A variant of surgical tactics in treatment of the hip subluxation in children caused by the developmental defect of acetabular arch has been proposed. The mathematical substantiation of using this method is presented. The rules of postoperative management of patients undergone surgical treatment have been proposed. The immediate and long-term results of treating children with the hip congenital subluxation have been followed after the introduction of the treatment-and-diagnosis algorithm proposed.

A new technique of triple pelvic osteotomy has been developed for treating children with the hip congenital pathology. Ischial bone transection is made from the interfragmental approach after femoral osteotomy performance. In this case no additional approach to it is required, thereby decreasing the intervention invasiveness. The pubic bone should be transected at the base, the iliac one – transversely or semicircularly above the lower anterior iliac spine. The bone fragment resected during femoral osteotomy is used for defect filling and fixation of the mobilized acetabular fragment in the supraacetabular area. The technique proposed has been applied to 13 children at the age of 9-14 years in 14 joints for pathology of dysplastic genesis (in 9 joints of 8 patients), for osteomyelitis consequences (2), aseptic necrosis outcome after conservative treatment of the hip congenital dislocation (1), Perthes disease (1), the hip paralytic dislocation (1). Follow-up after surgery was from 6 months to 6 years. Positive clinical-and-roentgenological dynamics has been observed while studying the results obtained, as well as congruence and stability of the hip has been achieved, injuries of neurovascular masses have been noted in no cases, complete bone covering of the femoral head has been got. The technique proposed allows to reduce technical difficulties and secure surgical intervention for one-stage reconstruction of pelvic and femoral components.

The results of the comparative evaluation of Dopplerography parameters in children with the hip irreducible congenital dislocation have been analyzed. Dopplerography examination of 36 patients (58 joints, among them 10 belonged to control group, 26 joints – before treatment and 22 one – after surgery) has been performed in the clinic of SRITO of the Ministry of Health of the Republic of Uzbekistan. The patients were divided into 3 groups for the purpose of comparative evaluation of the hip circulation disorders. It has been established that in case of the hip irreducible dislocations after a single unsuccessful reposition procedure during surgical intervention the reliable significant increase of mean Dopplerography parameters occurred in the second group of patients comparing with control group, thereby evidencing the recovery of the hip circulation and approximation to normal parameters.

The aim of this work is to study the possibilities of individual surgical treatment of femoral neck fractures in subjects of young and middle age. The optical density of proximal femoral cancellous bone tissue was determined preoperatively using digital computer technologies. Computer modeling of the dynamics of mechanical properties, the parameters of proximal femoral cancellous bone structure and compression forces produced by threaded fixators was performed based on the data obtained. Individualization of the surgical treatment of femoral neck fractures consisted in applying rigid threaded fixators with the pre-calculated tightening moment. Fracture union was achieved in 18 subjects of young and middle age among 19 as a result of surgical treatment of femoral neck fractures using the technology mentioned. Thus, the technique has been developed providing an individual approach to osteosynthesis of femoral neck fractures by using threaded fixators and allowing to reduce significantly the number of unfavorable outcomes for femoral neck osteosynthesis in subjects of young and middle age.

The results of anterior decompression are presented in 20 patients with comminuted fractures of lumbar vertebrae accompanied by spinal canal critical stenosis. The monitoring at the stage of decompression in the study group (n = 10) was performed using a video endoscopic bar, in the control one (n = 10) – "ad oculus". The use of endoscopically assisted anterior decompression for lumbar vertebral injuries allowed to decrease the duration of surgery and reduce the amount of intraoperative blood loss (p less 0.05).

The problem of development of the complex nervous system providing a controlling function in ontogenesis in patients with I-II
degree scoliosis is of current interest, and it is little worked out. The aim of the present work was to study ontogenesis of specific and
non-specific regulatory systems in patients with I-II degree scoliosis on the basis of the probabilistic analysis of the brain bioelectrical background activity. The studies were performed in 104 patients at the age of 7-18 years with I-II degree scoliosis. The functional condition of cerebral hemisphere cortex was evaluated by the data of frontoparietal lead EEG. The reliably high values of Δ- and θ-rhythm activity were obtained in patients of the age-related group of 6-10 years, as well as the low values of α2- and β-activity, in comparison with other age-related groups thereby evidencing the immaturity of both the frontothalamic and non-specific regulatory systems. Complete maturation of the brain regulatory systems in patients with I-II degree scoliosis takes place by the age of 18 years.

The work demonstrates the results of examination of 162 patients with pathological compression and comminuted fractures of the spine associated with osteoporosis. Radiation methods of diagnosis were used as follows: radiography of the spine, dual-energy X-ray absorptiometry (DEXA), computer tomography (CT) and multispiral computer tomography (MSCT). The characteristic types of vertebral body deformities are described depending on the presence or absence of the case history of the spine injury, as well as the sings of stable and unstable fractures revealed with CT and MSCT. The findings of DEXA as a method required for complex examination of patients with the pathology mentioned are analyzed.

Aim of Study. To analyze the effect of «Kollapan» preparation on the processes of bone tissue regeneration for the spine experimental osteomyelitis. Materials and Methods. The experimental osteomyelitic defects of rat tail vertebrae were filled with “Kollapan” preparation. Animals were clinically observed in the postoperative period, and histological samples were studied radiographically and morphologically in the periods of one, three and six months. Results. Bone block has been formed by the period of 6 months after surgery when “Kollapan” is used for bone tissue defect filling. Conclusions. The experimental model of the spine chronic osteomyelitis in rats has been developed which allows to study the processes of reparative osteogenesis and “Kollapan” effect on it. Surgical debridement of the spine osteomyelitic process using “Kollapan” material contributes to bone block formation and to complete regression of inflammatory episodes with recurrence absence and animal recovery.

The cases of closed thoracic injuries have been analyzed in clinical practice and during sectional investigation in children. Rib injury character, incidence and localization of incomplete fractures have been studied, as well as correlation of the parameter investigated in view of injury mechanism, injury severity and children age. The tactics of clinical examination of children with severe thoracic injury has been substantiated, as well as that in lethal outcomes – details of medicolegal examination.

Aim: to determine the role of osteoclast-osteoblast remodeling (OOR) as a mechanism responsible for morphofunctional skeletal stability and fatigue injury elimination from functional osteology point of view. Based on the data of literature and their own findings the authors have revealed two mechanisms of fatigue micro-injury elimination. The first mechanism begins with resorption of the involved area and subsequent deposition of new bone tissue (OOR), the second one is responsible for filling the gap space with mineralized bone tissue without cement line formation and preliminary resorption. It is suggested that the initiation of the mechanisms of fatigue micro-injury elimination is regulated by feedback principle: the higher is the level of cyclic deformities, the more active is the process of filling without preliminary resorption, and, vice versa, the less is the level of deformity, the more intense is resorption activation with delayed deposition of bone tissue within the space of resorption lacuna. In its essence OOR is a local regulator of the degree of bone structure deformability, because, according to the laws of material science, resorption cavities while decreasing the modulus of elasticity of any material, increase its deformability. The greater is porosity, the higher is deformity level, and vice versa. As a result, optimization of the level of cyclic deformities is provided, initiating the convectional fluid flow along the lacunar-andcanalicular system and delivery of nutritious substances, regulators, etc. to osteocytes, as well as withdrawal of residues from them.

The morphological features of reparative osteogenesis have been studied experimentally in rats for bone fracture healing under the conditions of transosseous osteosynthesis performance and EHF-range electromagnetic radiation influence. Irradiation was made simultaneously with two radiators (EHF noise spectrum) in the occipitoparietal zone and in that of fracture for 10 minutes every other day. Both the formation of regenerated bone and the consolidation of fragments have been established to occur earlier, as well as the processes of reorganization and compactization of newly formed bone tissue – to occur more rapidly, the degree of its maturity – to increase, comparing with control.

The authors have studied the effect of implantation materials based on calcium-phosphate compounds (CPhC), isolated from mature bovine compact bone tissue, into which both organic matrix derived from bovine bone tissue and polypeptide growth factors isolated from serum of animals with active osteogenesis – serum proteins, were injected to improve osteoinduction properties. Animals were divided into five groups: 1) that without implantation; 2) that where bone defects were filled with CPhC; 3) where bone defects were filled with biocomposite having CPhC and organic matrix in its composition; 4) where bone defects were filled with biocomposite including CPhC and serum proteins; 5) where bone defects were filled with biocomposite containing CPhC, organic matrix and serum proteins. The results of x-ray study and those of the dynamics of defect shadow optical density by the digitized x-ray images have demonstrated that addition of CPhC-based implantation materials composed with both organic matrix and serum proteins contribute to defect filling.

10), as well as that of similarly isolated blood serum fraction of somatically normal donors (the reference group, n=10). The content of proteins, protein fractions, hydroxyproline, sialic and uronic acids, and also that of insulin-like growth factor-1 was studied. The fraction of the main group has been found to consist of polypeptide- and carbohydrate-origin components and to contain more than 20-fold higher concentration of insulin-like growth factor-1 in comparison with the reference group fraction.

The results of surgical treatment of 39 patients with consequences of humeral shaft fractures are presented in the work. The description and evaluation of the clinical effectiveness of the new developed techniques of osteogenesis stimulation under stable fixation of fragments are demonstrated during rehabilitation of patients with humeral non-united fractures and pseudoarthroses.

A study performed in all the St. Petersburg traumatologic-and-orthopedic departments simultaneously has demonstrated that the proportion of patients with indications for transosseous osteosynthesis performance amounts to 0.6-1.6%. Among them 43% are socially unprotected. The necessity for staying 45% of patients in a hospital for a long time (above 3 weeks) is connected not only with transosseous osteosynthesis technology, but with inadequate work of out-patient departments as well. It has been found that 86% of traumatologists questioned have no adequate specialized training in the field of external fixation. The current state of external fixation presupposes two levels of its organization: "traumatologic (urgent)" and "orthopedic" which differ significantly in the required level of specialist training, equipping and treatment process organization. There is a need for foundation of the specialized centre for treatment of difficult orthopedic-and-traumatologic pathology with the use of transosseous osteosynthesis technologies, the adoption of progressive techniques and the perfection of the known ones, as well as for methodical and educational support organizing.

The work deals with the problems of femoral lengthening and surgical elimination of the patellar dislocation of congenital etiology. 21 patients were observed who underwent femoral lengthening and patellar dislocation correction at different times. The results of femoral lengthening are compared before and after patellar dislocation repositioning, and in two patients – for simultaneous femoral lengthening and dislocation correction. The results of lengthening are analyzed for the congenitally shortened femur complicated by severe patellar dislocation in six patients and in two of them – by flexion-and-extension contracture and posterolateral rotary subluxation of the leg as well. The best functional results have been obtained for femoral lengthening after preliminary elimination of patellar dislocation.

The elbow injuries are the first in the number of posttraumatic complications, and they lead to persistent disability of patients in 29.9% of cases. The made analysis of treatment of children with the elbow contractures has revealed the achievement of good long-term results of the upper limb function recovery in case of complex orthopedic-and-surgical treatment.

A case of treating a patient with tibial upper-third varus-and-recurvation deformity combined with the knee instability and limb shortening is demonstrated. The Ilizarov fixator use has allowed to restore the segment anatomical axis, as well as to compensate for the shortening with maintainance of the joint mobility. Surgical intervention contributed to the knee stability increase and limb weight-bearing recovery.

The work deals with biotribology possibilities in diagnostics of the knee conditions using arthrophonography. The results are presented as the method sensitivity, specificity and predictive value for revealing the most widespread injuries of the knee.

The work deals with the data concerning analyzing the special features of immune status in 159 patients with idiopathic, hypoplastic, posttraumatic osteoarthrosis of the knee and the hip, coxarthrosis – the outcome of femoral head aseptic necrosis (FHAN), osteoarthrosis of large joints, developed through rheumatoid arthritis.

The experience of treatment of 95 patients with different posttraumatic stumps of the hand has been summarized. New techniques of surgical treatment based on the principles of local plastic surgeries have been proposed for the purpose of grasp function recovery. Reconstruction character conformed to the hand posttraumatic defect shape. The improvement of the hand stump functional potentials has been achieved in most cases (92%).

The results of treatment of 53 primary school age children (7-11 years old) with congenital recurrent clubfoot, treated in RISC «RTO» clinic within the period of 1999-2010 by transosseous osteosynthesis method, have been analyzed. Long-term results have been followed in 39 (73.6%) patients, good results of treatment were observed in 66.7% of cases.

We have examined 109 children at the age from 2 months to 14 years in order to study ultrasonography potentials of bone age determination. The study is based on comparing the left hand X-rays with ultrasound scan data using the technique proposed by us. As it has been established, the ultrasound scan method is characterized by high sensitivity, specificity and accuracy for all age-related groups. The method proposed makes it possible to reveal earlier the ossification foci consisting of non-mineralized or little mineralized bone tissue which have not yet been determined by x-rays.

New information has been obtained concerning the dynamics of histological structure changes, stereological characteristics and vascularization of canine anterior tibial muscle during reinnervation based on the data of experiments using 34 adult mongrel dogs, and the effect of cerebrolysin paraneural injections on the muscle reinnervation and revascularization has been studied.

Histological changes of the anterior tibial muscle, the artery of the same name and the branches of the deep peroneal nerve have been studied experimentally in 7 dogs during leg lengthening at the upper-third level by 1 mm for 4 times, computer morphometry of the muscle has been made. The syndrome of the anterior tibial artery compression was revealed in 3 experiments of 7, the reparative reaction to intima injury – subintimal and myointimal hyperplasia, lumen stenosing was observed in most perimysial arteries in all the experiments. Hypovascularization and the disorder of myon neurotrophism was marked for up to 30 days after the fixator removal. Lengthening at the level of leg upper third seems to be less advantageous in comparison with lengthening at the level of shaft middle third.

An overview of studies on the physical-and-chemical, biochemical, immunological properties of synovial fluid normally and for pathology development is represented in the work, as well as the possibilities and prospects of their use in clinical practice.

The review of the literature on the heredity problems of cobbler’s chest and keeled chest deformities is presented in the work, as well as related genetic syndromes and chromosome aberrations.

The case report is presented: male patient M., 22 years old. The diagnosis on admission: combined injury. Open fracture of right
leg bones, displacement of fragments. Chest and liver contusion. CT examination has revealed the displacement of the liver to the thoracic cavity, its upper margin being at the level of rib 5; S4, S6, S9, S10 atelectasis on the right, suspected diaphragmatic rupture. Postoperative diagnosis: combined injury. Posttraumatic diaphragmatic rupture on the right. The contusion of the lower lobe of the right lung. Open comminuted fracture of both leg bones in the middle third with displacement of fragments. Closed fracture of the main phalanx of the right hand finger III without displacement. Early postoperative period was uneventful. The patient was discharged in satisfactory condition on Day 14 for outpatient treatment.

The unit of bone fixation has been developed, which consists of the half-pin for osteosynthesis used in wire-pin devices with longitudinal slots made in it, as well as of wires and a coupling fixing wires in the slots. The arrangement of the fixation unit components is shown once inserted into bone, and the results of the unit evaluation testing experimentally and clinically are presented.