The purpose of this work was to evaluate the effect of high-frequency variable electromagnetic field, generated with «OREOL 2» device, on reparative regeneration processes of bone tissue for purulent infection cases. The experimental study was performed on 96 rabbits, which were divided in 4 groups in 24 animals each. A standard defect of bone tissue was made in radial shaft of left thorax limb in all the rabbits observing asepsis rules. Staphylococcus aureus culture suspensions were injected into the defect zone of 3 and 4 group rabbits. In experimental groups (2 and 4) the limb operated was subjected to the influence of “Oreol 2” device for reparative process stimulation. The results of the experiment were evaluated by X-ray and morphological data. Taking into consideration the results of experiment, the authors have come to the conclusion, that «Oreol 2» device has a positive effect on the processes of bone tissue regeneration, microcirculation and mobilization of organism reserve potentials.

The authors describe a restorative stage of surgical intervention in the purulent-and-necrotic focus in the process of chronic osteomyelitis treatment. Rather known and perfected techniques along with modern original ones for filling a residual bone cavity, being formed after necrosequestrectomy, are demonstrated. The authors tried to classify the techniques mentioned.

The article deals with analyzing the diagnostics and treatment of acute hematogenous osteomyelitis in adults. 16 patients with this rare pathology were treated and observed in the clinics of the Samara State Medical University within the period of 2003-2008. Use of bone scintigraphy and computer tomography has been noted to contribute to early reveal of the disease. Different methods of radical surgical intervention, and factors influencing the choice of optimal therapeutic management have been analyzed. Gravitational therapy is considered to be an important part of postoperative treatment.

Arginine-glycine-aspartic acids (RGD) are ones among the main participants of cell adhesion; they recognize the sequences in cell adhesion molecules, being high-affinity ligands for integrine receptors on cells, including stem cells and progenitor cells of bone marrow. In this work the regulating effect of RGD peptides on osteogenic potential of nanostructural calcium-phosphate (CP) coatings of different kinds has been examined using the test of ectopic osteogenesis (in vivo bioreactor). RGD peptides modulated distribution, functional activity and differentiation of bone marrow stromal and hemopoietic cells. Nevertheless, they inhibit the adhesion of bone marrow stem cells, and impair bone tissue remodeling. This fact may restrict their prospects for bone tissue engineering on CP coatings.

The mechanisms of organism allergic reorganization on the contractile function of the isolated «fast» skeletal muscle of mice leg – extensor digitorum longus, have been studied. It has been demonstrated that in case of protein sensitization the contractile force of “fast” muscle produced by cholinoceptive carbacholine decreases. It has been also found that protein sensitization results in the decrease of acetylcholine non-quant secretion in the muscle fiber end-plate zone of “fast” skeletal muscle. The vector of contractile force change of skeletal muscle under cholinomimetic influence for protein sensitization correlates with the change in acetylcholine non-quantal secretion. It has been suggested, that the mechanisms of the change in “fast” skeletal muscle contractile function for protein sensitization are first of all caused by the dynamics of cholinomediated processes of membrane excitation in skeletal muscle fibers.

The effect of distraction osteosynthesis on subsequent growth of congenitally shortened leg has been evaluated in 86 patients. While comparing the measurements of lengthening outcomes, the authors reveal the stimulating effect of high-division monofocal distraction osteosynthesis on subsequent growth of leg bones. Simultaneous femoral lengthening does not oppress the development of congenitally shortened leg. Reconstruction of foot bones has a negative effect on subsequent growth of leg bones. Multi-stage lengthening of leg bones has a negative effect on segment development as well. Use of osteogenesis stimulation techniques, as well as performing derotations at the level of forming distraction regenerated bones, subsequently leads not only to maintaining the measurements of leg growth rate, but to their decrease too.

Muscular adaptability and plasticity has been analyzed during limb lengthening depending on distraction mode. Regeneration of the muscle fibers, subjected to degenerative death during distraction, manifests itself by formation of discrete myotubes, separated by fibrous scar layers. Local injuries often lead to formation of split fibers. Low-division distraction contributes to effective regeneration and adaptation growth of contractile elements, but during fixation atrophy occurrences predominate; after fixator removal the size characteristics of type I muscle fibers recover, but not those of type II muscle fibers. High-division autodistraction induces more complete recapitulation of postnatal growth, than low-division one; after the fixator removal the muscle fibers of the mucle been lengthened become hypertrophied, normal size relations of the fibers of slow and fast type recover.

Current conceptions of structural adaptation of nerve fibers to limb lengthening for ontogenesis and distraction osteosynthesis are presented according to literature data and to the authors’ own studies of 89 dogs.

116 patients with limb shortenings and deformities of different etiology have been examined to study the condition of maternal bone before and after lengthening using the techniques of computer tomography (CT) and those of magnetic-resonance one (MRT). The results obtained demonstrated that the change in the density of different femoral and tibial parts before and after treatment was characterized by nosological features, the organotypical reorganization of the bone lengthened was completed within 1-3-year period with variations depending on disease etiology, the degree of pathomorphological and biomechanical changes, limb function. The density of cortical plate during lengthening and in the period of fixation 200-300 HU decreased, and after fixator removal it 300-400 HU increased, thereby demonstrating the normal processes of bone tissue remodeling after lengthening.

The width of external and internal cortical layers, as well as that of tibial and fibular medullary cavities has been studied by x-rays of youths at the age of 18,9±1,3 years with varus position of lower limb axis from “golden section” position.

The experience of surgical treatment of 11 patients with patellar extension dislocation of congenital etiology has been summarized. In two of them surgery has been performed for both knees. The techniques of preoperative examination are described, as well as indications for the surgical treatment, and its performance. The surgery was used, directed to decreasing the angle of m. vastus lateralis tendon insertion to m. rectus femoris tendon and patella, strengthening its tendinous-and-ligamentous apparatus, as well as the fibrous capsule of the patellofemoral joint from inside. In case more than 10-mm lateral displacement of the patellar ligament it was moved medially. In case of patella high setting it was brought down by the amount required, calculated before surgery. After surgery patellar fixation was performed with the Ilizarov device, configuration of which gave the possibility to start of the knee training early. Good result was achieved in all 14 cases.

The authors present the main symptoms characterizing the syndrome of patellar disbalance. Moreover, surgical tactics for the syndrome of patellar disbalance is given depending on its constitutive symptoms.

The authors have proposed an original approach to leg weight-bearing restoration in case of tibiofibular synostosis failure; this approach consists in purposeful formation of additional tibiofibular synostoses and correction of segment biomechanical axis. Differentiated use of the osteosynthesis techniques developed allows to reduce the probability of tibia nonunion recurrences.

A new technology for the hip cementless endoprosthesis implantation with bone autoplasty of posttraumatic acetabular marginal defect is presented. RF patent has been taken out for this technique. The authors illustrate the technique with a clinical example.

The results of complex examination and treatment of 240 patients with spondyloarthrosis have been analyzed. The effect of risk factors on spondyloarthrosis has been studied, as well as the features of the disease clinical course and tactics of its treatment. Spondyloarthrosis has been revealed to be an independent cause of lumbar pain syndromes, amounting to 69,4 % of all the arthroses and ligamentoses of lumbar spine. Spondyloarthroses treatment is no trouble in case of correct and timely making the diagnosis, and competently performed preventive measures allow to avoid the disease repeated occurrences.

The results of surgical treatment have been studied in 86 patients, who were subjected to repeated interventions for degenerative diseases of lumbar spine. The details of surgical tactics for re-surgeries influencing results of treatment have been determined; and they consist in performing radical surgeries using modified laminectomy, and eliminating all the factors of neuronal and vascular structure compression, as well as eliminating instability by dynamic stabilization of the vertebral motor segment involved using loopy couplers of nitinol.

“Prevention of traumatism in the Ordzhonikidzevsky district of the city of Yekaterinburg” target complex program has been developed and introduced, which has united the efforts of different ministries and departments.

The data of analyzing medical-and-diagnostic aid on the basis of the standardized chart developed for detailed studying the structure of traumatological out-patient departments, differed in the form of rendering aid to population on the Horezm region example. The analysis made has demonstrated that introduction of the united standardized documentation with software has allowed as a whole to assess the activity of traumatological out-patient department and define physician’s actions concretely.

This work is based on the results of studying 455 victims with a combined trauma, urgently admitted to the reanimation-and-anesthesiology department of the Ufa Municipal Clinical Hospital within 2001-2006. The combined trauma takes place predominantly among the population of able-bodied age (83,3%) and mainly in male subjects (61%), leading to high lethality(36,5%). In most cases combined trauma reasons are traffic injuries (59,6%), high falls (27%), designed injuries (7,7%). Every third person is admitted in the condition of alcohol intoxication. Among the victims of traffic accidents in a megalopolis pedestrians predominate to a great extent (82,3%). For all the cohort the frequency of hospitalizations differs reliably in seasons of year (р=0,021), days of week (p=0,007), time within twenty-four hours (p less 0,001). Understanding through the reasons, regularities of victims’ admissions allows to carry out the work on warning prevention.

Rotation contracture for transosseous osteosynthesis of forearm injuries develops in 30-83 % of cases, and it’s caused by fixation of soft tissues to bone. In case of performing transosseous osteosynthesis for Monteggia injuries both techniques the isolated reposition of ulnar bone fragments and adaption of radial head to radial notch of ulna, are possible acutely or discretely by time depending on trauma duration period. A reposition device allows to move radial head in any plane. Training of forearm rotation movements starts with radius after subsystem dismounting. The range of rotation movements before ulna regeneration completion is 80/0/60. This technology was used for treatment of 15 patients. There were no complications.

This article reveals the urgency of the problem of treating patients with closed olecranon fractures. The clinical-and-statistical characteristic of 103 patients at the age from 7 to 76 years with closed olecranon fractures, who have been managed at the FSI RISC ―RTO‖ within the period of 1970- 2005. New techniques of transosseous osteosynthesis with the Ilizarov fixator have been modified and developed depending on olecranon fracture type. Long-term anatomic-and-functional results of treatment have been analyzed. High effectiveness of the transosseous osteosynthesis technologies used has been demonstrated in treatment of patients with olecranon fractures.

The mechanical properties of bone-implant system under the conditions of osteosynthesis different variants for tibial shaft fractures have been studied. Any variant of stable-and-functional osteosynthesis has been revealed to provide the greater stability of synthesized segment to increasing axial load than that of intact sample. The systems of intramedullary fixation have demonstrated the greatest stability to axial compression, however, the systems of extrafocal fixation have shown the longest stabilty to loading. The systems, fixed with LC-DCP plates, were the least strong among those examined, nevertheless, their stability was 22% more on the average, than that of the intact samples of control group.

The authors have proposed transosseous osteosynthesis techniques using rod bone fixators for treatment of patients with leg bone shaft fractures. The use of the techniques worked out gives the possibility to improve treatment results at the expense of decreasing complications in number.

The results of rehabilitation of 84 patients with type C3 intraarticular fractures of lower limbs have been studied. In 15 (17,9%) patients autografts were used for bone defect filling, in 69 (82,1%) cases – porous implants were used. Fixation was performed according to the technologies of transosseous and external bone osteosynthesis. The most effective method is that ofcombination of bone defect plastic filling combined with transosseous osteosynthesis.