Purpose. To evaluate the potential of using the acromial clavicular end fixation with the Ilizarov fixator.
Materials and Methods. The results of treatment analyzed in 65 patients with the acromioclavicular articulation tears. The technique of closed resetting of the clavicle with subsequent fixation using the Ilizarov fixator made in 42 patients with fresh and old injuries. Open resetting of the clavicular acromial end dislocation, as well as lavsan-plasty with further external fixation using the Ilizarov fixator performed in 12 patients. Open reduction of the ligamentous apparatus with lavsan prosthesis made in 6 patients with long-standing injuries, and fixation of the acromioclavicular articulation performed using the Ilizarov fixator in 5 patients.
Results. Long-term outcomes traced in all the patients, positive results of treatment obtained in 100 % of cases.
Conclusion. The use of transosseous osteosynthesis with the Ilizarov fixator for the acromioclavicular joint restoration demonstrated its high effectiveness.

Purpose. To analyze the errors made during treatment, and to develop the ways of their prevention.
Materials and Methods. The results of surgical treatment analyzed in 90 patients with intra-articular fractures of proximal tibia.
Results. 18 cases of local complications revealed during the analysis, that amounted to 18.1%. The key positions highlighted which allowed preventing local complication development in surgical treatment of intra-articular fractures.
Conclusion. CT and MRI use to verify articular involvement, as well as observation of the main principles of intra-articular fracture surgical treatment such as open osteosynthesis with articular surface integrity restoration and subchondral defect filling by using bone auto- and alloplasty, biocomposite materials, primarily stable osteosynthesis using support metal fixators, and a competent program of rehabilitation – all this allows to reduce the rate of errors and complications significantly.

Purpose. To work out an effective and simple technique for determination of the size and direction of rotational displacements by two standard x-ray views based on the regularities of changes in linear parameters of fragments for different direction and angles of their rotation around their own axis.
Material and Methods. The technique for rotational displacement diagnostics for fractures developed on the basis of leg bone tomogram analysis.
Results. The simplicity and accuracy of the proposed technique proved by clinical examples.
Conclusion. The use of the technique proposed allows to facilitate the diagnostics and elimination of fragment rotational displacements in case of leg bone fractures to a great extent.

We studied 34 severely injured open fractures of long bones, managed by Ilizarov external fixator in National Institute of Traumatology and Orthopaedic Rehabilitation, Pink unit-II (Ilizarov, Deformity Correction and Reconstruction Unit) Dhaka, Bangladesh. All the patients were selected according to inclusion criteria and through counseling the patients and his/her relative. Duration of study was 2 years. Average post-operative hospital stay was 10 days. Pin sites inflammation, pin loosening and pain at rest, swelling of leg and thigh were the commonest complications in our study. Average union time was 20 weeks and union rate was 100%. Close adherences to Ilizarov principles make it now possible to successfully treat orthopedic conditions that previously were fraught with high morbidity rates and poor results.

Purpose. To study the possibilities of lower limb lengthening after total hip arthroplasty in children.
Material and Methods. The early results of the lower limb length restoration presented in 4 children at the age of 15-17 years after total hip arthroplasty.
Results. Maintaining the distraction device stability during femoral lengthening noted, and that of endoprosthesis stability in the long-term periods of observation as well.
Conclusion. The restoration of the lower limb length after total hip arthroplasty in children is possible by femoral lengthening. The negative effect of femoral lengthening on the degree of the hip endoprosthesis stability not found by preliminary data. Distraction regenerated bone forms within the average periods of time characteristic of the normal running of osteogenesis processes.

Purpose. To reveal the details of forming compensatory changes in lumbar lordosis in patients with arthrosis deformans of the hip based on the complex analysis of sagittal radiologic parameters of the lumbar spine and pelvis.
Material and Methods. The results of standardized radiologic examination analyzed in 90 patients with uni- and bilateral Stage III coxarthrosis combined with chronic lumbalgia. Three pelvic and six spinal sagittal parameters measured, the obtained data processed statistically, correlations established between the studied parameters.
Results. The applied clinical-and-radiological study allowed exploring the features of forming compensatory lumbar lordosis in the sagittal plane in patients with coxarthrosis, determining correlations between sagittal pelvic and spinal parameters, as well as identifying the distribution of patients by lumbar lordosis type.
Conclusion. The studied details of spinopelvic relations in patients with arthrosis deformans of the hips confirm the presence of significant compensatory changes in the sagittal spine in patients of the category considered, the relations described between the main pelvic and lumbar spinal radiologic parameters.

Purpose. To evaluate the effectiveness of complex conservative treatment of patients with II-III Stage coxarthrosis using different scales and tests.
Materials and Methods. 66 patients with II-III Stage coxarthrosis examined. VAS, Lequesne Algofunctional Index, McGill Questionnaire and WOMAC used in the study. The complex of conservative treatment includes the prescription of chondroprotectors, vascular and metabolism-improving preparations, NSAIDs of short course, exposure to ultrasound and laser, exercise therapy with the techniques of gravitational loading and post-isometric relaxation, as well as massage with ischemia-caused compression of trigger points.
Results. The study demonstrated that the complex treatment of patients with coxarthrosis decreased pain intensity and changed it emotively, but didn’t lead to significant joint function improvement.
Conclusion. The comprehensiveness and continuity of restorative treatment should be observed at all the stages of rehabilitation from the out-patient clinic to rehabilitation department and sanatorium in order to achieve a stable positive effect.

Purpose. To make analysis of the effectiveness of combining intraosseous reinforcement using wires with osteoinducing coating and transosseous osteosynthesis for filling long bone heterogenous defects and pseudoarthroses including those with purulent infection.
Materials and Methods. New technology proposed for treatment of patients with long bone defects and pseudoarthroses, including those complicated by chronic osteomyelitis. The potential of transosseous osteosynthesis and fragment intraosseous reinforcement by wires with hydroxylapatite coating used for patients’ rehabilitation. The authors have the experience of successful treatment of 18 patients with heterogenous defects and pseudoarthroses of long bones.
Results. Anatomical integrity of injured segments restored in all the patients, there were no osteomyelitis recurrences within 1-3 years.
Conclusion. Our modest experience of combined application of intramedullary reinforcement by using wires with hydroxylapatite coating and transosseous osteosynthesis allows making only preliminary conclusions about the effectiveness and advisability of original technological solutions for rehabilitation of patients with defects and pseudoarthroses of long bones.

Purpose. To reveal osteogenesis features for canine leg defect filling under combined (the Ilizarov fixator and an intramedullary locked pin) osteosynthesis.
Materials and Methods. Five adult mongrel dogs used in the experiments. These dogs underwent modeling tibial defect-pseudoarthrosis. After that, intramedullary osteosynthesis performed with the pin locking in the proximal part, and the Ilizarov fixator applied with further osteotomy in the lower third.
Results. The support function of the limb occurred by the middle of distraction and became more active after the fixator removal in all the experiments. By the middle of distraction, the regenerated bone acquired zonal structure by X-rays, and its osseous parts looked like homogenous shadows of mainly periosteal structures. The median zone of radiolucency accounted for 35-40% of the regenerated bone area. By the moment of the fixator removal, the osseous parts of the regenerated bone presented as periosteal and endosteal structures, “growth plate” had well-defined boundaries and accounted for 15-20 % of the regenerated bone area. By 30 days after lengthening the regenerated bone lost zoning in most experiments, and formation of mechanically strong regenerated bone observed. Pseudoarthrosis consolidation noted by the same period as well.
Conclusion. The combined use of osteosynthesis various technologies allowed us to reduce the duration of device fixation stage with the kept volume of filling bone tissue deficit under the conditions of disordered intraosseous blood supply and endosteal osteogenesis.

Purpose. To study the main statistics of vertebral body fractures in children over 2 years.
Materials and Methods. A detailed analysis of daily monitoring presented concerning the appealability of children and adolescents at the age from 1 (one) month to 18 years with traumatic injuries of the musculoskeletal system including those of the spine within the period from September 1, 2010, to August 31, 2012.
Results. 39,604 children got different injuries of the musculoskeletal system for 2 (two) years. The number of child population on the basis of which the main statistics of child traumatism calculated was 149,363 children in this period of time. Vertebral body fractures diagnosed in 199 (0.49%) of them.
Conclusion. The proportion of the spine injuries in the child traumatism structure accounted for 9.02% clinical cases. They were third-ranked behind injuries of the upper and lower limbs. The proportion of compression uncomplicated fractures of vertebral bodies accounted for 5,52% of cases.

Purpose. To evaluate the intensity and asymmetry of sensorimotor deficit in the lower limb system for different manifestations of the degenerative-anddystrophic process in the lumbar spine.
Materials and Methods. The lower limb muscles tested by electroneuromyography technique (global, stimulation ENMG) in 25 patients with LIV-V intervertebral disc hernia, and in 8 patients with LIV vertebral spondylolisthesis in order to evaluate the sensorimotor deficit intensity and asymmetry for different manifestations of the spine degenerative-and-dystrophic process. A method of EMG-evaluation proposed for the radicular pain syndrome revealed at the moment of examination.
Results. Patients with LIV-V intervertebral disc herniae as established have both lower limbs involved despite the presence of clear lateralization of clinical radiculopathy signs in the most examined patients. In case of the degenerative-anddystrophic process progression ending by vertebral displacement, the asymmetry of initially developed motor disorders eliminated due to the decrease of functional characteristics of “less involved” limb.
Conclusion. The data allowed more detailed studying the processes of sensorimotor deficit formation for destructive involvements of the lumbosacral spine.

Purpose. To evaluate the biochemical changes in patients’ organism dynamically during posttraumatic osteomyelitis treatment by the Ilizarov method.
Materials and Methods. Blood serum biochemical parameters studied in 15 patients at the age of 20-55 years with chronic posttraumatic osteomyelitis of the leg. The technique of monolocal compression osteosynthesis used in six patients (Group 1). Bilocal distraction-compression osteosynthesis (Group 2) used in nine patients who required additional surgical intervention, tibial osteotomy to fill the developed defect that performed 3-4 months after wound healing and purulent process stopping. The activity of phosphatases, lactate dehydrogenase, creatinase studied, as well as the concentration of general calcium, phosphate, magnesium, general protein, triglycerides, general cholesterol and glycolysis products determined.
Results. The reliable (p less 0.05) decrease of general calcium level, the decrease of acid phosphatase bone isoenzyme activity, the maintenance of glycolysis product elevated concentration – all this found in blood serum of both group patients at the stages of treatment. The content of general protein and inorganic phosphate decreased significantly in Group 1 patients during treatment, while that of triglycerides and general cholesterol – in patients of Group 2.
Conclusion. The character and the depth of blood serum biochemical parameter shifts in patients with chronic posttraumatic osteomyelitis of the leg in the dynamics of treatment by the Ilizarov method depended on the extent of surgery. In this case, the subsequent filling of the defect regardless osteosynthesis technique didn’t lead to substantial metabolic disorders.

Purpose. To clear some conditions for realization of the phenomenon of the influence of blood plasma fraction injection on reparative osteogenesis depending on the dose and recipient animal’s regenerative status.
Materials and Methods. The influence of blood fractionated plasma injections on reparative osteogenesis depending the dosage and initial recipient’s regenerative status investigated in an experimental study. Blood taking performed in experimental animals (dogs) in the distraction period during leg bone osteosynthesis according to Ilizarov. Plasma fractionation made by original technique. Laboratory mice subjected to rib osteotomy served as recipients. A single injection of fraction within the doses from 10 to 60 mg/kg made before and after surgery. Morphologic and biochemical investigations of blood and tissues performed 10 days after surgery.
Results. Blood fractionated plasma found to have both osteoinductive and inhibiting properties. The fraction dose and recipient organism’s metabolic status at the time of injection influence the impact intensity and direction.
Conclusion. The results evidence promising use of blood preparations in order to optimize reparative osteogenesis.

Purpose. To analyze the gait in patients with achondroplasia after the lower limb lengthening.
Materials and Methods. 63 patients with achondroplasia at the age of 6-18 years examined before treatment, during limb segment lengthening and in the immediate (3, 6 months) and long-term (12, 24, 36 months) periods after the fixator removal. The procedure of limb segment lengthening performed mono- and bilocally by the technique of transosseous distraction osteosynthesis.
Results. The gait analysis demonstrated that patients with achondroplasia before treatment had relatively a short stride, the low values of walking speed, daily locomotor activity, thereby determining a low rate of walking. Ultrasound control during leg lengthening allows identifying the critical structural condition of muscles determined as «the effect of frosted glass» accompanied by a long rehabilitative period. The gait parameters determined by the range of motions in the joint in the long-term periods after lengthening. In all the patients after femur and leg lengthening the disorder of gait symmetry registered more towards the limb side where femur lengthening made at the last stage with the increase in stride variability. The force- and time-related parameters of stride cycle approached to the norm for leg lengthening up to 10 cm. The decrease in force-related parameters of stride cycle conforms to the reduction of range of motions in the joints for 12-14-cm leg lengthening. Due to the decreased angle between the foot axis and the body movement direction, the altered structure of foot rolling through the support surface persists on account of non-participation of the medial foot structures in the support.
Conclusion. The studies and the results allow correcting the lengthening value in order to normalize the walking process in patients with achondroplasia.

Purpose. Comparative analyzing histological changes in skeletal muscle for canine leg lengthening using autodistraction daily by 3 mm for 120 and 180 times.
Material and Methods. The histological changes in the anterior tibial muscle studied in the experiments on 15 dogs for leg lengthening by an autodistractor with the daily rate of 3 mm for 180 and 120 times.
Results. Both modes of distraction established to be traumatic. The leading mechanisms of injury – muscle microinfarction with further focal substitutionary fibrosis, the disintegration of myons’ contractile apparatus structures not accompanied by sarcolemma integrity breach and thereby not causing tissue (inflammatory) reaction – less marked in case of “3 mm for 180 times” distraction.
Conclusion. The foci of acute ischemic necrosis of muscle fibers revealed in the experimental series studied (muscle microinfarctions) don’t allow recommending the modes of «3 mm for 120 times» and «3 mm for 180 times» to be used in clinical practice. Perspectively, the further search of the optimal mode of high-division distraction with increased daily rate should be made.

The definition of acrocephalosyndactyly conception evaluated on the basis of literature data, the data of the mentioned abnormality incidence, its etiopathogenesis presented, as well as the most common classifications. The techniques of surgical treatment of the hand and feet developed deformities considered, and also the used technologies for their treatment.

The technique of two-staged treatment developed for patients with humeral condyle pseudoarthrosis accompanied by the elbow contracture. Tunnelization of humeral condyle, humeral osteosynthesis using the Ilizarov fixator performed at the first stage of treatment. At the second stage, wedge-shaped osteotomy of olecranon made after bone union achievement in order to recover the upper limb extension function, as well as ulnar osteosynthesis using the Ilizarov fixator, the latter application to humerus for graduated elimination of contracture soft-tissue component. The results of treatment presented in female patient S., 55 years old. Both pseudoarthrosis zone union, and the restoration of limb axis and the elbow function achieved.

The result of surgical treatment presented in a patient with congenital dislocation of the hip and dysplastic coxarthrosis formed in neoarthrosis. At the first stage pelvic component implanted into the true acetabulum with bone autoplasty and additional fixation of prosthetic cup with a screw, the Ilizarov fixator applied to the pelvis and right femur for its closed graduated putting down. At the second stage, after femur putting down, prosthetic femoral component and head implanted. The result one year after the surgery considered to be good.

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.

Purpose. To develop a little-invasive technique for osteosynthesis of proximal femoral fractures which would allow to reduce the duration of surgery, as well as to increase fixation stability, implement graduated interfragmental compression, early activation of patients, and to shorten the periods of inpatient treatment.
Materials and Methods. A little-invasive technique developed for osteosynthesis of proximal femoral fractures, as well as a device for its realization in order to improve the quality of treatment.
Results. The proposed device approved in clinical setting. Surgical intervention time shortening, stable fixation and graduated interfragmental compression achieved by using the device, as well as radiation exposure decrease, the reduction of surgery time and manipulations for the exact insertion of wires and a compressing rod into the femoral head.
Conclusion. The studies demonstrated the effectiveness of using the developed device for proximal femoral injuries.