Федеральное государственное бюджетное учреждение «Российский научный центр "Восстановительная травматология и ортопедия" им
The quantitative and qualitative analysis of the dinamoplantogrammes was done in 17 children at the age of 7-17 years old (21 feet) with congenital recurrent clubfoot before and after the treatment by the method of GA. Ilizarov. The average age of the surveyed children was -13,6±3,8 years. All patients were divided by the presence of the components of the deformation, which were dominant and not eliminated by the manual redressment to overcorrection, into 2 groups. All surveyed patients received treatment according to the method of GA. Ilizarov. For the control of used facts from the survey of 17 healthy children 717 years old without orthopedic foot pathology. Quantitative and qualitative assessment of dinamoplantogrammes was carried out with the help of DiaSled-Scan, the city of Saint-Petersburg. Before treatment all indicators of dinamoplantogrammes in statics and walking in patients with recurrent clubfoot deviated from the norm. After surgical treatment the coefficients and estimates of the partial load of the foot in statics were corresponded to the values of the norm, but when walking in patients with relapsed equinus component of foot deformation was observed moderate overload forefoot (on the average on 30%), as well as in all patients remained reduced (on the average on 50%) of the load on the first toe of the foot, which can be viewed as additional quantitative criteria of the muscle imbalance limbs with congenital clubfoot and take into account the rehabilitation of the child.
The result of the hip replacement presented in a female patient with coxarthrosis in the presence of the deformity of proximal femurs after the osteotomies made before. The analysis of functional state during preoperative preparation allowed studying the characteristics of the locomotor system adaptation, as well as determining the sequence with the need to perform reconstructive replacement of the left hip at this stage. This approach allowed obtaining a positive result of treatment.
The estimation of state of vegetative nervous system (by cardiointervalography) in 20 children and. adolescents of 10-17 years (13,5 ± 2,1 years in average) with dysplastic coxarthrosis was realized. The study showed that before the treatment increase of activity of sympathetic nervous system prevails. During the first week after surgery acetylcholine type of regulation of heart rate accompanied by increased activity of sympathetic division of vegetative nervous system was registered. Postoperative treatment time (during 1 month) and. increased physical activity contribute to the restoration of regulatory systems to the original level. During the treatment by Ilizarov apparatus the decrease of level of tolerance to hypoxia and. decrease of processes of general adaptation are registered.
Indices of energy metabolism in blood serum and partial oxygen and. carbon dioxide pressure in the injured limb tissues were studied in dynamics in 32 patients with open leg fractures (Kaplan-Markova type I-II B, C) during their treatment with the Ilizarov method. It was revealed that circulatory hypoxia, complicated by hemic hypoxia and followed by tissue hypoxia developed sequentially in the tissues of the injured limb segment in the posttraumatic period.
У 32 пациентов с открытыми переломами костей голени (типа I–IIБ, В по классификации Каплана – Марковой) в динамике лечения методом чрескостного остеосинтеза по Илизарову проведено исследование показателей энергетического обмена в сыворотке крови и парциального давления кислорода и углекислого газа в тканях травмированной конечности. Обнаружено, что в посттравматический период в тканях поврежденного сегмента последовательно развивалась циркуляторная гипоксия, отягощенная гемической формой гипоксии с последующим формированием тканевой гипоксии.
Indices of energy metabolism in blood serum and partial oxygen and. carbon dioxide pressure in the injured limb tissues were studied in dynamics in 32 patients with open leg fractures (Kaplan-Markova type I-II B, C) during their treatment with the Ilizarov method. It was revealed that circulatory hypoxia, complicated by hemic hypoxia and followed by tissue hypoxia developed sequentially in the tissues of the injured limb segment in the posttraumatic period.
A comparative physiological and biomechanical study of 19 patients with phosphate diabetes (PD) and 44 patients with the lower limb varus deformities without PD has been performed. The retardation of body longitudinal growth, the decrease in limb muscle contractility, locomotion velocity- and force-related characteristics, capacity for work was revealed in patients with PD. The moderate decrease in the muscle strength of the leg deformed, the weakening of foot balancing function and the decrease of loading foot parts in walking was observed in patients without PD.
2 groups of patients of different age with varus deformity of lower extremities bones (19 patients with phosphate-diabetes (PD) and 36 patients without this disease) were examined. Control group consisted of 50 healthy female coevals. Patients with PD had. lag in lengthwise body growth, decrease of contractive ability of extremities' muscles, decrease of speed and power characteristics of locomotions, decrease of availability. Patients with,deformations of bones but without PD had. decrease of shin muscle power, weakening of balance function of a foot and. decrease of load, on foot segments while walking.
2 groups of patients of different age with varus deformity of lower extremities bones (19 patients with phosphate-diabetes (PD) and 36 patients without this disease) were examined. Control group consisted of 50 healthy female coevals. Patients with PD had. lag in lengthwise body growth, decrease of contractive ability of extremities' muscles, decrease of speed and power characteristics of locomotions, decrease of availability. Patients with,deformations of bones but without PD had. decrease of shin muscle power, weakening of balance function of a foot and. decrease of load, on foot segments while walking.
The comparative data about the effectiveness of the rehabilitation of patients in case of acute and chronic subtotal defects of tibia by transposition of fibula with the usage of Ilizarov's method are given in the article. The positive treatment result with the improvement or restoration of patients' life quality is achieved by gradual shift of fibula with tibiofibular synosteosis by the method of transosseous osteosynthesis by Ilizarov.
An ultrasonic study of contact regenerated bones has been performed in 14 patients at the age from 27 to 53 years with open fractures of leg bones. Reposition of bone fragments was made using the Ilizarov fixator. Sonography technique use allowed to single out two main types of consolidation for open fractures of leg bones. In case of normal process some isolated vessels were visualized in the zone of regeneration. The increased number of block-like formations in the zone of regenerated bone, as well as the presence of «circumflex» artery evidenced an unfavorable process of consolidation.
An ultrasonic study of contact regenerated bones has been performed in 14 patients at the age from 27 to 53 years with open fractures of leg bones. Reposition of bone fragments was made using the Ilizarov fixator. Sonography technique use allowed to single out two main types of consolidation for open fractures of leg bones. In case of normal process some isolated vessels were visualized in the zone of regeneration. The increased number of block-like formations in the zone of regenerated bone, as well as the presence of «circumflex» artery evidenced an unfavorable process of consolidation.
The analysis of the sonographic characteristics and functional state indices of leg muscles was made in 18 male patients at the age of 12-62 years (33,4 ± 3,54 years) with «acute» posttraumatic tibial defects of 5-14 cm in the process of restoration of leg bone integrity by filling a bone tissue defect in the fascial-and-muscular sheath without additional lengthening of soft tissue component using the techniques of transosseous osteosynthesis. After the end of treatment, when the integrity of leg bones has been restored as well as their length, according US study the restoration of muscular structure occurs much slower. Within 6 months after the device removal atrophy of all the muscles studied is preserved, and the values of m. tibialis ant., m. gasrocnemius, m. soleus echodensity are increased due to the deficient time of rehabilitative process. Foot plantar flexors have a relatively fast rate of restoration, and foot dorsal flexors a slow one, because the area of their attachment to tibia is damaged. The greatest rate of restoration is noted for muscular «contractility» index, which reaches 80 % of normal values.
