[Ultrasound scanning of the distraction regenerate in case of multilocus elongation of the fragments in patients with defects of long bones].

It was done ultrasound examination of distraction regenerates in patients with defect of bone tissue. The first group included 4 patients who had the size of congenital bone tissue defect 15.8±8.1 cm; the second group (3 patients) included posttraumatic defects with defect size 11.75±3.6 cm; the third group (4 patients) included posttraumatic defects with defect size 11±5.3 cm. It was discovered the particularities of distraction regenerate structural condition in case of low level of reparative osteogenesis. In the first group "ischemic" regenerate was characterized by slow formation of bone trabecules. In the second group "ischemic" regenerate had one or two hypo-echogenic cystic-like formations in the intermediate regenerate area. All patients of the third group had organotypic remodeling of the regenerate according to terms of distraction and fixation.

[Peculiarities of cerebral structures functioning in adolescents with achondroplasia].

Complex neurophysiological examination (rheoencephalography, electroencephalography) was carried out in 12 adolescents 12 to 18 years old in order to reveal the peculiarities of cerebral structures functioning in adolescents with achondroplasia. Some deviations from the normal values were found out: reduced blood filling of the brain vessels in the pools of a. carotis interna and a. vertebralis, rheoencephalographic signs of intracranial hypertension of mild degree and brain cycling characterized by moderate and significant amplitude increase, presence of pathological types (delta-, theta-) of the rhythmics and the reduction of the physiological ones (alpha-, beta-). At the same time the peculiarities of rheoencephalographic indices were observed while functional testings (hypercapnia, hyperoxia). Brain cycling differed from normal values by weaker response to the weight-bearing, mainly in alpha- and beta-ranges.

[Diagnostic significance of podography in patients with gonarthrosis].

Results of podography in 48 women aged 24-62 (46.6 +/- 2) years with bilateral gonarthrosis of metabolic/dystrophic etiology (grade I, II, III by N.S. Kosinskaya's osteoarthrosis classification) were analysed using a DIASLED-SCAN computed system (Sankt-Peterburg). Qualitative and quantitative changes detected by podography proved to be typical of different stages of female knee osteoarthrosis. A summary table illustrating dynamics of quantitative podogram characteristics as a function of severity of the disease is presented.

[Functional state of lower extremities muscles at the patients with shin congenital defects before and after treatment with Ilizarov device].

Results of examination (dynamometry, electromyography, ultrasonography) of 34 patients aged 6 to 23 years before and after treatment with Ilizarov's method are analyzed. Decrease of dynamometry and electromyography parameters, ultrasonic data are evidence of hard structural and functional disorders of motor system of these patients. Decrease of force and activation characteristics of tested muscles of operated extremity after removal of external fixator relates to high level of central protective inhibition and prolonged afferentation dysbalance at somatosensory system. Degree of recovery is limited and depends on patient age: recovery resources are presented at children before 8 years, but at juveniles they are depleted during the growth.

[Evaluation of the gas regimen in the damaged tissues]. / Otsenka gazovogo rezhima povrezhdennykh tkanei.

Dynamics of CO2 and oxygen was studied in the skin of 35 patients with open fractures of the crural bones. The results were compared with homeostasis in the whole blood. It was found that immediately after surgery there is marked acydosis, gas regimen of the skin adjacent to the wound is characterized by hypoxia and hypercapnia. By month 2 after the trauma the excessive amount of organic acids was compensated by falling content of CO2, i.e. development of CO2 alkalosis. A complete compensation was not achieved within the treatment period and normalization of acid-base balance in patients was not observed.

[Hyperbaric oxygenation in the treatment regimen using Ilizarov technique in patients with open fractures]. / Giperbaricheskaia oksigenatsiia v sisteme lecheniia po metodu Ilizarova bol'nykh s otkrytymi perelomami.

The dynamics of clinico-physiological parameters in complex treatment of patients with open fractures of the extremities using hyperbaric oxygenation was analyzed in 22 patients with severe injuries with different degree of ischemia of the extremity, and 9 patients with scanty injuries of the soft tissues. It was shown that vasospasm was observed in patients with the initially normal microcirculation after a course of HBO treatment. In patients with no or initially low capillary blood flow the microcirculation was enlarged due to vasodilatation of the arterioles. No considerable effects of the course of HBO on the main blood flow was revealed. Recommendations are given on using the HBO therapy in management of patients with severe open fractures and osteosynthesis of the injured segment by the Ilizarov methods.

[Changes of the rheologic properties of blood in patients operated upon with spleen trauma in the long-term postoperative period]. / Izmenenie reologicheskikh svoistv krovi u bol'nykh , operirovannykh pri travme selezenki, v otdalennom posleoperationnom periode.

Investigations of changed viscosity, erythrocyte deformation and aggregation indices in patients on the traumatized spleen in the long term postoperative period were carried out in 85 patients. Spleenectomy was fulfilled in 35 patients, organ saving operations in 20 patients, and autolientransplantation in 30 patients. Spleenectomy was shown to cause increased viscosity, indices of deformation and aggregation of erythrocytes. To prevent the changes of the rheologic properties organ-saving operations and autolientransplantation should be widely used.

[Peripheral hemodynamics in patients with posttraumatic osteomyelitis of leg bones]. / Perifericheskaia gemodinamika u bol'nykh posttravmaticheskim osteomielitom goleni.

Complex examination of peripheral hemodynamics with rheovasography, US-dopplerography and laser flowmetry was carried out in 67 patients with posttraumatic osteomyelitis of leg bones. In these patients before treatment there were sings of functional spasm of popliteal artery, increase of circulatory resistance in the bed of anterior and posterior tibial arteries, decrease of precapillary vessels reactivity by hypertonic type, decrease of capillary elasticity, their spasm, difficulty of blood outflow from great and middle veins. During treatment by transsosseous osteosynthesis main-changed type of blood flow, unstable vascular tones, decrease of greater artery elasticity, hypertoe of pre- and postcapillary small vessels were found. After treatment normalization of vascular tone, balance of status of pre- and postcapillary vessels, normal reaction of capillaries to functional test were demonstrated.

[Reconstruction of vascular bed in the affected segment of the leg in patients with defects of the crural bones complicated by chronic osteomyelitis]. / Vosstanovlenie sosudistogo rusla v porazhennom segmente u bolnykh s defektami kostei goleni, oslozhnennymi khronicheskim osteomielitom.

The article analyses the results of medical rehabilitation of 176 patients with defects in the leg bones complicated by chronic osteomyelitis by methods of transosseous osteosynthesis. In average hospitalization terms of 380.8 +/- 15.6 days, medical rehabilitation was achieved in 88.6% of patients. The results of complex clinical and laboratory examination of 46 patients by means of angiographic, radionuclide, and physiological methods confirm gradual correction of the initial regional arterial insufficiency which was combined with anatomical and physiological rehabilitation of the affected leg by the end of treatment. It was established that the high clinical result of the developed methods of transosseous osteosynthesis is based on the formation of a new zone of the vascular channel in the affected limb segment.