Over the period from 1997 to 2006, 580 patients (14 to 45 years old) with back pain and gonalgia complaints were examined, including 292 female and 288 male patients. Hip joint pathologies in the so-called incipient stage were found in 192 (33,7%) patients, with progressive disease being detected in 128 (66,3%) cases. When choosing a medical examination plan it is very important to take into consideration the patient’s complaints, his/her occupation, case record, sex, age and genetic predisposition. It is also important to check whether the patient received conservative treatment and what was the treatment response. Radiation examination includes X-ray of joints, MRI and computer-assisted tomography. A comprehensive and consistent examination of patients allows diagnosing progressive coxarthrosis at an early stage.

The objective of the present study was to analyse results of the treatment of 267 patients with pseudoarthrosis of the extremities and to use them for the development of criteria for the choice of methods for rehabilitative therapy. It was shown that stability of fixation of bone fragments by metal devices in patients with false joints (unlike fractures) varies depending on bone tissue condition. With this in mind, the patients receiving rehabilitative treatment were allocated to three groups differing in the degree of immobilization in the postoperative period. One group included the patients who did not need immobilization of the affected extremity. The other comprised those requiring immobilization only in case of axial load. Patients of the third group needed immobilization throughout the entire period until the completion of fragment consolidation. The results thus obtained were used to develop tactical schemes of combined treatment of patients using up-to-date orthotic techniques. It is proposed to divide the post-surgery treatment schedule into the following periods: early postoperative, early rehabilitative, the onset of active functional loading, and the period of functional and vocational rehabilitation. Such a differentiation is believed to enhance efficiency of the above rehabilitative strategy and facilitate the adequate choice of combined remedial treatments. Excellent and good outcome of rehabilitation with the use of this technology have been achieved in 98.9% of the patents.

In treatment of 88 patients with different posttraumatic abnormalities of osseous regeneration autotransplantation of marrow in conjunction with crystalline chymotrypsin dissolved in was applied. Analysis of results showed effectiveness of proposed method in delayed union by 100% cases, in ununited fractures by 91,7%, in hypertrophic pseudoartrosis by 91.7%, in hypotrophic pseudoartrosis by 76,6%, and in pseudoartrosis in combination with marginal bone defect by 66,7%. Rigid fixation of fragments is indispensable condition of beneficial effects achievement.

Since 2000 year 39 patients with diaphyseal femoral fractures have been treated using the technique of extramedullary compressive-dynamic osteosynthesis. Treatment is finished in 25 patients, 11 of them resumed their previous activities, while 14 did not. They are under follow-up and demonstrate different stages of fracture consolidation. The constructed device meets the requirements of extramedullary fixation and develops the necessary compression of the fracture zone. The flexible partly transfers the load to the fracture area, stimulating, thus, regeneration and consolidation of the lesion.

Modern technology of total hip replacement in case fractures of proximal parts of hip (femur) which detected at senile age, fulfilled in 420 cases with minimum share of complications. This technology gives highly favorable results, allows to restore painless movements and supporting functions of lower extremities and ensure possibility of self attendance.

Disturbance of femur diaphysis compact substance was induced experimentally in rabbits. In the course of the operation single administration of crystalline chimotripsin into the wound was performed and its influence on bony structures regeneration was studied. Methods of light and scanning electron microscopy revealed that reparative processes started earlier and were more active than that in control. This promotes regenerate formation and complete healing of bone defect. Intramuscular administration of proteolytic enzyme does not exert essential influence on bone regeneration.

The authors noted a number of peculiarities and positive moments in case of application of hip joint transosseous access after Kulish with 87 patients, aged 14-64 years, with deforming coxarthrosis, femoral head aseptic necrosis, coxa vara, congenital hip dislocation and femoral head epiphyseolysis. The access is simple, effective, comparatively low traumatic and can be successfully applied in hip joint reconstructive orthopedics.

The authors have proposed a method of surgical treatment of posttraumatic coxa vara. The treatment was given to 19 patients aged 16 to 43 years. The essence of the operation consists in oblique intertrochanteric osteotomy of the femur, osteotomy of the lesser trochanter and a muscular pedicle graft formation from the lesser trochanter which is used in grafting the defect observed after the correction of the spatial position of the proximal end of the femur.

On the basis of the data of X-ray examination of 378 patients (466 joints) with aseptic necrosis of the femoral head and their surgical treatment (314 patients) the authors have distinguished four roentgenotopographic forms of avascular lesions: peripheral, central, segmental and total. Certain dependence of the localization of the necrotic focus on a number of determined etiologic factors has been pointed out, such as the character of the preceding injury and the type the hip lesion, supercooling or the patient's occupation. The authors believe that the choice of the most adequate type of surgical intervention should be based not only on the stage of the process, but also on the size and the localization of the femoral head lesion.

A method of the operative treatment of the II stage of aseptic necrosis of the femur by subchondral autoplasty (with bone chips with crystal chymotrypsin) is described. In 18 of 22 patients operated upon good results were noted, in 3 patients results were satisfactory during 2-5 years.