The original approach to leg weight-bearing restoration according to the Ilizarov method is described for the “acute” diaphyseal tibial defect present. The potentials of transosseous osteosynthesis in treatment of severe leg tissue destructions are demonstrated: the transosseous osteosynthesis allows to make radical debridement of soft-tissue and bone wounds creating “comfort” conditions for tissue defect filling at the expense of fibular transposition at a single stage of treatment.

Open femoral fractures are a serious problem of the traumatology of our country. There is no consensus about osteosynthesis techniques for these fractures. Some authors suggest treatment with external fixators only, others — to use consecutive osteosynthesis. The primary, delayed intramedullary osteosynthesis of open femoral fractures has been analyzed by us, as well as treatment of
these injuries using external fixators.

A new device (Author Certificate No. 42528 PK) for osteosynthesis of proximal humeral fractures has been developed. Osteosynthesis stability of proximal humeral fractures using traditional fixators and the new device has been studied experimentally. As a result of the experimental studies it has been established that the application of 2,5‑fold greater efforts is required for the fixation stability disorder of the fracture modeled with the device proposed, than for fixation with T‑shaped plates, and those 3,5‑fold greater than for fixation with wires and using the wire. The data obtained in the process of experimental study reliably evidence the feasibility of using the new device in clinical practice.

for implantation of proximal fixation femoral components CORAIL (DePuy) and TAPERLOCK (Biomet) in 2 groups of patients with coxarthrosis of different etiology and aseptic necrosis of the femoral head. 126 patients underwent 131 surgeries of primary total endoprosthetics using «Corail» stem, 95 patients — 103 surgeries of primary total endoprosthetics using «Taperlock» stem. Clinical assessment of the hip condition was made according to Harris scale, supplemented by the evaluation of the pain level for femur by a visual analog scale at three levels. In the process of assessing the clinical and radiological results of the femoral components in both groups the preference of using the proximal fixation femoral components has been revealed in all age-related groups, especially in young and active patients.

The data of radiographic examination of 18 adolescents with dysplastic coxarthrosis undergone reorienting pelvic osteotomy have been studied. The surgical intervention in the adolescent group analyzed contributed to partial acetabular remodeling, which mainly manifested itself in the change of acetabular vault shape and orientation and, to a lesser extent, as acetabular deepening. Acetabular vault formation occurred within the first 8-9 months after surgery, and the increase of deepening was observed 6-12 months after the fixator removal. The character of radiographic value change has demonstrated that the reconstructive intervention in the hip of the patients of the group studied contributes to coxarthrosis progress slowdown.

Many authors assess the pain syndrome manifestation and the hip osteoarthrosis degree by using different scales and tests, that sometimes leads to difficulties in comparison of the study results. The comparison of VAS values and MacGill, Lecken, Womac, Harris indices in 69 patients with coxarthrosis of 2-3 stage has been made. Correlation coefficients and regression equations have been revealed while comparing different values, including those for comparing with radiologic osteoarthrosis degree assessment.

The muscle strength and biomechanical parameters of walking have been studied in 136 patients with 1, 2, and 3 stage coxathrosis before and after complex conservative treatment. The strength increase of the muscles of uninvolved lower limb segments, the reduction of time-related stride parameters of the limb involved, the increase of functional loading of the support surface of both limbs was observed as a result of treatment.

The preliminary results of experimental osteoarthrosis modeling in dogs by the knee immobilization and femoral artery cutting are presented. The immediate results of the assessment of articular cartilage morphofunctional condition evidence the development of dystrophic changes, manifested themselves in death and destruction of a part of chondrocytes, disorder of extracellular matrix homogeneity and decrease of morphometrable parameters – cartilage thickness, volume and number density of chondrocytes. The changes mentioned appear as a result of disordering the metabolic processes in articular cartilage evidencing the decrease of synthesis and the prevalence of catabolic processes. Under these experimental conditions the articular cartilage cambium has been the most vulnerable – it is an intermediate zone, the cells of which are equidistant from both the vascular and synovial nutritional factors.

The results of studying the impact of regeneration cytotherapy on the process of I stage posttraumatic gonarthrosis with primary III-IV degree chondromalacia in laboratory animals are presented. It has been revealed, that using regeneration cytotherapy allows not only to improve the results of medical measures, but to stop the progression of the pathological morphological changes in the knee tissues effectively, as well as to achieve significant regression of the latters in the articular cartilage.

The results of diagnostics and treatment using arthroscopic technique are presented for thirty patients with the knee pathology, 12 ones among whom have undergone the procedure of acute meniscus cyst removal. Arthroscopy gives the possibility of acute revealing intraarticular changes, assessing cyst character and type, as well as determining the tactics of surgical treatment in each case.

The possibility of producing high concentration of antibiotics in the lymphatic system, long exposure due to slow lymph flowing, blocking infection lymphogenous spreading – this is an important advantage of the lymphatic antibiotic therapy in comparison with other methods.

Aim of Study: To suggest the use of the symptom of atypical hair growth (SAHG) in the spine zone for early diagnosing both dysplastic scolioses (DS) and congenital scolioses (CS). Since 1989 we have revealed a visual sign in 1028 of 3110 patients with scoliosisof the spine: thehair growth occurs as a centre-converging spiral looking like a snail shell, similar to the hair growth in theparietal zone. SAHG is roentgennegative. Before radiography making the tip of metal injection needle should be positioned in the centre ofthe hair twisting. The middle oftwisting for CS is in the projection of lateral semivertebrae with additional ribs, fused vertebrae,butterfly-shaped vertebrae. SAHG for DS conforms to the apex of scoliotic arch. In SAHG projection unilateral aplasia, hypoplasia or hyperplasia of ribs, that of transverse, spinous, articular processes can be determined, as well as the radiological changes characteristic of the vertebrae of scoliotic deformity apex. It is advisable to use SAHG in the spine zone for DS and CS early detection and timely treatment.

Diagnostic-and-treatment algorithm of rendering medical care in patients with fractures of the spine and spinal cord injuries has been developed and adopted. A neuro-orthopedic approach to the diagnostics and treatment of such patients has been proposed depending on injury character and time from injury. Modern methods of diagnosing the occult dysfunctions of the spinal cord and its terminal parts in the preclinical phase are presented in patients with unstable fractures of the spine. The indications for active surgical tactics of treatment of patients with spinal fractures and their postoperative management have been developed on the basis of clinical-and-radiological examination, magnetic resonance imaging, electroneuromyographic and biomechanical studies. The biomechanically reasonable techniques of effective and little-invasive correction of spinal deformity and closed decompression of the spinal cord and its derivatives, efficient in patients with fresh and neglected fractures of the spine, have been proposed. The developed technique for osteosynthesis of the spine using an external fixator allows to provide early activation of the persons injured, significantly reduces the periods of vertebral fracture consolidation and prevents disability in patients.

X‑rays, CT and MRI scans of the cervical spine have been analyzed in 70 patients with injuries. The diagnostic value of doubleview radiography has been assessed in the process of verifying cervical injuries. Lateral radiography has been established to provide the verification of posterior column in case of cervical injuries only in 45.3% of the cases.

The aim of this work was to make the neurophysiological evaluation of age and gender modulatory effect on the manifestation degree of sensomotor deficiency in patients with lumbar spondylolisthesis. Eighty eight patients at the age of 13–77 years (38 males, 50 — females) with spondylolistheses of different etiology have undergone complex neurophysiologic testing (global EMG, M‑response, H‑reflex, transcranially evoked potential). Age and gender have been established to have a distinct modulatory effect on the dynamics of developing pathological changes in the compressed radicular structures of patients with the spine disease mentioned.

The study of the urinary system condition has been performed in 31 patients with spine-and-spinal cord injuries using ultrasonography and excretory urography. The diffuse changes in the kidneys, the presence of concrements, the dilatation and deformation of the renal pelvicaliceal system, as well as the decrease of renal accumulative and excretory function has been revealed in the patients of this category. The thickening of urinary bladder wall, structural heterogeneity, the presence of suspension in the urinary bladder cavity was observed too. And, besides, the increase of prostate volume with vesiculitis signs.

4400 children and adolescents at the age of 7–17 years, belonging to the indigenous and nonindigenous population of the Far North, have been examined by the method of optical computer topography in the town of Nizhnevartovsk and in the area of Khanty-Mansi Autonomous Okrug. 1000 children among them are representatives of the indigenous population: the Khanty, Mansy, Nenets. The distinctive features have been revealed in posture and body structure, as well as in vertebral deformation pathology prevalence in the indigenous and nonindigenous population of the North. The body in the nonindigenous population is characterized by its pronounced longitudinal size and worse posture parameters. As for the indigenous population, the body is characterized by the pronounced transverse size and better parameters of posture condition in comparison with newcomers. Thus, scoliosis prevalence in the indigenous population amounts to 8.7%, while that in the nonindigenous population — 17.9%, respectively.

Peripheral nerve neuropathies impair active movements of the upper limbs significantly, severely limit the abilities of working activity, static-and-dynamic function of the lower limbs, as well as they represent significant challenges for rehabilitation. 115 patients with traumatic injuries of brachial plexus and peripheral nerves undergone direct puncture electrical stimulation have been treated in the department of neurosurgery within the period of 2004–2010. Positive results have been obtained in 76.53% of cases.

The problems of the importance of tendinous graft length determination in tendoplasty of 2–5 finger deep flexors have been considered. The mathematical modeling of finger flexion function has been made by us with evidencing the function disorder in case of the improper choice of tendinous graft length. An anatomical study using cadaver material has been performed, and the regularity of the graft length dependence on the main finger phalanx length has been deduced. 48 patients were treated using preliminary determination of graft length and early postoperative rehabilitation according to H. Kleinert with obtaining 74 % of good and excellent results.

The parameters of cellular and humoral immunity have been studied in 35 patients with solitary bone cysts at the stages of osteoplastic filling of cystic cavity. There were No changes revealed in the systemic immune response parameters before surgical interventions, the level of the main class immunoglobulins in peripheral blood and bone punctate had No statistically significant differences. The moderate decrease of lymphocyte number, the increase of immature neutrophils and mature ones was registered under tension conditions by compression or distraction of bone fragments and at the stage of fixation. The parameters studied did not differ reliably from the initial ones and they did not extend beyond the boundaries of physiological norm 1–5 years after the fixator removal.

The results of clinical and experimental-and-morphological studies of regenerated tissues being formed in filling large defects of abdominal wall and those of tibia under using implants of different biomaterials have been analyzed. Good perspectives have been demonstrated concerning the use of titanium nickelide grid constructions for successive surgical treatment of such diseases.

The comparative analysis of the X-ray signs of postoperative bone osteoreparation has been made in children after surgeries made using allogenic bone, non-biological implants based on calcium sulfate (Osteoset T) and hydroxyl apatite-tricalcium phosphate complex (BCP). The long-term results have been followed within the period of 12–32 months. The parameters of bone tissue optical density in the plasty zone by radiography data reach those of normal bone after 12 months in case of spongy allobone use and after 6 months in case of using calcium sulfate granules, while the use of hydroxyl apatite-tricalcium phosphate complex leads to 65%-excess of optical density parameters with dynamic preservation of this effect thereby reflecting incomplete implant resorption.

Computer tomography (CT) and densitometry (DXA) were used to study structure, density and mineral density (BMD) of lower limb bones in 32 patients with vitamin D-resistant rickets and in those with vitamin D-deficient rickets consequences. In patients with vitamin D-resistant rickets a roughly trabecular structure with trabeculae located in random way preponderated in epimetaphyseal bone parts, the least values of bone density were observed in femoral and tibial epiphyses (175 ± 85 HU and 174 ± 84 HU, respectively), there was bone age lagging behind the passport one, while in patients with vitamin D-deficient rickets consequences both epiphyses and metaphyses have fine cellular structure, zones of preliminary calcification are represented by isolated thin strips of sclerosis, bone age conforms to the passport one.

The use of intramedullary bioactive osteosynthesis combined with the Ilizarov fixator contributes to correction of skeletal deformities, allows to put patients with osteogenesis imperfecta on their feet. The morphofunctional parameters of culture of peripheral blood mononuclear cells can be considered as the probable markers and predictors of osteogenesis imperfecta process and duration of patients’ rehabilitation.

Composite implantation material, which consists of a calcium phosphate compound and the non-collagen proteins, isolated from bone tissue and having No affinity to ion exchangers, was implanted into tibial metaphyses of 10 dogs. The stimulating effect of the composite material developed on bone tissue regeneration in the zone of metaphysis has been established. The filling of defects was based on direct osteogenesis.

The metabolism of the main energy supply substrates of skeletal muscles has been studied for leg bone lengthening according to the Ilizarov method. The intensive glycogen consumption has been demonstrated to occur in the anterior tibial muscle of the limb segment being lengthened, the gastrocnemius muscle has been shown to use blood glucose and intracellular reserves of lipids as energy substrates. It has been determined that the similar muscles of contralateral limb segment use extra-muscular energy substrates (glucose and blood lipids).

The anatomical details of the tibia (length, curvature, Herzog corner, the size of the narrowest part of medullary cavity and the parameters of its upper and lower parts) have been studied clinically and by x-rays in youths of different constitution types.

The mechanisms of influencing the organism allergic reorganization on the contractile function of a mouse diaphragm (MD) muscle strip have been studied. In has been demonstrated that in case of protein sensitization (PS) the increase of the power of the contraction (PC) produced by cholinomimetic carbacholinum (ChC) in MD in vitro is observed, as well as the decrease of acetylcholine (ACh) nonquantum secretion (NQS) in the zone of end plate. PC increase under ChC is a consequence of the cholinomimetic sensitivity increase of muscle fiber postsynaptic membrane due to the decrease of ACh NQS in the zone of end plate. Exogenous ATP also increases PC and decreases ACh NQS of MD in both intact and sensitized mice. The vector of muscle PC dynamics under the cholinomimetic correlates with ACh NQS for all the variants of experimental influence. However, the extent of these changes in the muscle of a sensitized animal is less pronounced than in a non-sensitized animal. It is speculated that the lesser variability of functional properties caused by ATP in MD of sensitized mice compared with control is an evidence of developing mechanisms of the resistance for external loads in respiratory muscles, which appears for bronchospastic syndrome and bronchial asthma.

The institute archives’ materials have been presented for the first time, which deal with the organization and work of the Sverdlovsk UNIITO research laboratory on the problems of bone tissue regeneration under compression on the base of Municipal Hospital No 2 of Kurgan within the period of 1966–1969, as well as with its head, G.A. Ilizarov.

The analytical review of the literature is presented on the problem of predicting the results of surgical treatment for lumbar intervertebral disc herniations. At present the scientific researches in this field attract more and more attention of scientists. The urgency of the problem studied in the field of vertebral surgery does not give rise to doubts. Despite great achievements in the modernizing the methods and technologies of surgical interventions the number of reoperations for recurrent intervertebral disc herniation can not comply with the outcomes desired. The study was based on the abstracts from PubMed database, the articles published in The Journal of Bone and Joint Surgery, Spine, European Spine Journal, as well as Ukrainian and Russian medical journals for the last 15 years; books and articles of previous years were used if necessary.