[Age reactivity of the organism of patients for treating bone limits.]

The purpose of the study is to find out how reducing the reactivity of the organism in patients of different age groups affects the duration of treatment of fractures of the Shin bones. The Analyzed data 1 382 case histories of patients of different age with fractures of the tibia in the treatment by Ilizarov for the past 42 years. Instrumental in the process of treatment in 98 patients with fractures of Shin bones the studied indicators of muscle strength, oxygen tension in the tissues, the load on the limb, micromotion of bone fragments, the speed of regional blood flow and blood flow in the middle cerebral artery. In elderly patients an increase in terms of fixation of fragments of bones, decreased muscle strength, the load on the limb when walking, speed of cerebral blood flow and blood supply of the limb. It is shown that the increase in terms of fixing a bone caused not so much by the number of years lived, as the deterioration of the reactivity of the organism of patients of retirement age.

[INFLUENCE OF FUNCTIONAL MUSCULAR TEST ON BLOOD FLOW VELOCITY ON MEDIAL CEREBRAL ARTERY DURING TREATMENT OF PATIENTS BY G. A. ILIZAROV].

It was evaluated the influence of functional test on blood flow velocity (BFV) on medial cerebral arteries (MCA) at healthy persons of different age (30 persons at the age of 5-60 y. o.) and in patients (28) during operative limb lengthening for 2-15 cm. BFV was examined by the ultrasonic dopplerography method at rest, and repeated on both brain sides in handhold of gripper by right hand then left one. In healthy persons, with age increasing, reduction of BFV on MCA was observed, and was more significant in patients with orthopaedic pathology. In four-time repetition of functional test variants, maximum range of BFV variation on MCA did not grow out of 17-25 %. During the process of operative limb lengthening in significant reduction of BFV on MCA and increasing of range BFV variation, working capacity of patients was disturbed. Age-delayed BFV on MCA develop slowly with a saving of BFV changes variability, it is a prerequisite of saving of brain centers function.

[Disorder of the Longitudinal Limb Growth and Muscular Contractility].

BACKGROUND: The reduction of the muscular contractility in the patients after operative lengthening of the limb with delayed growth is the main factor limiting the volume of orthopaedic treatment. OBJECTIVE: Our aim was to study the dependence of the muscular contractility of the femur and tibia on their longitudinal sizes in healthy individuals and patients of various age and in the patients with different variants of natural growth disorders of one of the lower limb before and after its operative lengthening according to Ilizarov. METHODS: Maximal torque of various groups of the femoral and tibial muscles was evaluated in 78 patients aged from 4 to 40 years with delayed longitudinal growth from 3 to 12 cm of one of the lower limbs using original dynamometers. Control group included 424 healthy children aged from 7 to 15 years and 36 persons aged from 18 to 35 years. RESULTS: The dependence of maximal torque of various groups of the femoral and tibial muscles on their longitudinal sizes in healthy individuals and patients of various ages and gender as well as in the patients with growth disorders before and after their operative lengthening was presented. The affected limb muscular strength and the same of the intact one reduced every cm of the longitudinal growth delay (for instance, the posterior tibial muscle for 3.2 and 1.7 Nm correspondingly). CONCLUSION: Compensatory increase of the muscular strength in the contralateral femur was found only in significant reduction of the muscular contractility of the affected tibia. In equal amount of the tibial shortening its muscular strength reduced relatively more in the patients with congenital disease and consequences of the osteomyelitis and less in trauma cases.

[Blood Flow and Regional Blood Flow Rate in the Middle Cerebral Artery during Surgical Leg Lengthening in Patients with Congenital and Acquired Limb Shortening].

This is a comparative study of changes in blood flow rate in the popliteal artery, the arteries of bone regenerate and cerebral arteries in 45 patients with congenital and acquired diseases of the limbs at different stages of surgical lengthening of 3-15 cm shortened shin by Ilizarov method. We observed an increase in regional blood flow rate in all patients during the periods of distraction and fixation. A 25% increase in blood flow rate in the middle cerebral artery on the contralateral side was found only in patients of the first adult age with acquired limb shortening. Basing on the analysis of the reaction of cerebral arteries during a functional test with additional muscle work, we suggested that the absence of reaction in congenital diseases is caused by relative excess of somatic afferentation which results from morphological and functional immaturity of brain regulatory systems.