The aim of the study was to compare the reduction potentials of devices, which operate on the basis of passive computer navigation – hexapods (SUV-Frame, Taylor Spatial Frame, Ilizarov Hexapod Apparatus), and the Ilizarov fixator. The potentials of bone fragment reposition have been analyzed in the devices mentioned for three standard planes and for six degrees of freedom. 48 series of experiment have been performed. It has been revealed that among the devices with passive computer navigation characteristics SUV-Frame construction affords the best potentials as regards distraction, translation, angulation of bone fragments and rotation. In the aggregate, the Ilizarov fixator provides the best qualities of bone fragment movement in comparison with hexapods, however, mounting a special unified unit is necessary to correct every component of deformity.

EMG-studies of 35 dogs while modeling ischial bone body and ramus have revealed decrease of the activation ability of pelvic limb muscles of experimental animals, which was restored more rapidly and more completely under transosseous osteosynthesis, than in control under conservative treatment. Both the denervation-and-reinnervation process and the protective interoreceptive reflex are mechanisms of change in muscle functional state in case of pelvis injury.

The results of clinical neurological examination and the data of electroneuromyography (ENMG) of lower limb reflex activity in patients with pelvis injuries have been compared. A new estimation scale based on ENMG results was proposed for objective evaluation of the neuromuscular apparatus (NMA). The change in H-reflex parameters has been analyzed in patients with clinically normal reflexes, hyporeflexia and areflexia; NMA changes of these patients have been determined by the estimation scale proposed on the basis of ENMG data.

Surgical treatment of 95 patients with intraarticular fractures of proximal tibia has been performed within the period of 1999-2008 years. In 53 (55,8%) cases arthroscopy preceded osteosynthesis. Age of patients varied from 15 to 80 years. Outcomes of treatment have been traced within the period from 1 year to 9 years in 81 patients.

The condition of mineral metabolism have been studied using radiation methods in the process of treating 25 patients at the age of 21-60 years with closed fractures of leg lower half. Mineral density was evaluated with «Lunar» bone densitometer, the rate of mineral metabolism and blood flow – with the emission computer tomography of "Siemens" firm. The results obtained evidence the prolongation of the processes of bone formation and bone tissue reorganization after the occurrence of clinically determined fracture union, but with rate decrease dynamically.

The condition of mineral metabolism have been studied using radiation methods in the process of treating 25 patients at the age of 21-60 years with closed fractures of leg lower half. Mineral density was evaluated with «Lunar» bone densitometer, the rate of mineral metabolism and blood flow – with the emission computer tomography of "Siemens" firm. The results obtained evidence the prolongation of the processes of bone formation and bone tissue reorganization after the occurrence of clinically determined fracture union, but with rate decrease dynamically.

24 patients (26 feet) with the consequences of calcaneal intraarticular fractures were observed. The causes of obtaining unfavorable outcomes of treatment for calcaneal intraarticular fractures have been revealed. All the patients underwent a course of complex treatment with emphasized treating vector, depending on the mechanism of pathology development. In 8 cases decompression of tarsal channels was performed, in 2 cases – correcting arthrodesis of talocalcaneal joint. Long-term results were analyzed in 17 patients (18 feet). Good results were obtained in 14 patients (15 feet), satisfactory – in 3 patients; there were no unsatisfactory results.

13 patients with tubular bone fractures, admitted to the department of traumatology of the Perm Wagner State Medical Academy have been surgically treated using the technique of Minimally Invasive Plate Osteosynthesis (MIPO) within the period of 2007-2008

The efficiency of rehabilitation was evaluated by the algo-functional index (AFI) in 40 patients with gonarthrosis of all stages at the age of 53-73 years, who underwent treatment using the techniques of subchondral decompression-draining tunneling of articular parts. The results of treatment have been studied in all the patients with follow-up periods up to 2 years after surgery. Good rehabilitation outcomes were obtained in 34 cases, and satisfactory ones – in 6 patients. The analysis of the data obtained confirmed the high reliability of evaluating gonarthrosis treatment results evaluation according to RISC "RTO" AFI.

The influence of standard methods of treatment on pathological progress in patients with the knee posttraumatic osteoarthrosis of II stage has been studied. Based on the large scope of clinical material the authors have demonstrated the insufficient effectiveness of the influence of standard treatment measures on the progress of local morphological changes in the knees, arising due to pathological process progression.

A technique for quantitative evaluation of the complex of articular cartilage parameters has been worked out at organic, tissue and cellular levels using half-thin sections of large area. The technique of quantitative evaluation proposed allows to get objective information on the degree of reactive-and-destructive changes and restorative processes in articular cartilage under limb lengthening, as well as it might be recommended for biopsy material processing for the purpose of joint pathology diagnostics and studying the influence of different factors on articular cartilage condition.

The effect of complex pathogenetically substantiated conservative treatment including the use of chondroprotectors, non-steroid anti-inflammatory preparations, calcium preparations, physiotherapeutic procedures, exercise therapy, on the level of spontaneous production of serum cytokines (IL-1β, TNFα, IL-6, IL-10) has been studied in 69 patients with I-II stage osteoarthrosis of the knee and the hip. The statistically significant decrease of IL-1β level within 6-24 months, as well as that of initially increased TNFα level in the periods of 12-24 months after conservative therapy start has been revealed in the group of patients with good and satisfactory results of treatment. In case of therapeutic effect absence (pain syndrome remaining) the short-term decrease of IL-1β level has been observed after 6 months and that of TNFα concentration after 12 months since treatment course start. The data obtained are recommended to be used for evaluation of the effectiveness of therapeutic measures in patients with early stages of large joint osteoarthrosis in out-patient conditions.

The rate of lower limb magistral and capillary blood flow has been studied in 580 female and male subjects at the age from 6 to 75 years using the techniques of ultrasound and laser Doppler flowmetry. It has been demonstrated that as far as age increases regional and systemic arterial pressure (AP) becomes higher, the rate of linear blood flow along the femoral artery decreases and it increases along the leg and foot arteries. At the age above 50 years the functional reserves of vascular bed adaptation, initially higher in women, begin decreasing.

85 patients at the age of 17-61 years with the ankle advanced injuries have been examined by the technique of magnetic resonance tomography (MRT). The patients had the sequences of the ankle bone fractures, accompanied by ligamentous apparatus advanced damages, the chronic instability of the ankle due to damaging the distal tibiofibular syndesmosis ligamentous apparatus, the posttraumatic deforming osteoarthrosis, accompanied by pain syndrome. In the long-term period the character of changes in the ligaments damaged has been caused by fibroblastic processes in the avulsion or rupture zone of ligament, its irregular thickening, avulsion dislocation, wavy contours, moderate perifocal edema.

Mineral mass and density have been determined in the process of lower limb bone deformity correction in 15 patients with imperfect osteogenesis using the X-ray double-energy bone densitometer of ―GE/Lunar Corp.‖ firm (USA). Wire bioactive coating with calcium-phosphate compound contributes to local correction of mineral metabolism disorders. The use of intramedullary bioactive reinforcement contributes to consolidation of bone fragments for correcting osteotomy of long bones. Mineralization level increases not only in the zone of fracture, but in the whole skeleton as well. The results of examination have demonstrated that 15-20% increase of mineral density was observed for all skeletal bones in the process of deformity correction. The effect was achieved at the expense of skeletal axis straightening, positive neurohumoral changes and greater motor activity. Calcium-phosphate bioceramics has high biocompatibility and the ability of integration with bone tissue.

Treatment results have been analyzed in 75 patients (132 feet) with hallux valgus, treated at Russian Ilizarov Scientific Centre ―Restorative Traumatology and Orthopaedics within the period of 1995-2006. All the patients have been operated according to the technologies, worked out at RISC ―RTO‖ with the Ilizarov fixator use in view of hallux deformity severity degree. On the basis of the results achieved the authors have described and analyzed the errors and complications occurred in such patients, as well as the methods of their prevention and timely adequate treatment.

The results of treatment were analyzed in 73 patients with humeral hematogenous osteomyelitis sequelae, who had been treated at RISC ―RTO‖ within the period of 1982-2005 and subjected to distraction osteosynthesis of humerus with the Ilizarov fixator. All the patients were operated according to the technologies, worked out at RISC ―RTO‖ in view of the features of the disease process. Based on the results obtained, the authors described and analyzed the results of treatment, errors and complications, observed in such patients, as well as the methods of their prevention and those of timely adequate treatment.

The authors have analyzed the results of surgical treatment of 468 patients with different spinal pathology, complicated by compression of spinal cord and its roots (212 patients with traumatic compression, 256 − with compression for spine degenerative-and-dystrophic diseases). Applied in surgical treatment of spine diseases and injuries dynamic fixators of nitinole demonstrate high effectiveness of their use. They allow to achieve the reliable constant internal fixation of spinal fragments or that of the spinal motor segment injured, and carry out the prolonged graduated compression of spinal bone fragments thereby promoting consolidation. The use of dynamic fixators of nitinole makes it possible to maintain spine biomechanics, the probability of progressing the degenerative-and-dystrophic process in spinal intact segments decreases.

The authors have made comparative analysis of the results of surgical treatment of patients with lumbar spine degenerative involvements by corporodesis developed techniques and traditional ones, who were treated in BSRCTO department of spine pathology within the period from 2003 to 2006. It has been revealed that new technological approaches for lumbar osteochondrosis instable forms make available to achieve good results of treatment, promote osteointegration process of implants, prevent their migration and reduce the periods of in-patient treatment.

The technique of interspinous bi- and monosegmental spondylodesis has been developed and successfully used in 32 cases for treatment of non-complicated compression (type A1 according to AO classification) fractures of lower thoracic and lumbar vertebral bodies.

The author illustrates a stage-by-stage psychotherapeutic model, proposed for patients with chronic osteomyelitis, within the framework of complex postoperative rehabilitation; the mentioned model is intended for the elimination of manifested psychopathological reactions caused by surgical intervention, and the solution of internal personal conflicts. The article demonstrates the effectiveness of psychotherapy in 241 patients of the department of purulent orthopaedics. The author comes to the conclusions concerning the expediency of psychotherapeutic courses for all the patients with locomotor system pathology, who are subjected to prolonged treatment.

The author has analyzed the expenditures of time in laboratory workers for activity maintenance according to the existing medical standards. The results obtained show sufficient labor productivity (non-productive losses of time are less than 20 min. per day). It has been established that the expenditures of time mentioned do not differ significantly among different categories of workers in the laboratories of different treatment-and-prophylactic institutions.

The authors have come to the conclusion that both the decreased formation of bone tissue and the decrease of osteoclasts in number dominate in case of I-type diabetes mellitus. While studying bone metabolism markers the decrease of osteocalcin content is found to be the most frequent and constant value. The pathogenetic role of glucocorticoids is being discussed, as well as that of parathyroid and sex hormones, calcitonin, vitamin D active metabolites, local factors and microangiopathy. Local factors such as IGF-I, IGF-II, prostaglandins, cytokines (interleukins including) are involved in the mechanism of osteopenia development. Diabetic microangiopathy is of more vital importance in the mechanisms of diabetic osteoarthropathy and local demineralization development. Mineral density tends to be decreased to a greater extent in women, than in men.

Three cases of the rare form of patellar congenital dislocation are presented. In the same patients their patella was dislocated during the knee flexion, and some time later dislocation can occur while extension during quadriceps sharp contraction. This form of dislocation is called by us intermediate. Three joints were operated. The roentgenological symptom is demonstrated, which characterizes this rare form of dislocation, as well as indications for surgical treatment and its performance. The reconstructive surgery was used, which reduced the probability of patellar dislocation for the knee flexion and extension. Good result was achieved in all cases.

The acute coronary syndrome, a rare complication after vartebroplasty, is being discussed in a female patient at the age of 65 years with a lumbar vertebral fracture. The surgery was performed under local anesthesia according to «Stryker» technology. In the process of cement insertion thoracic spine pain developed, as well as loss of consciousness and suppressed respiration. Timely diagnostics and adequate treatment have allowed to avoid fatal outcome.

We have demonstrated our experience of treatment of 16 patients with tumor-like diseases of long tubular bones. We performed intraosseous stressed elastic reinforcement of involved bone simultaneously with transosseous osteosynthesis performance in 11 patients. In 5 patients with minimal risk of pathologic fracture the intraosseous stressed elastic reinforcement was used as an independent osteosynthesis technique. The anatomical restoration of segment with complete organotypic reorganization of the bone part involved was noted in all the patients.