Purpose. To analyze the results of treatment in patients with habitual shoulder dislocation using arthroscopic technique.
Materials and Methods. The analysis of the results of treatment of 68 patients with habitual shoulder dislocation presented. The patients underwent arthroscopic stabilization of the shoulder using anchoring fixators (Bankart surgery). The features of surgical technique and postoperative rehabilitation highlighted.
Results. Short-term results of treatment (up to one year) evaluated in 35 patients, long-term ones – in 11 patients. Positive results observed in all the patients during the nearest follow-up, and in 10 (90.1%) patients during the long-term follow-up. Dislocation recurrence occurred in one case due to sharp adduction and external rotation of the shoulder (work with cable cutters); the dislocation was single, being corrected by the patient independently.
Conclusion. This technique is efficient and advisable for treating the shoulder habitual dislocation. Arthroscopic stabilization of the shoulder for its habitual dislocations allows to achieve the shoulder stability recovery with limb function maintenance in full, minimum invasiveness of surgical intervention, and low recurrence.

Purpose. To evaluate the results of the knee arthroplasty in patients with gonarthrosis after rehabilitation, and their quantitative characterizing the effects on quality of life.
Materials and Methods.The orthopedic status followed dynamically in 25 patients with gonarthrosis before and after total arthroplasty of the knee, 33 surgeries performed.
Results. The role and importance of the rehabilitation period has been specified: total Lequesne algofunctional indexes significantly 40.0% decreased (p less 0.001), total values of WOMAC functional index 50.9 % decreased (p less 0.001), and the values of Visual Analog Scale
(VAS) for pain 44.9 % decreased (p less 0.001). The long-term results of the knee total arthroplasty demonstrate 51.9% of joints to have the pathology and to require repeated orthopedic correction.
Conclusion. The data indicate the necessity of the patients’ dispensary observation in the postoperative period.

Purpose. To study the effect of using femoral subchondral wire tunnelization on the results of treatment measures in patients with initial stages of posttraumatic gonarthrosis.
Materials and Methods. The results of treatment of 228 patients with X-ray stage I-II posttraumatic gonarthrosis and predominantly degree I-II chondromalacia (ChM) of articular cartilage previously treated using arthroscopic technologies without femoral subchondral wire tunnelization have been analyzed. The patients were divided into two groups. 76 patients with X-ray stage I gonarthrosis and predominantly degree I ChM of articular cartilage were included in Group 1, and 152 patients with X-ray stage II gonarthrosis and predominantly degree II ChM – in Group 2. A repeat treatment-and-diagnostic arthroscopy with subchondral wire tunnelization performed in 49 patients from clinical Group 1, and in 37 ones from Group 2.
Results. Significant (р less 0.01) difference in the pain syndrome manifestation according to Visual Analogue Scale (VAS) revealed between the patients undergone subchondral wire tunnelization and those not subjected to tunnelization.
Conclusion. The use of femoral subchondral wire tunnelization in patients has been proved to improve the results of treatment measures.

Purpose. To assess quality of life quantitatively in elderly patients with gonarthrosis treated at RISC RTO using the techniques of decompression-draining surgeries.
Materials and Methods. Eighty patients (95 joints) with gonarthrosis (Stage II-III) at the age of 64±0.5 years treated by the techniques of decompression-draining surgeries. The patients were divided into two groups: those without limb axis disorder, and those with the disorder. All the patients operated according to the techniques developed at the Center. The Algofunctional Index (AFI) developed at RISC RTO in order to reveal changes in the joint for patient’s self-assessment of pain, discomfort (stiffness), and doing everyday activity. This is a measure of patient’s state scored according to a special questionnaire including the criteria of pain levels, discomfort, and doing everyday activity, and calculated by 19 criteria.
Results. Significant decrease in pain sensations, up to their disappearance, and that in joint stiffness observed in the patients of both groups after surgical treatment; significant improvement achieved in terms of doing everyday activity.
Conclusion. Patient’s comparative algofunctional subjective self-assessment of the rehabilitative treatment performed for gonarthrosis using the Center techniques is an additional social confirmation which supplements objective rehabilitation efficiency measures determined by the physician.

Purpose. To make a comparative analysis of MRT and USE efficiency when revealing pathology of the elements of the knee for its injuries.
Materials and Methods. Ultrasound examination and magnetic resonance tomography performed in 85 patients at the age of 14-62 years with the knee element injuries. A comparative analysis of USE and MRT data versus arthroscopy results made in order to calculate the sensitivity and specificity of the techniques.
Results. The results demonstrated high percentage of combined injuries of the knee structures (40%) among the subjects examined. USE procedure found to be rather efficient for the diagnostics of isolated injuries of the medial meniscus, while it was little efficient for revealing the injuries of cruciate ligaments, and combined injuries of intraarticular structures. In this case MRT procedure is more informative because it allows rather perfect visualization of both isolated and combined injuries in the acute period of trauma.
Conclusion. As the data have shown, it’s necessary to make comprehensive examination in order to reveal pathological changes in the structural elements of the knee injured, as well as to select the tactics of further treatment.

Purpose. To analyze the results of treating patellar dislocation combined with accompanying deformities of distal femur and the knee contractures.
Materials and Methods. The results of surgical treatment analyzed in 15 patients (16 knee joints) with patellar dislocation of different etiology and severity combined with deformities of distal femur and contractures of the knee. The tendinous-and-ligamentous apparatus dissected from the outside and fastened from the inner side of the patella for dislocation of mild severity. As for dislocation of severe degree, the technique of reconstructing the knee extension system was used with the patellar ligament transfer medially. The patellar dislocation of mild degree and, in six cases, that of severe degree has been eliminated with simultaneous deformity correction by performing supracondylar osteotomy, as well as femoral, patellar, and leg fixation with the Ilizarov fixator. Supracondylar osteotomy performed at first in two patients with severe dislocation to correct accompanying deformities, and patellar dislocation eliminated at a stage. The dislocation was corrected in one female patient, and supracondylar osteotomy performed with acute elimination of valgus deformity followed by further gradual correction of the knee flexion contracture.
Results. Normal biomechanical axis was recovered, and patellar dislocation eliminated in all the patients.
Conclusion. The use of the proposed techniques allows solving the posed clinical problems and improving patients’ quality of life.

Purpose. To study the circulation of acetabulum and paraosseous tissues in the hip area of growing dogs.
Materials and Methods. Hemodynamics investigated in the bone part of acetabular vault, as well as in paraosseous soft tissues of puppies at the age of 6-11 months using rheography.
Results. The reduction of the amplitude parameters of pulse blood flow observed in the parts investigated, as well as the decrease of volumetric circulation rate in acetabular bone part in case of the absence of the differences in the value of blood inflow.
Conclusion. Based on the findings acetabular dysplasia established to be accompanied by congenital anomaly of the vascular bed.

Purpose. To develop a new technology for transferring the pre-existing blood-supplied refused osteocutaneous structures of bone segments pre-formed by distraction technique for finger reconstruction.
Materials and Methods. A new technology presented in order to reconstruct fingers of the hand for its injury consequences which consists in transferring the hand refused segments on distracted pedicles. The technique has been used for treatment of 64 patients with 84 fingers reconstructed. Full-length finger transferred in three cases (3.7%), finger stump – in 33 cases (40.7%), and metacarpal stump – in 45 cases (55.6%). Long-term results of treatment studied by clinical, X-ray, biomechanical, biophysical, and morphological methods. They estimated according to A.E. Belousov technique perfected by the authors.
Results. Excellent results obtained in 40.0% of patients, good ones – in 5.0%, satisfactory – in 47.5%, and unsatisfactory – in 7.5% of patients. The resistance of the transferred segment bone skeleton to resorption has been proved. The indications for the technique use have been determined depending on the hand defect type.
Conclusion. The approach developed allows to broaden the possibilities of finger reconstruction significantly due to local donor resources for the consequences of mechanical, gunshot, and thermal injury. Moreover, the technique allows to achieve qualitatively new results with minimal donor faults in patients with different types of the hand posttraumatic defects

Purpose. To optimize the techniques of treatment for refractures in children by combining different surgical approaches, and by possible prolongation of immobilization periods with studying long-term results.
Materials and Methods. The long-term results of treatment studied in 103 patients with refractures. The results (clinical, radiological, and functional) evaluated by three-point system: good – 3 points, satisfactory – 2 points, unsatisfactory – 1 point. Children were operated using the technique of combined osteosynthesis with achieving positive results in case of unsatisfactory results of refracture conservative treatment.
Results. Unsatisfactory results obtained in two patients out of six when using intramedullary osteosynthesis: pseudoarthrosis of radial lower third developed in one patient, and contracture of the elbow developed in another child due to prolonged immobilization. In contrast to intramedullary ostesynthesis, there were no refractures and other complications when combined osteosynthesis used due to additional external fixation, but in this case immobilization periods increased up to 2-3 weeks on the average.
Conclusion. When selecting a technique of treatmentfor refractures in children a conservative technique is preferred. When a surgical technique is required a combined one should be preferred which allows to consider itself the best surgical solution of the problem, and which completely eliminates the likelihood of developing refractures, nonunions and pseudoarthroses.

Purpose. To develop a complex of diagnostic measures and to improve the results of surgical treatment for osteoid osteomas and osteoblastomas of the spine in children using modern techniques and instrumentation.
Materials and Methods. The study is based on the results of surgical treatment of 65 patients with diagnosed osteoid osteoma and osteoblastoma of the spine at the age of 6-18 years among which 37 patients suffered from osteoid osteoma, and 28 ones – from osteoblastoma. There were 26 females and 40 – males among the patients.
Results. The use of navigation technology contributed to 100% removal of the tumor. The results of diagnosis and treatment followed within the period from 6 months to 10 years.
Conclusion. We used the technique of setting a landmark in the focus under the control of computer tomography. The treatment of osteoid osteoma using navigation technologies is the most efficient method of treatment for small-size tumors.

The basic principle of systems for computer-assisted surgery (CAS – «Computer Assisted Surgery») consists in the possibility of three-dimensional determining the position of surgical instruments both in the operative field, and in preoperative or operating images. The first CAS systems for the spine were introduced in the late 90s in order to optimize the placement of transpedicle screws. Two technologioes are used: navigation based on computer tomograph (CT) images and fluoronavigation which is an alternative system. New intraoperative navigation technologies became to be used in the spine surgery at the end of the first decade of the XXI century. 3D electron-optical converters are used for three-dimensional visualization like CT. In view of individual anatomical parameters of vertebrae this thechnology allows to choose the optimal intrapedicle trajectory properly both at the stage of preoperative planning and in the process of surgery. It involves digital processing of CT-examination data, and construction of trajectories for implantation thereby allowing to determine the correct entry point and the vector of the screw being implanted intraoperatively. Such mini-robots as «Bone Mounted Robot» (a robot with bone fixation) are more assistants during auxiliary instrumentation placement than real robots. They are fixed directly on the vertebral spinous process, and modeling the trajectory of implantation is carried out on the base of CT-model. Navigation provides the accuracy of high degree for choosing projection and vectors of transpedicle screw implantation comparing with traditional surgical methods. The advantage of navigation systems becomes evident when transpedicle implants are used for correction of the spine large deformities or through locking the spine segments. Meta-analysis demonstrates that among often used navigation systems CT-based navigators provide somewhat greater accuracy than fluoronavigation 2D systems. However, the accuracy level of these two systems is a little lower than that of the new systems of fluoronavigation 3D. As for the degree of exposure (radiation), these methods can be arranged in descending order as follows: traditional fluoroscopy, fluoronavigation 2D, CT-based navigation, and fluoronavigation 3D. Moreover, the surgery duration when using fluoronavigation 3D system is comparable with traditional surgery.

Purpose. To study the possibility of influencing the blood platelet-rich plasma (BPRP) lyophylizate on bone reparative regeneration for applying BPRP as a part of an agent for external use.
Materials and Methods. The influence of Tizol gel suspension, as well as that of blood platelet-rich plasma (BPRP) lyophylizate of intact donors as a part of an agent for external use on regeneration process after rib osteotomy in recipients (laboratory mice) studied. The similarly diluted BPRP-free Tizol applied to the animals of control group. The cell composition of regeneration zone, and the biochemical values of blood serum in recipients studied ten days after surgery.
Results. A lot of cells of osteoblastic differentiation line found in the regenerated bone tissues of the animals in experimental group, as well as fewer cells of chondroblastic differentiation line (441 % and 45 % of control values, respectively). The lower calcium concentration found in blood serum of the animals in experimental group (79 % of control values).
Conclusion. The acceleration of regeneration processes concluded for this mode of BPRP using, and the approach proposed to consider this phenomenon mechanisms.

Purpose. To create an improved atlas designed to insert transosseous elements through foot bones.
Materials and Methods. The study performed in two stages using eight frozen (fixed) and ten non-fixed cadaveric preparations of leg-foot complex. The foot was divided in 14 transverse and 3 oblique levels. 12 positions were determined at each of the levels for each bone of the level. Both prohibited positions (the projection of significant blood vessels and nerves) and safe positions determined in the frozen preparations. The displacement amounts of soft tissues in the non-fixed preparations studied relative to foot bones for movements in the ankle, metacarpophalangeal, and interphalangeal joints. The positions with minimum displacement of soft tissues and with the absence of significant vessels and nerves were designated as “recommended positions” for insertion of wires and half-pins in transosseous osteosynthesis.
Results. The data obtained during the experiment were processed graphically and presented as an atlas each of 17 levels in which included the information about “Contraindicated positions”, “Safe positions” and «Recommended positions” for transosseous element insertion. It is the most detailed atlas of those known today.
Conclusion. The use of the developed atlas will be useful for specialists engaged in the field of correcting complex foot deformities and applying external fixation for fractures.

Purpose. To reveal the diagnostically significant and statistically reliable anthropometric features of cranial structure in patients with achondroplasia. To study the possibility of using the methods of mathematical statistics based on the results for differential diagnostics versus skeletal dysplasiae of other types by the head anthropometric characteristics.
Materials and Methods. The photos of 25 patients with achondroplasia, and 15 patients with hypochondroplasia treated at RISC RTO in the period of 2007-2012 studied, as well as those of 25 normal subjects who were included in the control (reference) group. All the subjects were Caucasians. Two statistical methods realized in «AtteStat» special program used for mathematical analyzing the data in order to study the possibility of differential computed diagnosing the diseases. Standard encephalometric points which can be rather clearly presented on human head, the photo including, were selected for the study.
Results. The data of anthropometric features of the head structure in patients with achondroplasia have been obtained for the first time. The cephalometric indexes obtained based on performed measurings among which the most diagnostically significant values revealed by the methods of mathematical statistics.
Conclusion. The analysis of the values revealed by the method of multiple logistic regression made it possible to obtain a parametric value reflecting the probability of the disease presence in a particular patient with a given set of anthropometric characteristics.

This article presents the literature review of native, foreign and scientific publications for the last 5-10 years dealing with diagnostics and treatment of intraarticular fractures of proximal tibial epimetaphysis. The authors describe the widely used classifications of these injuries, the indications for surgical treatment, as well as they highlight the details of using internal osteosynthesis, characteristics and substantiation of selecting modern metal fixators. The use of current methods for diagnosing the intraarticular fractures of proximal tibia (CT and MRI), timely performed surgical treatment with restoring the integrity of articular surface, subchondral bone defect filling with bone autograft, and primary stable osteosynthesis using support metal fixators allow to achieve positive results, by the data of literature.

The modern views about the possibilities and techniques of surgical treatment for articular cartilage injuries and diseases using cell technologies presented based on the literature analysis and on the results of our own studies. Clinical and experimental morphological studies have demonstrated the use of cell technologies for subchondral zone tunneling according to the technique developed at our Center to be of high efficiency in terms of reparative osteo- and chondrogenesis stimulation.

Limb amputation leads to many negative medical, psychological, and social consequences, and the phantom-pain syndrome among which plays a leading role both by its incidence, and by the severity of clinical manifestations. The incidence of this pathology development after amputation is evaluated in the range from 44.6 % to 90 %. Relevance of this problem is caused by increasing the number of injured persons in military conflicts, natural disasters, and industrial accidents, as well as by high proportion of occlusion vascular involvements of the lower limbs in the morbidity structure. The disease pathogenesis highlighted in the article, and current approaches to the phantom-pain syndrome diagnosis, treatment and prevention considered.

The typological features of cognition process summarized, semiotic features of cognition described according to the literature. The differences in formation of research purpose and methodology demonstrated for fundamental and applied sciences

The result of treatment of a female patient with metatarsalgia through rheumatoid involvement of the forefoot presented. The combined use of transosseous osteosynthesis technique and screw internal fixation allowed performing successful treatment with maintaining the metatarsal bone heads as the main supporting elements of the forefoot. Moreover, this approach facilitated the patient’s earlier activation, as well as the ability of the whole foot use for support, and the reduction of the periods of treatment.