP.

Description and Clinical Assessment of the Bone Block Tendon Interposition Technique for the Management of Thumb Carpometacarpal Joint Osteoarthritis

2018 ◽  
Vol 23 (04) ◽  
pp. 515-519
Author(s):  
Diego F. Rincon Cardozo ◽  
Wynston J. Alvarez Martinez ◽  
Jhon F. Castañeda Lopez ◽  
Fredy A. Angarita Maldonado ◽  
Juliana A. Rojas Neira ◽  
...  
Keyword(s):  
Case Series ◽  
Functional Results ◽  
Interference Screw ◽  
Pinch Strength ◽  
Bone Block ◽  
Dash Score ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Thumb Carpometacarpal ◽  
And Function

Background: Pellegrini’s surgical technique is the most useful for thumb carpometacarpal joint osteoarthritis. The purpose of this paper is to describe the technique of a modified version using a bone block in the tunnel through which the flexor carpi radialis tendon is passed (BBTI). Methods: Case series of patients diagnosed with osteoarthritis of the thumb carpometacarpal joint, in stage II or higher based on Eaton’s classification, that were intervened using the BBTI technique for a 2-year period. Grip and pinch strength, range of motion, and 1–2 metacarpal angle were evaluated. Pain and function were measured using the visual analogue scale and the Disabilities of the Arm, Shoulder and Hand (DASH) scale. Results: The study included 16 cases in 14 patients (11 women and 3 men), with an average age of 55.7 ± 7.1 years. Encouraging results were obtained, with an average DASH score of 24.3 ± 17.9 and a minimum VAS pain score. A total of 58% showed a grip strength of over 80% and the postoperative movement was equivalent to the contralateral limb. No cases of infection were reported, and only two minor complications were observed. Conclusions: The BBTI technique is a surgical option that incorporates an interference screw, offering good functional results for managing osteoarthritis of the thumb carpometacarpal joint, with a similar complication rate to that of the original technique.

scholarly journals On the local damaging effect of biogenic degradation products of the BAK-1000 silicate matrix after implantation (experimental morphological study)

2018 ◽  
pp. 44-49
Author(s):  
А.Ф. Фидаров ◽  
А.С. Григорьян ◽  
Т.Д. Колокольцова ◽  
А.А. Орлов ◽  
Е.Е. Устинова ◽  
...  
Keyword(s):  
Bone Tissue ◽  
Morphological Study ◽  
Degradation Products ◽  
Healing Process ◽  
Male Rats ◽  
Tissue Integrity ◽  
And Function ◽  
Tissue Trauma ◽  
Tissue Restoration ◽  
Late Stages

Актуальность. Травматизм костных тканей остается одной из серьезных проблем современности. Восстановление структуры и функциональности костной ткани больных с посттравматическими поражениями подчеркивает высокую значимость и актуальность проведения исследований по поиску новых методов и материалов для восстановления целостности и оптимизации процессов заживления костной ткани. Целью исследования было экспериментально-морфологическое изучение эффективности применения остеокондуктивного апатитосиликатного композита БАК-1000 в качестве имплантационного материала для восстановления обширного дефекта костной ткани. Методика. Исследования проведены на крысах линии CD, самцах массой 600 ± 10 г (n = 12). После остеотомии с удалением фрагмента кости размером 0,3 х 0,5 см дефект заполняли стерильным имплантационным материалом БАК-1000 в виде цилиндрических блоков того же размера. Контроль восстановления костной ткани проводили гистологическим методом. Результаты показали, что БАК-1000 обладает выраженным местным побочным эффектом, приводящим к возникновению очагов патологического процесса на поздних сроках заживления. Заключение. Данные экспериментально-морфологического исследования подтверждают необходимость проведения более тщательных исследований предлагаемых для использования в клинической практике материалов или композитов на поздних сроках после применения. Background. Bone tissue trauma remains one of serious current challenges. Restoration of the bone tissue structure and function in posttraumatic lesions emphasizes a high relevance of searching for new methods and materials to restore the bone tissue integrity and optimize the healing process. The aim of this experimental morphological study was to evaluate the effectiveness of an osteoconductive apatite-silicate composite BAK-1000 as an implant material for restoration of large defects in bone tissue. Methods. The study was performed on male rats (CD strain) weighing 600 ± 10 g (n = 12). After osteotomy with removal of a 0.3 х 0.5 cm bone fragment, the defect was filled with sterile BAK-1000 implantation material in the form of cylindrical blocks of the same size. The bone tissue restoration process was monitored histologically. The results showed that BAC-1000 had a pronounced local side effect, leading to the emergence of pathological foci at late stages of healing. Conclusion. This experimental morphological study confirmed the need to study more thoroughly the materials or composites proposed for use in clinical practice at late terms following application.

scholarly journals THE TREATMENT OF EXTRA- AND INTRA-ARTICULAR FRACTURES THE DISTAL HUMERUS

2010 ◽  
Vol 16 (3) ◽  
pp. 96-102
Author(s):  
V. V. Klyuchevsky ◽  
Hassan Ben El Hafi
Keyword(s):  
Soft Tissues ◽  
Functional Results ◽  
Distal Humerus ◽  
Distal Segment ◽  
Rigid Fixation ◽  
Performance Score ◽  
Mayo Elbow Performance Score ◽  
Articular Fractures ◽  
Active Mobilization ◽  
Violent Acts

From 2005 to 2009 we treated 112 patients with fractures of distal segment of the humerus, 83 (74,10%) of them were injured when falling from the height of its own growth, 8 (7,14%) - in an accident, 6 (5,35%) - a fall from a height, 13 (11,6%) - in sports, and two - as a result of violent acts. In 97 (87%) cases the fractures were closed, in 15 (13%) - open. 19 patients were treated conservatively and 93 - operatively. Functional results were evaluated using the Mayo elbow performance score (MEPS) in 78,37% of patients. Results of the conservative method: excellent and good - 46,66%, and in all patients with type A without displacement - in 100%. The fair results - in 33% and the poor in 20% - with type В and C. The results of operative treatment: excellent and good - 90,41%, the fair results - in 9,58%, no poor results. Initial prevent the oedema and bleeding into joints and soft tissues, adequate rigid fixation of fractures with the maximal restoration of the elbow joint congruent without additional immobilization and early active mobilization is essential to prevent the elbow stiffness and achieve a good outcomes.

Method of surgical treatment of the saddle nose deformity

2021 ◽  
Vol 20 (4) ◽  
pp. 43-47
Author(s):  
D. S. Pshennikov ◽  
◽  
Z. M. Abdulaev ◽  
◽  
Keyword(s):  
Surgical Treatment ◽  
Local Anesthesia ◽  
Nasal Septum ◽  
Soft Tissues ◽  
Operation Time ◽  
Functional Results ◽  
Nasal Dorsum ◽  
Superficial Musculoaponeurotic System ◽  
Saddle Nose Deformity ◽  
External Nose

Saddle deformity of the external nose, which is a consequence of trauma, is usually combined with a nasal septal deviation and is quite widespread in the population. The problem of surgical treatment of this group of patients lies not only in the technical complexity, trauma of the proposed methods but also in the need to carry out significant interventions under general anesthesia, which limits the use of available techniques by a wide number of ENT surgeons, increases the duration of the operation, recovery time and temporary disability of the patient. The invention aims to improve surgical treatment of patients with saddle nasal deformity by providing stable cosmetic and functional results. Materials and methods: The proposed method of surgical treatment of saddle deformity of nasal dorsum includes several stages. Cartilage autograft taken from nasal septum during septoplasty is milled to 0,5–1,0 mm, mixed with 0,5 ml of latex tissue glue (LTG) having hemostatic and antiseptic properties due to aminocaproic acid and dioxidine content, respectively. This mixture is kept for 5 minutes and delivered to the pocket formed under the SMAS (superficial musculoaponeurotic system) layer in the soft tissues of the dorsum of the external nose, after which the final shape of the nose is simulated and fixed with a plaster splint for a week. Results: Based on the department of otolaryngology of Semashko Ryazan Regional Clinical Hospital, for the period from 2012 to 2019, 17 patients were treated with a diagnosis: saddle deformity of the external nose and nasal septum deviation. All patients underwent rhinoseptoplasty under local anesthesia using LTG as described above. No complications were observed in the postoperative period. During follow-up from 7 to 24 months, patients retain constant functional and cosmetic results. Conclusions. This method is a simple, low-traumatic one of surgical treatment of saddle deformity of the nasal dorsum, which allows reducing the operation time, performing it under local anesthesia and obtaining good cosmetic and functional results. The technical simplicity and accessibility of the method make it possible to use it in hospitals engaged in the surgical treatment of nasal diseases.

Evaluation clinical efficacy of immunotherapy in complex treatment of acute optic neuritis associated with herpesvirus infection

2021 ◽  
pp. 167-171
Author(s):  
D.А. Povalyaeva ◽  
◽  
V.V. Egorov ◽  
G.P. Smoliakova ◽  
L.P. Danilova ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Clinical Efficacy ◽  
Irrigation System ◽  
Functional Results ◽  
Complex Treatment ◽  
Herpesvirus Infection ◽  
Results Of Treatment ◽  
Acute Optic Neuritis ◽  
Key Words Optic Neuritis ◽  
Retrobulbar Space

Purpose. To study the clinical efficacy of complex treatment of optic neuritis (ON) associated with herpesvirus infection (HVI), including methods of immunotherapy. Material and methods. The clinical study involved 37 people (37 eyes) with acute ON associated with HVI. The treatment regimen for all patients within 10 days included delivery through irrigation system implanted into the retrobulbar space to optic nerve: solutions Dexamethasone on decreasing scheme, Emoxypine 1% 0.5 ml and Dicynone 12.5% 0.5 ml, in combination with administration of drugs neuroprotection. All patients were divided into 2 groups depending on characteristics of therapy. The 1st group consisted of 17 patients, who were treated according to the standard method. 2nd group consisted of 20 patients who received additional intramuscular Imunofan in the regimen and doses according to the manufacturer's instructions. Results. Analysis of obtained datas showed that more significant positive dynamics was noted in the clinical course of ON in patients of the 2nd group of observation in comparison with the 1st group. Conclusion. The strategy of etiotropic and pathogenetic immunotherapy at ON, associated with HVI infection, developed by us, allows to shorten recovery time and improve functional results of treatment in absence of relapses of disease within 1 year of follow-up. Key words: optic neuritis, herpesvirus infection, corticosteroid therapy, immunotherapy.

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