ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS
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Published By "Orthopaedics, Traumatology, And Prosthetics"

2518-1882, 0030-5987
Updated Thursday, 04 November 2021

Author(s):  
Barkov Barkov ◽  
Oleg Veretelnik ◽  
Mykola Tkachuk ◽  
Mykola А. Tkachuk ◽  
Victor Veretelnik

Objective. To study the stress-strain state of the elements of the human lumbar spine when we use the transpedicular system, taking into account different angular values of segmental and total lumbar lordosis. Methods. For computer modeling of the stress-strain state of the elements of the human lumbar spine after mono- and polysegmental fixation, the Workbench product was used, and for the construction of parametric three-dimensional geometricmodels — the SolidWorks computer-aided design system was used. 4 groups of decisions were studied, which differed in angular values of segmental and total lumbar lordosis. In each group, 11 models were analyzed that describe the lumbar segments after mono- and polysegmental fixation in various configurations of the sagittal alignment of the lumbar spine. Results. It was found that the maximum stress on the cortical bone is concentrated on the base of the LV in case of the «pathological» intervertebral disc LV–S in the group of patients with hyperlordosis. At polysegmental fixation of the LI – S, there is a redistribution of stress on the cortical bone of all vertebrae, the maximum values of which is present in the bodies of the LV and S vertebrae. And only in the group with hypolordosis this stress is minimal. The maximum stress was always on the overlying intervertebral disc during transpedicularfixation. Significant increasing of cartilage stress in the facet joints of the LIV–LV segment was recorded during fixation of the LV–S segmentin case of hyperlordosis. The maximum stress on the rods was identified in the group of patients with hyperlordosis and polysegmentalfixation of the LI –S, on screws — on LV, LIV, LIII vertebrae during fixation in all groups, except for hypolordosis. Conclusions. Increasing in angular values (hyperlordosis), which describe segmental and total lumbar lordosis, leads to the stress elevation in the fixing elements and structures of the spinal motor segments, and, conversely, a decreasing in angular values (hypolordosis) causes the stress falling.


Author(s):  
Volodymyr Moseichuk ◽  
Vladyslav Moseichuk ◽  
Vasyl Makolinets

Molecular hydrogen is one of the effective antioxidants, which not only does not disrupt normal metabolism in the body, but also activates its antioxidant systems. Hydrogen-saturated water has  antioxidant, anti-inflammatory, anti-allergic, anti-apoptotic properties, stimulates energy metabolism and contributes to the systemic recovery of the body. It is used as a therapeutic factor for the treatment of patients with various pathologies: arterial hypertension, coronary heart disease, diabetes, obesity, metabolic disorders, disorders of the musculoskeletal system. The article discusses the various methods of obtaining molecular hydrogen and hydrogen water (direct and indirect saturation). Technical characteristics are described and features of the hydrogen generator GVCh Life (manufacturer LTD «Chemtest Ukraine+», Kharkiv, Ukraine), which produces molecular hydrogen (purity of which is 99.99 %, productivity — 100 ml/min) and saturates water with it (https://chemtest.com.ua/generator_vodorodnoy_vodi_i_dihanie_gvch_life). In contrast to the problems of most known generators in the device GVChLife is completely no contact of the electrodes with water, so it is not subject to electrolysis and is not saturated with metal ions. Water saturated in this way has the following characteristics: redox potential 560 mV, hydrogen concentration 1.0–1.15 ppm(water volume 1 l, saturation duration 10 min). The generator can be used for both hydrogen saturation and hydrogen inhalation. In the case of therapeutic use of hydrogen water to obtain it, you can use any drinking water (spring, prepared or non-carbonated bottled), hydrogen inhalation using nasal cannulas. Inhalation of pure hydrogen gas (99.99 %) for 30 minutes is equal to the use of 15 liters of hydrogen water (concentration 1.1–1.2 ppm). Conclusions. The developed MoHC Life molecular hydrogen generator is safe to use, without special requirements during operation. It can be successfully used in the complex therapy of patients with various diseases, including musculoskeletal system.


Author(s):  
Stanislav Bondarenko ◽  
Per Kjærsgaard-Andersen ◽  
Valentyna Maltseva ◽  
Ahmed Badnaoui

Nowadays total hip arthroplasty (THA) is one of the most successful surgical procedures in the world and the number of procedures performed is growing every year. However, its success largely depends on the absence of postoperative complications. Among the risk factors affecting the occurrence of postoperative complications are smoking, alcohol abuse, drug abuse, human immunodeficiency viruses (HIV), obesity, anemia, diabetes mellitus, malnutrition, rheumatoid arthritis, cardiovascular diseases, renal failure and dialysis, depression and anxiety. In the presented manuscript, such factors as HIV, smoking and alcohol abuse were considered. In smokers, bone regeneration slows down due to impaired bone metabolism and a slowdown in vascular recovery. Alcohol abuse affects human immunity, inhibiting T-helper cells, and also causing blood coagulation disorders. Alcohol abuse increases the risk of hospital complications, surgery related complications and general medical complications. Smoking can increase the risk of septiccomplications (lower respiratory tract infection, sepsis, urinary tract infection), myocardial infarction, risk of aseptic loosening of implants. Mortality was also higher in smokers compared to nonsmokers. HIV increases bone fragility, debilitation, rate of cardiovascular diseases and decreases the number of CD4+ cells in the blood, which directly affects the risk of periprosthetic joint infections and revision. All three factors increase the patient's lengthof stay in the hospital after THA. Currently, recommendations have been developed for preventive measures that need to be taken to reduce the risk of postoperative complications by performing primary THA. According to the recommendations, quitting smoking and drinking alcohol 4 weeks before THA will significantly reduce the risk of postoperative complications. For HIV-positive patients, antiretroviral therapy and subsequent assessing the viral load arerequired prior to THA. Preoperative care in this category of patients, undergoing primary THA, can reduce the risk of complications.


Author(s):  
Sergij Khmyzov ◽  
Yelizaveta Katsalap

Congenital pseudarthrosis of the tibia (CPT) is a rare disease that is detected with a frequency of 1 in 140–250,000 newborns. The disease is characterized by a wide range of clinical and radiological signs from progressive antecurvature deformation of the tibia to nonunion with a significant bone defect. Changes in the CPT area are caused by the influence of pathologically altered periosteum, which forms a fibrous hamartoma and is responsible for the deformityof the biomechanical properties of bone tissue. CPT can be formed at the moment of birth or developed spontaneously or as a result of minimal trauma in the early years. The main method of treatment of CPT is a surgery. Nowadays a number of surgical techniques, which are actively used and improved by specialists in the world, has been developed, The most used methods are the Ilizarovʼs method, application of intramedullary fixators, techniques with the use of vascularized tibial autograft, «induced membrane» technique. However, there are a few studies on comparing the effectiveness of different techniques or metal fixatives, most of them are presented in the format of a retrospective analysis of clinical cases series. This is due to the rarity of the disease and the lack of unified approaches on the choice of surgical treatment techniques. The main aim of surgical treatment of CPT is to achieveconsolidation in the area of pseudoarthrosis, which may restore the limb resistance. The part of primary consolidation of CPT after using the surgical treatment various techniques varies very much, range from 60 to 100 %. The percentage of children with CPT tibial amputations has decreased significantly over the past 30 years, which generally indicates an improvement of the results of surgical treatment of the mentioned pathology. However, CPT still remains one of the most difficult diseases of pediatric orthopedics due to the large number of unsatisfactory results and complications after surgery.


Author(s):  
Inna Golubeva ◽  
Olena Baburkina

B. I. Simenach: the life devoted to science


Author(s):  
Staff of "ORTHOPAEDICS, TRAUMATOLOGY AND PROSTHETICS"

On June 12, 2021, Vladyslav Volodymyrovych Povoroznyuk, the scientific director of the Department of Clinical Physiology and Pathology of the Musculoskeletal System of the State Institution “Institute of Gerontology named after DF Chebotaryov NAMS of Ukraine ", President of the Ukrainian Association of Osteoporosis and the Ukrainian Association of Menopause, Andropause and Musculoskeletal Diseases, President of the Ukrainian Division of EVIDAS, Member of the Board of the International Osteoporosis Association (IOF), Deputy Chairman of the Gerontologist Of Ukraine, Vice President of the Ukrainian Association of Rheumatologists, Member of the Board of the Ukrainian Association of Orthopedists-Traumatologists, Member of the Public Council of the Ukrainian Federation of Public Organizations for Civil Society Health Promotion, Honorary Member of the Association of Implantologists of Ukraine, Member of International Associations ACR, ASB EFORT, EMAS, EULAR, ISCD, ISSAM, OARSI, SICOT, director of the Ukrainian Scientific and Medical Center for Osteoporosis.


Author(s):  
Volodymyr Radchenko ◽  
Frieda Leontyeva ◽  
Oleksandr Barkov ◽  
Vladyslav Tuliakov ◽  
Iryna Korzh

As a result of screw fixation at the surgical treatment of patients with spinal diseases, certain complications may occur, of which soft tissues inflammation is frequent. Therefore, it is especially important to study the metabolic status of patients before surgery to determine the increased possibility of complications. Objective. To study the biochemical and immunological blood serum parameters and determine their diagnostic sensitivity in patients with the thoracic and lumbar spine diseases after screw fixation with postoperative inflammatory response. Methods. Comparisons of blood parame­ters were carried out in two groups of 20 patients in each group: the first one — patients at whom the postoperative period passed without complications, the second group — a soft tissues inflammation around the metal structure was observed in the postoperative period. Blood for the study was taken before the surgery on an empty stomach for determination of: C-reactive protein (CRP), sialic acid, alkaline phosphatase (ALP) activity, haptoglobin, content of total chondroitin sulfate (ChS), glycoproteins, circulating immune complexes (CIC), the rate of spontaneous lymphocyte mig­ration, the level of lymphocyte migration with antibodies to bone and cartilage antigens. For quantitative characterization of diagnostic reliability of laboratory test was used the criterion of diagnostic sensitivity. Results. In patients with postoperative soft tissue inflammation around the metal device before surgery, the following indicators were the most informative: the content of ChS (95 %), CRP (80 %), glycoproteins (95 %), haptoglobin (92 %), ALP activi­ty (80 %), sialic acid content (90 %), CIC concentration (70 %), the rate of spontaneous lymphocyte migration (65 %). Conclusions. The laboratory parameters complex with the highest diagnostic sensitivity can be recommended for the selection of preventive measures in the preoperative period, which will improve the results of surgical treatment, reduce its duration and costs.


Author(s):  
Staff of "ORTHOPAEDICS, TRAUMATOLOGY AND PROSTHETICS"

The article is devoted to the well-known specialist in the field of clinical laboratory diagnostics, biochemist, teacher and organizer, candidate of biological sciences, senior researcher, head of the department of laboratory diagnostics and immunology F. S. Leontieva.


Author(s):  
Staff of "ORTHOPAEDICS, TRAUMATOLOGY AND PROSTHETICS"
Keyword(s):  

On May 13, 2021, at the age of 75, the heart of the scientist, orthopedist-traumatologist, candidate of medical sciences Dudnik Vyacheslav Sergeevich stopped beating.


Author(s):  
Iryna Harbuzniak ◽  
Anastasiia Hrуtsenko

Syndactyly is a congenital malformation which is characterized by impaired differentiation of upper extremity tissues. Surgical correction of syndactyly is aimed to achieve satisfactory cosmetic and functional result. Most often, elimination of the total syndactyly form of the fingers implies is achieved by techniques according to Flatt (1962), Cronin (1943), Gilbert (1986), Wood (1998), bone form requires usage of Buck-Gramko technique. Objective. To conduct a retrospective study of surgical treatment results in patients with various forms of hand syndactyly. Methods. The study included 84 patients (109 hands) with hand syndactyly who were operated during the period from 2012 to 2020 in the pediatric orthopedics clinic of the Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine. The mean age of patients was 6.5 years (1 to 16), 39 (46.4 %) boys and 45 (53.6 %) girls. Most often syndactyly of III–IV fingers (105 (96.3 %) hands) was managed by the Wood method, namely in 63 (60.0 %) hands and 8 (7.6 %) cases with severe bone forms were corrected by Buck-Gramko method. Rotational skin pieces Ghani and Buck-Gramko were used for surgical correction of I–II fingers syndactyly. Treatment results were evaluated by the Vancouver Scar Scale (VSS). Results. According to VSS, the treatment result was classified as satisfactory in 73 (67.0 %) hands. Complications were noted in 11 (10.1 %) cases: 2 patients (18.2 % of 11) with congenital amniotic membranes were found to have lysis of a free skin piece; 1 (9.1 %) after removal of the bony syndactyly form had deviation of the nail phalanx; 3 (27.3 %) with Poland-syndrome were shown to have scarring of the interdigital space; 5 (45.4 %) with a complex bony form of syndactyly further on developed pulling scars, which caused deformity of the fingers and resulted in a correction in the form of multistage Z-plastics. Conclusions. All the patients showed improvement in the function and cosmetic results of the hand at the end of treatment. The best results were obtained in the case of simple and total forms of syndactyly treated with Wood technique.


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