Thompson and Hamilton type IV Freiberg's disease with involvement of multiple epiphyses of both feet.

A 17-year-old boy reported left second and third toe pain after axial loading injury to his left foot. Radiographs showed collapse of the second metatarsal heads and epiphysial irregularities of the fifth metatarsal heads and the condyle of the proximal phalanx of the hallux of both feet. The patient was diagnosed to have Thompson and Hamilton type IV Freiberg's disease. He was screened for epiphysial dysplasia of the other sites. He had on and off bilateral hip and knee pain. Radiographs showed bilateral symmetrical epiphysial abnormalities with morphological change as focal concavity in bilateral femoral heads and fragmentation of the patellar articular surface with preservation of the patellofemoral joint space.

[Evaluation of the efficacy of therapeutic physical training in patients with osteochondrosis according to rheoencephalography data].

This paper reports results of clinical and rheoencephalographic examination of 40 middle-age women with cervical osteochondrosis and symptoms of insufficiency of vertebrobasiliar blood circulation. A system of methods for therapeutic physical training has beendeveloped to normalize hemodynamics in the basin of vertebral arteries. The system was tested on 20 patients during a year. It included special physical exercises, massage, and automobilization. The efficiency of therapeutic physical training was evaluated by rheoencephalography. The women involved in the testing reported a marked improvement of the health status. Their rheoencephalograms suggested diminishing of the asymmetry coefficient and beneficial effect of therapeutic physical training on the elastic properties of vertebral arteries. No such changes were documented in a control group of women with osteochondrosis.

[The use of nitric-silica mineral water in combined rehabilitative therapy of musculotonic dorsopathy syndromes].

Nitric-silica baths had beneficial myoadaptive and analgesic effect on patients with reflex dorsopathy syndromes. Balneotherapy combined with the treatment by sinusoidal modulated currents, massage, and remedial gymnastics was efficacious in alleviating musculotonic and orthopedic problems in patients with lumbar osteochondrosis. This effect was more pronounced than with the use of gas-bubble baths due to the improvement of trophic processes in the muscular tissue of the affected back and limb regions.

[Efficiency of short courses of physiotherapy with the use of energy metabolism regulators in patients with dorsopathy].

The assessment of procedure tolerance, their efficiency at shortening of courses of dorsopathies physiotherapy to 12-14 days made possible to detect presence of unfavorable reactions to treatment in 32% of cases. Regulator of energy metabolism, included in the therapy, assists to good tolerance to shortened courses of dorsopathy rehabilitation (frequency of presence and expression degree of reaction to treatment reduced to 15%), stabilization of energy system in patients' organism, absence of hyper activation and stress of adaptive mechanisms, maintenance of compensatory abilities reserves.

[The vegetative status in patients with vertebrogenic vertebral artery syndrome, and its correction with health resort treatment].

According to statistics, osteochondrosis is one of the most prevalent diseases resulting in changes in the musculoskeletal, nervous, and cardiovascular systems. In vertebral artery syndrome, the irritation of sympathetic plexuses around this artery results in vasomotor changes in the vertebrobasilar system and determines the clinical picture of the syndrome, i.e. its vegetalgic and angiodystonic components. Pathology of central regulatory mechanisms and suprasegmental divisions of the vegetative nervous system appears.

[Low-energy wideband electromagnetic radiation and manual therapy in the treatment of neurological manifestations of spinal osteochondrosis].

It is shown that the advanced technique of low-energy wideband electromagnetic radiation improves vascular tonicity and peripheral circulation while a modified technique of manual therapy facilitates movements in the affected part of the spine and reduces tonicity of the muscles involved in the pathological process.

[Laser puncture in the treatment of reflectory manifestations of lumbosacral osteochondrosis in elderly patients in geriatric hospital]. / Lazeropunktura u kompleksnomu likuvanni bol'ovykh reflektornykh proiaviv poperekovoho osteokhondrozu u khvorykh heriatrychnoho statsionaru.

Peculiarities of involution age are of great importance choosing treatment methods. Laser puncture was shown to be an effective method in treatment of pain syndromes in elder patients with lumbosackul radiculitis. Combination of pharmacotherapy, laser stimulation, acupuncture, vaccum massage, bishophit use enhances considerably efficiency of the treatment.

[Complex treatment of elderly patients with pain reflectory manifestations of lumbosacral osteochondrosis and peripheral circulation disorder]. / Kompleksne likuvannia khvorykh starshykh vikovykh hrup z bol'ovymy reflektornymy proiavamy poperekovoho osteokhondrozu ta porushenniamy periferiinoho krovoobihu.

Involutional age makes difficult the treatment of pain syndromes of vertebra origin. Concomitant diseases, age stress syndrome, hormone disbalance constrain the management of the disease. Combination of laser stimulation, reflexotherapy, psychodiagnostics and psychocorrection enhances the efficiency of the treatment of pain syndromes in patients with lumbo-sacral radiculitis and peripheral circulation disorder.

[Effect reflexotherapy on cervical-thoracic and lumbar pain syndromes in spinal osteochondrosis]. / Vliianie refleksoterapii na sheino-grudnye i poiasnichnye bolevye sindromy pri osteokhondroze pozvonochika.

Acupuncture used in cervical-thoracic and lumbar pain arrested the pain completely in 41.7 and partially in 53% patients with spinal osteochondrosis of the neck and chest spine. In lumbosacral osteochondrosis pain eliminated in 33 and 61.2% patients, respectively. If acupuncture is ineffective, vacuum blood letting is recommended as an adjuvant treatment to relieve pain.

[The treatment results in a persistent pain syndrome in the neurological manifestation of lumbosacral osteochondrosis using osteoperiosteal electro- and laser puncture]. / Rezul'taty lecheniia stoikogo bolevogo sindroma pri nevrologicheskom proiavlenii poiasnichno-kresttsovogo osteokhondroza osteoperiostal'noi élektkro- i lazeropunkturoi.

The use of osteoperiosteal electropuncture and laser puncture combined in a complex treatment of 162 patients with lumbosacral osteochondrosis resulted in dissipation or apparent decrement in clinical manifestations of the trouble. In patients with lumboischialgia, there was an improvement in the pain syndrome as evidenced by scores on global painfulness (2.3 +/- 0.45 versus 30.2 +/- 0.62 before the treatment) in patients with degree IV pain. Less intensive pain (degree II-III as to I. P. Antonov) has gone away completely. In radicular pain syndrome, results on pain relief were much lower (P < 0.05), those on total vertebral and extravertebral painfulness much better (2.4 +/- 0.2 versus 17.3 +/- 0.7 and 1.2 +/- 0.6 versus 30.4 +/- 1.82 respectively). The secured results of treatment remained stable during two years.

Radiofrequency energy-induced heating of bovine articular cartilage using a bipolar radiofrequency electrode.

Radiofrequency energy is used for thermal-assisted chondroplasty to treat grade II and III chondromalacia with the lowest possible energy setting that achieves the desired result. The purpose of this in vitro study was to determine the temperature changes associated with the use of radiofrequency energy delivered at different settings to bovine articular cartilage using a bipolar electrode. Cartilage samples were placed in a temperature-controlled (37 degrees C) saline bath for the delivery of radiofrequency energy. A fluoroptic thermometry probe was positioned to record the temperatures at the electrode-tissue interface. The electrode was activated for 2 seconds at settings of V2-120, V2-60, V2-40, and V2-20 in two modes: ablation and desiccation. Additionally, the cartilage samples were visually inspected to determine changes in appearance. The highest average temperatures were as follows: ablation mode, 78.5 degrees C (V2-120), 62.6 degrees C (V2-60), 58.1 degrees C (V2-40), and 54.1 degrees C (V2-20); desiccation mode, 71.8 degrees C (V2-120), 61.4 degrees C (V2-60), 57.7 degrees C (V2-40), and 53.3 degrees C (V2-20). There were statistically significant increases in temperatures associated with each of the respective settings. There were no substantial visual changes produced by the V2-20 settings, while the other settings produced a gradation of effects. These data provide information to help guide the use of a bipolar radiofrequency electrode and electrosurgical system for thermal-assisted chondroplasty.

[Changes in various neurophysiological indices in treatment of lumbosacral osteochondrosis by combined osteoperiostal electroacupuncture and laser puncture]. / Izmeneniia nekotorykh neiropfiziologicheskikh pokazatelei v lechenii poiasnichno-kresttsovogo osteokhondroza osteoperiostal'noi élektroakupunkturoi v sochetanii s akupunkturoi.

The conducted dynamic rheovasographic investigations in 67 patients with neurological manifestations of lumbosacral osteochondrosis as well as determination of skin temperature in 162 patients, and employment of stimulation electromyography in 40 patients showed the presence of definite positive shifts (P < 0.001) both in patients with lumboischialgia and in those with the radicular pain syndrome, which fact was evidenced by the clinical data suggesting to us the feasibility of use of osteoperiostal electropuncture combined with laseropuncture with infrared radiation.

[Combined treatment using electrostimulation of the radicular-vascular syndromes in lumbar osteochondrosis]. / Kompleksne likuvannia iz zastosuvanniam elektrostymuliatsiï korintsevo-sudynnykh syndromiv poperekovoho osteokhondrozu.

Multiple-modality treatment was administered to 50 patients with radicular-vascular syndromes of lumbar osteochondrosis, involving various electrostimulation techniques. Treatment options for the patients were determined by character, duration and gravity of the illness. Efficacy of the treatment carried out differed; it was assessed on the basis of clinical and electrophysiological findings, such as those from electromyography, rheovasography. Better results were obtainable in those patients presenting with a single radicular lesion. Linkage was found of duration of paresis to treatment results: the earlier the start of the treatment involving electrostimulation the higher is its effectiveness.

[The effect of combined treatment with the use of magnetotherapy on the systemic hemodynamics of patients with ischemic heart disease and spinal osteochondrosis]. / Vliianie kompleksnogo lecheniia s primeneiem magnitoterapii na sistemnuiu gemodinamiku u bol'nykh ishemicheskoi bolezn'iu serdtsa i osteokhondrozom pozvonochnika.

The authors examined 66 patients with ischemic heart disease and concomitant cervico-thoracic osteochondrosis and 22 patients without osteochondrosis. Differences were revealed in values of the systemic hemodynamics with prevalence of the hypokinetic type in patients with combined pathology. Inclusion of magnetotherapy in the treatment complex of patients with ischemic heart disease and osteochondrosis favours clinical improvement, normalization of indices of central and regional blood circulation.