[Problems of expert application of «Medical criteria to determine the severity of harm caused to human health¼ in closed injury of the shoulder joint]. / Problemy ekspertnogo primeneniya «Meditsinskikh kriteriev opredeleniya stepeni tyazhesti vreda, prichinennogo zdorov'yu cheloveka¼ pri zakrytoi travme plechevogo sustava.

The represented analysis shows the mechanism of formation of traumatic shoulder dislocation and potential intra-articular anatomic-morphological damages of humeral head according to the Hill-Sachs type in order to objectify the criteria of determination the severity of harm caused to human health. The potential Hill - Sachs classifications of shoulder dislocation are considered depending on size of humeral head defect. During the period of 2015 to 2020, 250 «conclusions¼ of forensic investigations of patients with the injuries of the shoulder joint were analyzed, performed by an expert traumatologist. It was identified, that in 8 patients with shoulder joint dislocation among 32 cases of shoulder injury, experts interpret this injury as a severe harm caused to human health without sufficient justification, using the conclusions of radiology specialists who gave a very brief description of X-rays indicating the diagnosis «fracture of humeral head according to the Hill-Sachs type¼. The severe harm caused to human health was detected correctly only in 2 patients with impression fracture of humeral head.

[Medical expert evaluation of medical care for patients with musculoskeletal injuries]. / Mediko-ekspertnaya otsenka okazaniya meditsinskoi pomoshchi patsientam s travmami oporno-dvigatel'nogo apparata.

The objective of the study is to analyze 220 forensic medical examinations on criminal and civil cases and pre-investigation checks concerning the quality of emergency trauma care, involving an orthopedic traumatologist as a member of the expert panel. The main aspects of the forensic evaluation of medical care for patients with musculoskeletal injuries are described, including a thorough review of medical documentation data, completeness of past and present medical history in the medical records, injury mechanism, and completeness of the trauma course description in the medical records. The reasons for the forensic examinations, the causes of the main types of defects in medical care, and their relation to adverse outcomes were determined.

[Prevention of adverse events following the use of local anesthetics in traumatology and orthopedics]. / Profilaktika nezhelatel'nykh sobytii pri primenenii mestnykh anestetikov v travmatologii-ortopedii.

The article analyzes the frequency of development of adverse toxic reactions when using local anesthetics in the practice of an orthopedic traumatologist; based on the conclusions of commission forensic medical examinations conducted in the framework of criminal proceedings on the death of patients, the features of the onset of LAST syndrome are studied, which significantly increases the medical risk for the patient and the legal risk for the doctor. An analytical study of scientific publications on the possibilities of using the local anesthetic Articaine-Binergia 20 mg/ml in the daily work of both polyclinic and inpatient doctors to ensure the safety of medical activities was conducted.

[The Impact of Labor Conditions on Health Conditions of Traumatologists of Emergency Service].

The organization of emergency medical care varies from one country to another. However, the basic requirements applied to specialists in case of emergency curative diagnostic measures are common: fast feedback, professionalism, emotional stability. Therefore, the key characteristic of emergency medicine is to instantly react twenty-four hours per day. The medical workers of considered category are in condition of increased physical and mental loading. According the WHO concept, a negative impact of working environment is a key factor of development of professional burn-out syndrome. Despite that in publications there are enough data concerning prevalence of this syndrome among physicians, there is no common approach to establishment of causes of its development. The sociological survey was carried out using the technique of the Maslach's Burnout Inventory questionnaire concerning traumatologists of emergency medical care in profile departments of metropolitan medical organizations. It is established that emergency as a special operating mode is a key factor in development of professional burn-out syndrome. Its development results in both deterioration of mental and physical health of medical workers of the given category and negative impact on efficiency of their work.