TRAUMA http://trauma.zaslavsky.com.ua/ <table id="table1" width="100%" border="0"><tbody><tr><td colspan="2" align="center" valign="top"><span style="color: #0d1e9f; font-family: Verdana; font-size: 13.3333px; font-style: normal; font-variant: normal; font-weight: bold; letter-spacing: normal; line-height: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 1; word-spacing: 0px; -webkit-text-stroke-width: 0px; display: inline !important; float: none; background-color: #ffffff;">The journal Trauma (Travma) is the professional scientific and practical specialized peer-reviewed publication for orthopedists-traumatologists, emergency physicians and other physicians, covering scientific and practical developments in the field of traumatology and orthopedics.</span></td></tr><tr><td colspan="2" valign="top"><hr noshade="noshade" size="1" /></td></tr><tr> <td valign="top" width="19%"> <img src="/public/journals/348/homeHeaderTitleImage_uk_UA.jpg" alt="Заголовок домашньої сторінки" width="250" height="375" hspace="10" /></td> <td valign="top" width="80%"><strong>The founder: </strong>Donetsk State medical University.<br /> <strong>Publisher: </strong>Zaslavsky O.Yu.<br /> <strong>Language of edition: </strong>Ukrainian, English, Russian.<p><strong>Registration Certificate: </strong>КВ № 15994-4466 Р. Issued by the Ministry of Justice of Ukraine 02.11.2009.</p><p>The journal is included in the new List of scientific publications of the Higher attestation Commission, which can publish results of dissertations on competition of scientific degrees of doctor and candidate of Sciences. Order of the MES from 26.11.2020 № 1471.</p><p><strong>Publication frequency:</strong> 6 times per year.<br /> <strong>Founded:</strong> 2000</p><p><strong>ISSN</strong> 1608-1706 (print)<br /> <strong>ISSN</strong> 2307-1397 (online)</p><p><strong>DOI: 10.22141/1608-1706</strong></p><strong><a href="http://www.mif-ua.com/">http://www.mif-ua.com/</a><br /> <a href="http://www.dsmu.edu.ua/">http://www.dsmu.edu.ua/</a></strong></td></tr></tbody></table> <table id="table2" width="100%" border="0"><tr><td valign="top" width="98%"><hr></td></tr><tr> <td valign="top" width="98%" align="center"> <a href="http://www.irbis-nbuv.gov.ua/cgi-bin/irbis_nbuv/cgiirbis_64.exe?Z21ID=&I21DBN=JRN&P21DBN=JRN&S21STN=1&S21REF=10&S21FMT=fullwebr&C21COM=S&S21CNR=20&S21P01=0&S21P02=0&S21P03=I=&S21COLORTERMS=0&S21STR=Ж23024" target="_blank"> <img src="http://www.mif-ua.com/media/uploads/index/vern_e.jpg" alt="" width="100" height="37"></a>&nbsp;<a href="http://www.irbis-nbuv.gov.ua/cgi-bin/irbis_nbuv/cgiirbis_64.exe?C21COM=S&I21DBN=REF&P21DBN=REF&S21FMT=fullwebr&S21ALL=(&lt;.&gt;I=Ж23024&lt;.&gt;)&FT_REQUEST=&FT_PREFIX=&Z21ID=&S21STN=1&S21REF=10&S21CNR=20" target="_blank"><img src="http://www.mif-ua.com/media/uploads/index/dj.jpg" alt="" width="100" height="37"></a>&nbsp;<a target="_blank" style="text-decoration: none; color: rgb(13, 30, 159); font-family: Verdana; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: center; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(251, 251, 243);" href="http://www.irbis-nbuv.gov.ua/cgi-bin/irbis_nbuv/cgiirbis_64.exe?Z21ID=&I21DBN=UJRN&P21DBN=UJRN&S21STN=1&S21REF=10&S21FMT=juu_all&C21COM=S&S21CNR=20&S21P01=0&S21P02=0&S21P03=PREF=&S21COLORTERMS=0&S21STR=Travma"><img src="http://www.mif-ua.com/media/uploads/index/npu.jpg" alt="" width="100" height="37"></a>&nbsp;<a target="_blank" style="text-decoration: none; color: rgb(13, 30, 159); font-family: Verdana; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: center; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(251, 251, 243);" href="http://ulrichsweb.serialssolutions.com/login"><img src="http://www.mif-ua.com/media/uploads/index/urw.jpg" alt="" width="100" height="37"></a>&nbsp;<a target="_blank" style="text-decoration: none; color: rgb(13, 30, 159); font-family: Verdana; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: center; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(251, 251, 243);" href="https://search.crossref.org/?q=1608-1706"><img src="http://www.mif-ua.com/media/uploads/index/cr.jpg" alt="" width="100" height="37"></a>&nbsp;<a target="_blank" style="text-decoration: none; color: rgb(13, 30, 159); font-family: Verdana; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: center; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(251, 251, 243);" href="https://www.worldcat.org/search?q=on:DGCNT+http://journals.uran.ua/index.php/index/oai+1608-1706+UANTU"><img src="http://www.mif-ua.com/media/uploads/index/w-c.jpg" alt="" width="100" height="37"></a>&nbsp;<a target="_blank" style="text-decoration: none; color: rgb(13, 30, 159); font-family: Verdana; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: center; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(251, 251, 243);" href="https://scholar.google.com.ua/scholar?hl=en&q=2307-1397&btnG=&as_sdt=1,5&as_sdtp="><img src="http://www.mif-ua.com/media/uploads/index/google.jpg" alt="" width="100" height="37"></a> <a target="_blank" style="text-decoration: none; color: rgb(13, 30, 159); font-family: Verdana; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: center; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(251, 251, 243);" href="https://elibrary.ru/title_about.asp?id=37721"> <img src="http://www.mif-ua.com/media/uploads/index/si.jpg" alt="" width="100" height="37"></a>&nbsp;<a target="_blank" style="text-decoration: none; color: rgb(13, 30, 159); font-family: Verdana; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: center; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(251, 251, 243);" href="https://cyberleninka.ru/journal/n/travma"><img src="http://www.mif-ua.com/media/uploads/index/c-l.jpg" alt="" width="100" height="37"></a>&nbsp;<a target="_blank" style="text-decoration: none; color: rgb(13, 30, 159); font-family: Verdana; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: center; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(251, 251, 243);" href="http://www.icmje.org/journals-following-the-icmje-recommendations/"><img src="http://www.mif-ua.com/media/uploads/index/icmje.jpg" alt="" width="100" height="37"></a>&nbsp;<a target="_blank" style="text-decoration: none; color: rgb(13, 30, 159); font-family: Verdana; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: center; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(251, 251, 243);" href="http://www.sherpa.ac.uk/romeo/search.php?source=journal&sourceid=31914&la=en&fIDnum=|&mode=simple"><img src="http://www.mif-ua.com/media/uploads/index/s-r.jpg" alt="" width="100" height="37"></a> <a href="https://www.base-search.net/Search/Results?lookfor=ТРАВМА+1608-1706&type=all&oaboost=1&ling=1&name=&thes=&refid=dcresen&newsearch=1" target="_blank"> <img src="http://www.mif-ua.com/media/uploads/index/base.jpg" alt="" width="100" height="37"></a>&nbsp;<a target="_blank" style="text-decoration: none; color: rgb(13, 30, 159); font-family: Verdana; font-size: 12px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: center; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(251, 251, 243);" href="https://www.ncbi.nlm.nih.gov/nlmcatalog/101125013"><img src="http://www.mif-ua.com/media/uploads/index/nlm1.jpg" alt="" width="100" height="37"></a>&nbsp;<a href="https://locatorplus.gov/cgi-bin/Pwebrecon.cgi?DB=local&v1=1&ti=1,1&Search_Arg=101125013&Search_Code=0359&CNT=20&SID=1" target="_blank"><img src="http://www.mif-ua.com/media/uploads/index/lp.jpg" alt="" width="100" height="37"></a> <a target="_blank" style="font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: center; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255);" data-mce-href="https://www.ebsco.com/" href="https://www.ebsco.com/"> <img src="http://www.mif-ua.com/media/uploads/index/ebsco.jpg" alt="" width="100" height="37" data-mce-src="http://www.mif-ua.com/media/uploads/index/ebsco.jpg" style="border: 0px;"></a> <a href="https://sfdora.org/" target="_blank"> <img src="http://www.mif-ua.com/media/uploads/index/dora.jpg" alt="" width="100" height="37"></a></td></tr></table> en-US <p>Our edition uses the copyright terms of <strong>Creative Commons</strong> for open access journals.</p><p>Authors, who are published in this journal, agree with the following terms:</p><ol><li>The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a <a href="http://creativecommons.org/licenses/by/4.0/"><strong>Creative Commons Attribution 4.0 International License</strong></a>, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.</li><li>Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.</li><li>The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.</li><li>The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.</li><li>The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.</li><li>The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.</li><li>The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal. </li></ol> traumajornal@gmail.com (Klymovytsky F.V.) onchullarisa@gmail.com (Onchul Larisa) Thu, 25 Mar 2021 00:00:00 +0000 OJS 3.2.1.2 http://blogs.law.harvard.edu/tech/rss 60 Outstanding issues of modern osteosynthesis of humerus fractures http://trauma.zaslavsky.com.ua/article/view/226391 <p><em><strong>Background.</strong></em> Over the past twenty years, there have been significant changes in the treatment of humerus fractures. Many high-tech tools have appeared in osteosynthesis. Numerous workshops and short-term courses do not sufficiently highlight vulnerabilities of osteosynthesis with fixators. Unfortunately, in many cases, the treatment results of humerus fractures could be better. The purpose of the work was the analysis of biomechanical aspects of modern fixators for humerus fractures osteosynthesis, causes for complications and unsatisfactory results in the application of fixators. <em><strong>Materials and methods.</strong></em> We have analyzed the available literature data, X-rays of interesting cases, patients’ histories with complications, and negative results of humerus fractures osteosynthesis by intramedullary blocking rods and LCP-plates. <em><strong>Results.</strong> </em>The outcome of the humerus fracture treatment largely depends on the understanding of the process of reparative regeneration. There is a tendency for a mechanistic approach in the treatment of bone fractures and their consequences. In the case of surgical neck fractures, the curved LCP-plates are used. They require the placement of at least 4 blocking screws into the bone epiphyses. This often leads to the development of aseptic necrosis. The lack of the anatomical reposition of the fragments as well as the placement of 5–7 screws into the humerus head leads to deforming arthrosis of the shoulder joint. We have observed similar complications in 10 patients. The placement of a significant number of screws into the bone head can lead to complications when a fixator breaks at the point of the plate tension change. In complex cases of humerus fractures and complications of osteosynthesis with other fixators in 170 patients, we used a device for fixing bone fragments that has been developed by us. It is protected by the patent of Ukraine N 17502. The device eliminates harmful pressure of a plate on a bone, carries out a stable osteosynthesis using the shortest possible plate. Blocking screws in a plate with insufficiently reposed fragments cause the development of pseudoarthrosis. A common complication of LCP plates is the welding effect between the screw head and the plate. Against the background of osteoporosis of the bone, the LCP plate actually acts as a prosthesis, which exacerbates the effects of osteoporosis. Late LCP plate removal in such cases might cause humerus refraction.<em><strong> Conclusions.</strong> </em>Osteosynthesis of humerus fractures using LCP plates has significant advantages over traditional contact plates. Complications and negative results of osteosynthesis may occur when they are used inappropriately and when the correct methods and techniques of surgical intervention and the appropriate postoperative care are not followed.</p> P.I. Bilinskyi, Y.P. Tsiura, V.R. Antoniv Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 http://trauma.zaslavsky.com.ua/article/view/226391 Fri, 09 Apr 2021 00:00:00 +0000 An experimental study of the mechanical properties of the Achilles tendon in rabbits during its recovery after injury http://trauma.zaslavsky.com.ua/article/view/226392 <p><em><strong>Background.</strong> </em>The problem of treating patients with tendon injuries remains unresolved. Unsatisfactory results after surgical treatment, according to different authors, range from 15 to 62 %. The functional outcome after surgical repair of damaged tendons is difficult to predict because of the high risk of scar block formation, which prevents them from sliding freely. Adhesions compromise the extensibility of the tendons, which in turn affects their strength. The purpose was to experimentally investigate the strength properties of the Achilles tendons after their surgical restoration with the further use of various medications. <em><strong>Materials and methods.</strong></em> The mechanical properties of the Achilles tendons of rabbits were investigated, on which a model of their partial damage was created by crossing by 1/2 the diameter. The injured tendon was sutured with a tendon suture. Within the experiment, 5 groups of preparations of the Achilles tendons of rabbits with a heel bone were studied, 3 preparations in each group. Group 1 was a control one. After performing the tendon suture, the wound was sutured. The rabbits of group 2 were administered Noltrex around the tendon suture. Group 3 included the animals who were injected with a preparation of hyaluronic acid. Group 4 consisted of the animals who were injected with lidase. Group 5 included the animals with the normal values, preparations of non-operated Achilles tendons of intact animals. All animals were withdrawn from the experiment on day 60. According to the test results, the value of the elastic modulus and the ultimate strength of the preparation was calculated. <em><strong>Results.</strong> </em>The greatest elongation under a tensile load of 30 N was achieved on preparations of unoperated Achilles tendons of rabbits — 2.96 ± 0.22 mm. The smallest elongation was obtained for the preparations of the control group — 0.83 ± 0.37 mm. The rest of the drug groups showed intermediate values. The Achilles tendon preparations of rabbits from the control group (0.216 ± 0.123 MPa) have the highest value of the elastic modulus. The smallest value of the modulus of elasticity was found in the study of non-injured preparations of the Achilles tendon (0.051 ± 0.004 MPa). The drugs of the control group had the greatest strength (the value of the maximum permissible load was 81.81 ± 0.34 N). The least strength was demonstrated by preparations of non-traumatized Achilles tendons of rabbits (the value of the maximum permissible load was 69.72 ± 0.18 N). <em><strong>Conclusions.</strong> </em>Within the recovery of the Achilles tendon in rabbits after injury, an increase in the values of indicators characterizing the strength properties of tissues is observed — elastic modulus, maximum permissible load, and ultimate strength. The values of indicators characterizing the plastic properties of tissues decrease, which can be one of the reasons for the development of post-traumatic contractures. The best indicators in terms of tissue plasticity were observed in the group of preparations of the Achilles tendon of rabbits treated with hyaluronic acid. The worst ones were registered in the control group.</p> O.M. Khvisyuk, V.V. Pastukh, M.Yu. Karpinsky, O.D. Karpinska, I.A. Subbota Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 http://trauma.zaslavsky.com.ua/article/view/226392 Fri, 09 Apr 2021 00:00:00 +0000 Dynamics of recovery of foot muscle strength in children with relapses of congenital equinovarus clubfoot after surgical treatment according to the Ponseti method http://trauma.zaslavsky.com.ua/article/view/226407 <p>Background. In the case of relapses of congenital equinovarus clubfoot (CEVC) at the age of 3–10 years, the approaches to treatment differ significantly. Thus, the treatment of recurrent CEVC at the age of 3–10 years after primary conservative treatment by the Ponseti method is carried out with the transposition of the tendon of the tibialis anterior to the 3rd sphenoid bone. The treatment of recurrent CEVC in children of 3–10 years old after traditional methods of treatment is more complex and less effective. The purpose was to determine the features of the recovery of strength of the foot muscle groups in children with recurrent CEVC before and after surgical treatment by the Ponseti method and after traditional treatment methods. Materials and methods. Dynamometric studies were carried out in 65 children with recurrent CEVC. The patients were divided into 2 groups: group I (33 children) included traditional techniques, which included initial surgical intervention to completely correct all components of the deformity; group II (32 people) — Ponseti method. All patients underwent dynamometry of the muscle groups of the dorsal flexors and plantar extensors of the foot. The study was carried out before treatment, after 6 months, after surgery, and after 1 year. Results. The results of the study showed that in patients who were treated by the Ponseti method (group II), the strength of the dorsal flexor muscle groups of the foot increased statistically significantly <br />(p = 0.002) to the 6th month after surgery. In patients who were treated by traditional methods, statistically significant changes in the strength of the dorsal flexors of the foot were observed only to the 12th month after surgery. In group I patients, a statistically significant increase (at the p &lt; 0.05 level) in the strength of the muscle groups of the plantar extensors of the foot was observed at all stages of the study. In patients who were treated by the Ponseti method, a statistically significant (p = 0.028) increase in the strength of the plantar extensors of the foot was observed only at the first stage (up to 6 months). Subsequently, the increase in the strength of the muscles of the plantar extensors of the foot significantly slowed down and averaged 0.2 ± 2.3 kg, which is not statistically significant (p = 0.880). Conclusions. In children of group I, the increase in muscle strength occurs more slowly than in group II, and the percentage increase in muscle strength compared to the initial va-lues is much less. Twelve months after the operation, the ratio of the strength of the dorsal flexors to the plantar extensors is almost completely restored in children, which justifies the advisability of using the Ponseti method as the primary method of treating CEVC in children.</p> S.O. Khmyzov, G.V. Kikosh, O.D. Karpinska, M.Yu. Karpinsky Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 http://trauma.zaslavsky.com.ua/article/view/226407 Fri, 09 Apr 2021 00:00:00 +0000 Mathematical calculation and coefficient value of chest shape recovery for planning thoracoplasty of pectus excavatum http://trauma.zaslavsky.com.ua/article/view/226408 <p><em><strong>Background.</strong></em> Pectus excavatum is characterized by retraction of the sternum and anterior ribs of different depth and width. The formation, its prediction, calculation of chest deformity, and their study when planning thoracoplasty using the Nuss procedure for this pathology is an important problem of orthopedics and thoracic surgery. The purpose of the work was to calculate the coefficient of restoration of the chest shape by the ratio of the pectus excavatum depth and the chest size in the frontal plane before and after mathematical modeling of thoracoplasty using the Nuss procedure. <em><strong>Methods.</strong></em> To assess displacement of ribs depen-ding on depth deformity of chest h, two models were built. The first model is a flat frame on supports, the elements of which consist of cartilaginous parts of ribs and sternum. For this model, the dependence of the force F was determined, which is necessary to correct the depth of chest deformity. The second model is a curved bar that simulates a rib, to one of the ends of which a support load is applied, calculated during the analysis of the first model. For this model, the displacement of the plate fixation point under the action of a given force was determined. To obtain more accurate results, a finite element study was performed on a chest model. <em><strong>Results.</strong></em> The correction of pectus excavatum depth without fixing plate to ribs was simulated. The displacements of rib sections in the place of plate fixation at different depths of pectus excavatum was assessed: h = 2 cm, h = 3 cm, h = 4 cm, h = 5 cm. The analysis of calculation results showed that after correction of the depth of chest deformity, its size in the frontal plane decreases. So, at the maximum deformation depth h = 5 cm, the deviation of the rib sections at the plate fixation point occurred by 2.4 cm. <em><strong>Conclusions.</strong></em> The relationship between the pectus excavatum depth and chest size in the frontal plane was established when modeling the newly formed chest form during for Nuss procedure. The coefficient of restoring the chest shape was mathematically calculated, which is 2 (2∆ = h), where h is the depth of pectus excavatum. The practical significance of the coefficient is that when planning thoracoplasty and shaping plate, the distance between its lateral ends, which corresponds to the chest shape and adjoin ribs, must be reduced by ½ h (where h is the depth of pectus excavatum) before correcting the pectus excavatum full adherence to the ribs in the postoperative period.</p> V.A. Dihtiar, M.O. Kaminska, O.V. Yaresko Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 http://trauma.zaslavsky.com.ua/article/view/226408 Fri, 09 Apr 2021 00:00:00 +0000 Analysis of surgical treatment of patients with primary tumors of the thoracic and lumbar spine http://trauma.zaslavsky.com.ua/article/view/226410 <p>Oncological radicalism (the scope of surgical treatment) and restoration of the supporting function of the spine remain the most pressing issues of surgical treatment for tumors. Purpose of the work: to analyze the outcomes of surgical treatment of patients with primary tumors of the thoracic and lumbar spine based on the appropriate rating scales. <em><strong>Materials and methods.</strong> </em>Forty-three patients, 22 women and 21 men aged 18 to 72 years, with benign and malignant primary tumors and tumor-like lesions of the spine were examined; they were treated at the Department of vertebrology of the Sytenko Institute of Spine and Joint Pathology of the National Academy of Medical Sciences of Ukraine. Localization of the lesions was as follows: cervical spine — 5 patients, thoracic — 17, lumbar — 19, sacrum — 2. According to the pathomorphological classification of primary tumors and tumor-like lesions of the World Health Organization, the patients were divided into those with benign (n = 26) and malignant (n = 17) tumors. The results of surgical treatment for primary spinal tumors were analyzed using the American Spinal Injury Association (ASIA) scale, Spinal Instability Neoplastic Score (SINS), Bilsky scale; the localization of tumors in different segments of the spinal column was considered as well. <em><strong>Results and discussion.</strong> </em>We evaluated the outcomes of surgical treatment of spinal tumors for the following indications: radical surgery, the presence of complications, the dynamics of neurological and orthopedic disorders, the presence of tumor recurrence and the life expectancy of patients. Radical tumor resection within healthy tissues was performed in 17 of 19 patients, who had indications for the use of this method. Twenty-four patients underwent surgical treatment in the form of decompression of the spinal canal and partial tumor resection to restore the supporting function of the spine. In 2 cases, ablasticity was not achieved. <em><strong>Conclusions.</strong></em> According to the ASIA, SINS, Birsky scales, it was found that surgical intervention in primary tumors of the spine is justified, it prevents neurological complications, significantly reduces existing neurological disorders, and prolongs the life of patients. The choice of the scope of surgical intervention aimed at restoration of the supporting function of the spine according to these scales is not shown. Treatment of primary tumors of the spine should include both radical removal of atypical tissues within the healthy tissues and palliative treatment if indicated. It is important to restore the supporting function of the spine in the area of its damaged segments.</p> V.O. Radchenko, A.I. Popov, K.O. Popsuishapka, V.O. Kutsenko, O.V. Perfiliev Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 http://trauma.zaslavsky.com.ua/article/view/226410 Fri, 09 Apr 2021 00:00:00 +0000 Substantiation of the method for determining the clinical and radiographic parameters of the hip joint in patients with cerebral palsy http://trauma.zaslavsky.com.ua/article/view/226411 <p><em><strong>Background.</strong> </em>The difficulties of diagnosis that arise when choosing therapeutic measures aimed at preventing sublu-xation, dislocation, and contractures of the hip joint in patients with cerebral palsy are a topical object of the research. The purpose was to improve the results of the diagnosis of the hip joint pathology by establishing objective radiographic parameters. <em><strong>Materials and methods.</strong></em> The total number of patients was 20 (40 joints), 10 boys and 10 girls aged 3 to 15 years. Sixteen joints were operated. Radiographically, we have determined neck-shaft angle and torsion of the thigh, projection and true according to Koval (using tables), acetabular angle, angle of inclination (Sharpe’s angle). Hip torsion was determined clinically according to Ruwe. Torsion was evaluated intraoperatively in our own way (patent No. a200512793). All patients were examined using our method (patent No. 137567). <em><strong>Results.</strong></em> Using the Student’s t-test for independent samples, the parameters of the hip joints were compared and significant differences were found between the neck-shaft angle in the standard position and the neck-shaft angle in our own position (p &lt; 0.05), as well as between the neck-shaft angle in the standard position and the neck-shaft angle true according to Koval (p &lt; 0.05). According to Fisher’s test, it was found that the torsion according to Ruwe and the torsion according to Koval are significantly different (p &lt; 0.05): Femp 1.87 &gt; Fkr 1.7. Using the method of odds ratio (OR), we determined that the sensitivity of torsion measurement by Ruwe was 0.7, the specificity of torsion measurement by Ruwe was 0.83 (OR = 11.67, confidence interval [1.94–70.18]) indicating that the chance of getting a coincidence by measuring torsion by Ruwe is 11.67 times higher than accor-ding to Koval, compared with intraoperative data. A well-defined amount of torsion of the thigh according to Ruwe provides true indicators of the hip joint using our own method. <em><strong>Conclusions.</strong> </em>The own method provides the determination of objective clinical and radiographic (diagnostic) parameters in patients with patho-logy of the hip joint. When performing one roentgenogram, it is possible to define all basic parameters of the hip joint (torsion of the hip, neck-shaft angle, Wiberg’s angle, Reimers’ index, index of vertical migration, acetabular angle, angle of inclination) and to standardize examinations of patients with cerebral palsy who are subject to screening throughout the whole period of their development. In this way, you can get radiographic indicators of patients with severe neuromuscular disorders (Gross Motor Function Classification System levels III and IV).</p> V.Yu. Hoshko, N.O. Naumenko, M.B. Yatsuliak, A.I. Cheverda, M.M. Nemesh, S.M. Martsyniak Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 http://trauma.zaslavsky.com.ua/article/view/226411 Fri, 09 Apr 2021 00:00:00 +0000 Sanitary losses of servicemen with gunshot wounds of major joints http://trauma.zaslavsky.com.ua/article/view/226413 <p>The paper analyzes the structure of sanitary losses within 2015–2020 in servicemen with gunshots of major joints during military participation in Joint Forces Operation on the East of Ukraine. The knee-joint damages prevailed in the structure of the gunshots, the ankle-joint and shoulder-joints damages took the second and the third places, respectively. By the shell type, the bullet wounds prevailed that is caused to our opinion by target-orients defeat by a marksman. That results in the resignation of a military serviceman from the Ukrainian Armed Forces and long-term treatment.</p> Yu.V. Klapchuk Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 http://trauma.zaslavsky.com.ua/article/view/226413 Fri, 09 Apr 2021 00:00:00 +0000