Репозиторий Университета

© 2019, Advanced Scientific Research. All rights reserved. Intra - and periarticular fractures of the distal humerus comprise from 0.5% to 15.3% of all fractures of the humerus and 3.5 - 5% of all fractures in adults. In recent years, the growing injury, including the localization. Treatment of fractures of the elbow joint is complex and not fully resolved problem of modern traumatology and orthopedics. This is due to the peculiarities of the structure and biomechanics of the elbow joint, predisposition to the occurrence of heterotopic ossification and the development of posttraumatic contractures. Incorrect healing of fractures leads to complications, so you need the exact matching of fragments. Treatment of intra - and periarticular fractures of the distal humerus remains a topical problem in traumatology. Common, both domestic and foreign authors, is the tactics of surgical treatment of such damage. This article presents one of methods of osteosynthesis of the lower third of the humerus is subcutaneous-subfascialosteosynthesis.

© 2019, Advanced Scientific Research. All rights reserved. A topical problem in traumatology is the choice of treatment methods for ankle fractures. The consideration of the anatomical and functional features of the ankle, condition of soft tissues in the area of fractures and the degree of edema in the ankle region is of great importance when choosing a particular treatment method. Therefore, reducing the degree of surgical aggression during surgical treatment of these injuries is an important task.. The aim of this study was to examine the possibilities of improving the results of surgical treatment of patients with ankle fractures with minimally invasive osteosynthesis technologies. This study presents the experience of treating 62 patients with fractures of the ankle joint. Two statistically homogeneous groups of patients with ankle fractures were identified. In one group, osteosynthesis with minimally invasive osteosynthesis techniques was used in 34 patients; in the other, osteosynthesis was performed in a conventional manner in 28 patients. A comparative analysis of the immediate and long-term results of treatment of patients in the study groups was carried out. The advantage of closed technology of osteosynthesis was proved. The preservation of the blood supply to the surrounding soft tissues with closed osteosynthesis provides a greater likelihood of fracture fusion, therefore the only condition in such cases is to eliminate the interposition of soft tissues in the area of lateral and medial ankle fractures.. The analysis of the obtained immediate and remote results of osteosynthesis in the two groups showed the best efficiency when using minimally invasive closed metal implantationtechnologies, especially when there are skin problems in the area of the injured ankle joint.

© 2018 by the authors. Licensee MDPI, Basel, Switzerland. Articular hyaline cartilage is extensively hydrated, but it is neither innervated nor vascularized, and its low cell density allows only extremely limited self-renewal. Most clinical and research efforts currently focus on the restoration of cartilage damaged in connection with osteoarthritis or trauma. Here, we discuss current clinical approaches for repairing cartilage, as well as research approaches which are currently developing, and those under translation into clinical practice. We also describe potential future directions in this area, including tissue engineering based on scaffolding and/or stem cells as well as a combination of gene and cell therapy. Particular focus is placed on cell-based approaches and the potential of recently characterized chondro-progenitors; progress with induced pluripotent stem cells is also discussed. In this context, we also consider the ability of different types of stem cell to restore hyaline cartilage and the importance of mimicking the environment in vivo during cell expansion and differentiation into mature chondrocytes.

© Bionika Media Ltd. The author has carried out a systems analysis of the data available in the current literature on the participation of vitamin D in the physiology of bone metabolism, the pathogenesis of osteoporosis, and the possibilities of osteoporosis therapy with active vitamin D metabolites. The paper describes the mechanisms of vitamin D participation in the processes of bone metabolism and calcium homeostasis. It presents the effects of vitamin D on connective and muscle tissues. Its deficiency is shown to play a role in the pathogenesis of osteoporosis and in the increased risk of low-trauma fractures. There are clinical trial findings that confirm the possibility of using active vitamin D metabolites for the therapy of osteoporosis and for the prevention of low-trauma fractures. Active vitamin D metabolites used alone or in combination with antiresorptive therapy for osteoporosis is an effective measure to prevent low-trauma fractures and can be prescribed for menopausal osteoporosis.

© 2018 Russian Electronic Journal of Radiology.All Rights Reserved. Purpose. To reveal the important clinical and radiologic characteristics of bony defects developing near vertical root fractures according to cone-beam computed tomography findings, which can be used for the diagnosis and differential diagnosis of root fractures. Material and methods. Eighty clinical cases suggestive for vertical root fractures were analyzed in the study. Teeth with vertical root fractures confirmed after extraction (n = 65) were divided according to tooth group and fracture propagation pattern as well as associated bone resorption according to cone-beam computed tomography. Clinical and radiographic features of vertical root fractures were compared with the mimicking conditions to reveal the differences. Results. From 80 teeth 65 were fractured; the conditions mimicking vertical root fractures included chronic periodontitis (2 cases), periapical pathology (13 cases), strip perforations (5 cases), and accessory canals (3 cases). The characteristic combination of clinical and radiographic features of vertical root fractures included a deep narrow periodontal pocket (52,3%), dehiscence-like defect of the buccal cortical plate with no or a lesser extent of periodontal destruction reflection on the other sites of the dentition and at the proximal surface(s) of the fractured root. Discussion: The differential diagnosis of vertical root fractures is a challenging task. The detection of fracture with cone-beam computed tomography is not always possible. However, this method may be used for the diagnosis of fractures by ascertaining the form and location of the bony defect. Conclusions. The analyses of characteristic features of the bony defect in conjunction with clinical findings allowed for diagnosis of vertical root fractures.

Cases of dental needle fracture during mandibular block were studied in the last 10 years. Despite dental anesthesia development, the cases of needle fracture occur regularly in the world practice. Some of these complications has iatrogenic nature while others may be attributed to independent reasons like patients' sharp movement and needle manufacturing defect. In most of the cases the needle migrates to surrounding anatomical spaces making operative removing a challenging task. Subsequent surgical removing of a foreign body has severe consequences to patient in the form of a large operating injury, long-term disability and functional limitations. The article presents an algorithm for prevention and emergency care for a patient with dental needle fracture during mandibular block.

© 2018 Ima-Press Publishing House. All rights reserved. Rheumatoid arthritis (RA) and the use of glucocorticoids (GCs) are proven risk factors for osteoporosis (OP) and osteoporotic fractures (OPF). There are also other reasons for increased fracture risk in RA. Objective: to determine the rate of RA in an epidemiological sample of persons aged 50 years and older and to identify those in need of antiosteoporotic therapy among the patients with RA in order to prevent OPF. Subjects and methods. The epidemiological sample included 18,018 people aged 50 years and older (13,941 women and 4,077 men; mean age, 62±10 years). The survey consisted of a unified questionnaire, measurement of daily dietary calcium intake, and calculation of a 10-year fracture risk using the FRAX® algorithm. Results and discussion. The prevalence of RA in the epidemiological population sample aged 50 years and older was 1.7% (1.9% in women and 1.2% in men; p=0.0047). The mean FRAX® values for major OPF in RA patients were significantly higher than those in non-RA individuals: 18.4±10 and 13.2±7.9%, respectively (p=0.0001) for women and 8.9±6.4 and 6.2±3.7%, respectively (p=0.0001) for men. 42% of the patients with RA were at high risk for OPF. Thus, 48% of the women with RA had FRAX® values above the therapeutic intervention threshold; and the non-RA group needed antiosteoporotic therapy significantly less (31%; p=0.00001). At the same time, the detection rate of high-risk OPF in men with and without RA did not differ significantly (8 and 5%, respectively; p>0.05). The most common risk factors (RFs) for OP and OPF in RA patients included previous fractures (33%), secondary causes of OP (30%), GC use (18%), and, additionally, smoking (33%) in male patients with RA. The female patients with RA significantly more frequently took GCs (17%) and had other secondary causes of OP and OPF (33%) than those without RA (7.7% (p=0.0001) and 23% (p=0.0004, respectively). The male patients with RA versus to the population-based control showed significant differences when they only used GCs (20 and 5%, respectively; p = 0.0001); the remaining RFs were encountered at the same frequency. Less than half of the normal daily calcium intake was observed in 20% of men and 16% of women (p=0.53). Conclusion. 42% of the RA patients aged 50 years and older were at high risk for OPF and needed antiosteoporotic therapy. Every third woman with RA had at least one other comorbidity or condition associated with the increased risk of OPF. In the male patients with RA, the FRAX® algorithm could reveal only 8% of persons at high risk for fractures, while 58% of them had two or more additional RFs that can negatively affect bone mineral density and increase the risk of fracture. To identify those who require prevention and treatment of OP and OPF, it is preferable to perform bone densitometry of the axial skeleton among male patients with RA.

© 2018 Media Sphera Publishing Group. All rights reserved. The objective of the present study was to develop the diagnostic criteria for determining the positions of the participants of a road traffic accident inside the passenger car compartment based on the analysis of the characteristic features of vertebral lesions in the victims. The archival documents of forensic medical expertises were used to analyze the specific characteristics of fractured cervical vertebra in the victims of the accident inside the passenger car compartments including the drivers (n=92), the occupants of the forward (n=43) and rear (n=37) seats of the car. Localization and mechanisms behind the formation of vertebral lesions in the cervical part of the spinal column associated with the intra-compartment injury is of primary importance for the diagnostic purposes. The character of an injury to the cervical region gives evidence of the position of the driver and the occupants of the car inside the passenge r compartment at the moment of the accident. Injuries to the cervical, thoracic, and/or sacral vertebrae may be indicative of the seat (either driver's, forward or rear) occupied by the victim(s). The fractures of the sacral part of the vertebral column are of negligible value for the differential diagnostics between the positions of the driver and/or other victims because they equally frequently occur in the drivers and occupants of both the forward and rear seats. Nevertheless, the proposed criteria made it possible to construct the mathematical model in the form of the logistic regression equations and to use them for making the probabilistic predictions as regards the positions of the participants of a road traffic accident inside the passenger car compartment based on the selected combination of pathomorphological characteristics in the victims.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To study peculiarities of clinico-radiological and anatomico-topographic relationship of sciatic nerve and acetabulum. Materials and Methods: Two stages experimental research was conducted in vitro on 20 human corpses, died due to various reasons. Clinico-radiological study was carried out in vivo on 41 patients with injuries of sciatic nerve and acetabulum. Results: Research data can confidently state that topographic proximity of sciatic nerve to acetabulum especially to its posterior-upper edge determines high risk of nerve lesion at acetabulum fractures due to influence of bone fragments, formed hematoma, forming scars. Conclusion: Acetabulum fractures are potentially dangerous for possibility of simultaneous injury of sciatic nerve; in this case a patient has to be subjected to special examination with the purpose of his sciatic nerve status evaluation.

© 2018 Media Sphera Publishing Group. All rights reserved. The objective of the present work was to develop the method for the visualization of the shape of the bone surface in the region of its traumatic damage based on the results of the analysis of a single X-ray image for the solution of the problems facing forensic medical expertise and traumatology. The three-dimensional models of the fractures of the long tubular bones constructed with the use of the visualization technique were shown to adequately reproduce the morphological picture of the injury. It allowed to enhance the potential of the forensic medical analysis and the accuracy of the diagnostic methods employed for the purposes of forensic medical expertise.