Ligamentous Apparatus Research Articles

Biomechanical Substantiation of the Strength and Stiffness of a Hip Joint Capsule Defect Fixation with Polypropylene Mesh.

Formulation of the problem Dislocation of the femoral component of the endoprosthesis is one of the most frequent complications of total hip replacement. The best option for the “treatment” of dislocation of the hip endoprosthesis is to prevent the development of primary instability. There are cases in which even with the correct installation of the endoprosthesis components, dislocations arise due to the weakness or defect of the capsular–ligament apparatus. Currently, many methods have been developed to strengthen and restore the posterior structures of the capsule of the hip joint with the help of auto- and allomaterials, which differ in both the fixation technique and the characteristics of the materials themselves. In this paper, we propose a method for restoring and strengthening the posterior structures of the capsule of the hip joint using polypropylene-based graft implants. The purpose of this study is to, with the help of specialized software, build a model of the capsule of the hip joint after capsulotomy and to determine the stiffness capabilities of the defect covered with polypropylene mesh. Results The study was performed using a software package based on the finite-element method. As a result of the performed calculations, pictures of the distribution of the stress–strain state in the “head-capsule” system were obtained. To assess the effectiveness of the method of closing the capsule, from the viewpoint of rigidity, as the main characteristics, the values of the opening of the cut are selected. Conclusions Under the kinematic loading of the model, the smallest values of the opening of the section are obtained when it is closed by a grid. In the case of thread fixation, the values were higher by 8.5%. However, the values of equivalent stresses, both in the capsule and in the head, in the model with the grid turned out to be the largest. These stresses were higher by 23.8% in the capsule and by 60.4% in the head than the same values for the thread fixation model. The obtained results indicate that the model with a grid is more rigid in the considered fixation variants.

Mid-term results of multi-ligament posterior and anterior cruciate ligament reconstruction using a modified method of bone tunnels drilling

The problem of diagnosis and treatment of chronic anterior-posterior instability of the knee joint in multi-ligamentous injuries remains relevant, both medically and socially. Conservative treatment of patients with this pathology is ineffective due to severe instability and gross violation of the biomechanics of the knee joint. Currently, there is no consensus on the tactics of surgical treatment of this disease, and on the method of plastic replacement of the lost ligamentous apparatus.
 Objective. To evaluate the clinical results of the modified technique of arthroscopic plastic surgery of both cruciate ligaments of the knee joint.
 Patients and methods. Based on previous anatomical studies, the authors formulated the basic principles of safe formation of bone tunnels in simultaneous arthroscopic plastic surgery of the anterior (PKS) and posterior (ZKS) cruciate ligaments. An original method of surgery aimed at minimizing the risk of injury to the popliteal artery during the formation of the tibial bone tunnel is proposed. In the period from 2010 to 2017, the Department of endoscopic surgery treated 20 patients with damage to the SCS and SCS using this technique. The results were evaluated 6 and 12 months after surgery. Clinical examination, IKDC and Lisholm-Gillqist questionnaires and the visual analog pain assessment scale (VAS) were used to evaluate clinical results.
 Results. The average score on the IKDC questionnaire was 34.1613.31 points before surgery, and 34.8918.37 points on the lisholm Gillqist questionnaire. 6 months after surgery 58.756.38 and 69.7814.10 points according to IKDC and LisholmGillqist, respectively, which is statistically significant (p0,05) higher than before surgery. A year after the operation, the positive dynamics was observed even more clearly (p0.01): 76.839.26 and 82.006.38 points, respectively. The final result of the evaluation according to the IKDC Protocol: 11(55.0%) patients were assigned to group A (good result),6 (30.0%) to group В (close to good result),2 (10.0%) to group C (satisfactory result) and 1 (5.0%) patient to group D (unsatisfactory result). Conclusion. The obtained clinical results allow to evaluate the proposed method as effective. In this case, the method of forming bone tunnels has a number of advantages compared to the classical technique, including minimizing the risk of intraoperative damage to the structures of the popliteal neurovascular bundle.

Changes in functional, anatomical and optical parameters of the eye in children with habitually excessive accommodation stress and pseudomyopia after regular badminton playing

Purpose. To study the state of refraction, accommodation, and blood flow in eye vessels of children with habitually excessive accommodation stress (HEAS) and pseudomyopia practicing badminton.Material and methods. The study involved 11 patients (20 eyes) aged 7 to 11 years (average M±SD: 9.24 ± 1.06 years) with pseudomyopia and HEAS: 4 patients with myopia (7 eyes), 3 children with hyperopia (6 eyes), 4 children with emmetropia (7 eyes) before they started practicing badminton and after playing it for a certain time. All patients were tested for visual acuity, subjective and objective accommodation, optical biometry, aberrometry, velocity of blood flow in eye vessels, and choroidal thickness.Results. After 1 year of regular badminton workout, the subjects revealed a 0.92 ± 0.82 D weakening of manifest refraction, a decrease in accommodation tone by 0.85 ± 0.77 D, an increase in blood flow rate in ophthalmic artery and the central retinal artery, an increase in positive spherical aberration, a decrease in aberrations associated with mismatch and irregularity ofoptical system elements (tilt, trefoil, coma), which indirectly indicates a strengthening of the ligamentous apparatus of the lens.Conclusion. Practicing sports (badminton) contributes to the elimination of pseudomyopia, improvement of uncorrected visual acuity, accommodative ability, and ophthalmic hemodynamics indicators.

Internal meniscus resections do not affect anterior knee joint stability

Meniscus injuries lead to increased knee joint instability. Currently, however, it is unclear whether arelevant medial meniscus part resection leads to an increased ventral tibia translation with intact anterior cruciate ligament. The aim of our study was therefore to clinically examine the stabilizer function of at least 30% resected medial meniscus for anterior tibial translation. In this prospective study, 18patients with unilateral medial meniscus lesion were treated before and after arthroscopic medial meniscus resection. They were treated on the healthy and on the sick leg through the use of two different apparatus methods (dynamic translation measurement using hamstring reflex apparatus and KT-1000 arthrometers) as well as afunctional test (computer-supported dynamic posturography (CDP)) and aclinical hop test. Further, the mean values for significance using non-parametric Wilcoxon test. After completing all the studies, we were not able to detect any significant differences in our study that would indicate increased ventral instability in the knee joint after arthroscopic medial meniscus resection. Inner meniscal partial resection does not lead to increased ventral knee instability in intact VKB. Whether in patients with instability (feeling) after partial meniscus resection, arotation instability is the cause or whether further injuries or disturbances in the capsular ligament apparatus are present, must be examined in further studies. Anterior knee joint instability cannot be adequately explained according to our study.

Применение инъекционной формы препарата «Форвет®» в блокадах ветвей V и VII нервов головы при лечении стоматитов, гингивитов и пародонтитов различной этиологии

Oral cavity diseases are common among small domestic animals; they can be of traumatic, inflammatory, bacterial, viral or mycotic origin. Pathologic process affecting superficial as well as deep layers of mucous coat of gingivae, ligamentous apparatus, periosteal coverage develops secondary to deterioration of metabolic processes or traumas and in any case is followed by decrease of immunological status of organism as a whole as well as local immune response to introduction of pathogen. Sharp pain syndrome and inflammatory edema of tissues troubles eating and drinking which additionally weakens the animal's organism and leads to even worse course of disease. The necessity of conducting research is dictated by the lack of information concerning the use of condylar blocking using immunomodulating and antibacterial drugs as a part of complex therapy of oral cavity diseases among small pets.
 
 Clinically disease declared itself in salivation of different intensity, hyperemia, anabrosis and ulcers with festering incrustations on mucous coat of oral cavity, swelling of submandibular lymphonodus, troubled eating and drinking or complete incapability to eat or drink as a result of sharp painfullness. In such cases the use of procaine block of supramaxillary and mandibular branches of trigeminus (V) which innervates skin and mucous coat of lips, gingivae, bottom of oral cavity, front parts of tongue, hard and soft palates and notal and ventral branches of buccal nerve (VII) which innervates cheeks, lips and nose muscles, joining together along their bodies and with branches of infraorbital nerve, temporal-auricular and mental nerve, sufficiently improves the state of animal by removing pain syndrome and as a result restoring blood circulation in damaged areas.
 
 Our work describes the methodology of condylar blocking with small pets as a part of complex therapy of diseases of oral cavity. Two new methods of blocking have been developed and tested. Anatomic assessment of effectiveness of different compositions of condylar blocks with cats and dogs has been made. In our work we studied the effectiveness of drug «Forvet®» as part of complex therapy of animal diseases of oral cavity using blocks of notal and ventral branches of buccal nerve (VII), supramaxillary and mandibular branches of trigeminus (V).

Systematic effects of femoral component rotation and tibial slope on the medial and lateral tibiofemoral flexion gaps in total knee arthroplasty

PurposeTo quantify the effects of the systematic internal and external femoral component rotations and tibial slope on the medial and lateral tibiofemoral gaps in total knee endoprostheses. MethodsNineteen knee cadaver specimens with an intact ligament apparatus were fixed in a custom frame, facilitating physiological flexion motion. Virtual total knee arthroplasty (TKA) was performed on three-dimensional models obtained from computed tomography ​scans (0° and 90° flexions) with systematically altered femur rotations and tibial slopes. ResultsBoth the femur rotation and the tibial slope influenced the medial and lateral tibiofemoral flexion gaps (p ​< ​0.001), and the effects differed between the medial and lateral sides (p ​< ​0.001). The medial tibiofemoral flexion gap increased by 2.90 ​± ​0.34 ​mm and decreased by 2.66 ​± ​0.26 ​mm for 7° external and internal femur component rotations, respectively (both with p ​< ​0.001). The lateral tibiofemoral flexion gap decreased by 3.11 ​± ​0.31 ​mm and increased by 3.29 ​± ​0.33 ​mm for 7° external and internal femur component rotations, respectively (both with p ​< ​0.001). ConclusionFor established surgical methods, we recommend a neutral femur rotation for a 0° tibial slope and a 3° external femur rotation for a tibial slope of 9–10°. The translational potential of this research shows that while the rotation of the femoral component in extension has no effect on the gap size, owing to the axis of rotation being perpendicular to the gap, for a 90° flexion, we not only observe differences in the gap size between the medial and lateral ​but also unequal differences on either side depending on the inward or outward rotation. The main reason for this is the position of the axis of rotation, which is not precisely half way between the lateral and medial contact points. The results show that rotation of the femoral component always creates an unbalanced flexion gap. The translational potential of this articleThe article points out the differences in the tibiofemoral gap in total knee endoprostheses due to the systematic internal and external femoral component rotation. While in lower leg extension there are no differences seen, in 90° knee-flexion there are unequal differences within the medial and lateral compartment that show a mathematical relationship towards the femoral compartment rotation which needs to be intraoperatively considered.

ОСОБЕННОСТИ МОРФОЛОГИЧЕСКОЙ ОРГАНИЗАЦИИ СВЯЗОЧНОГО АППАРАТА ТАЗА У МЛЕКОПИТАЮЩИХ СЕМЕЙСТВ CANIDAE, FELIDAE, MUSTELIDAE, INSECTIVORA, BOVIDAE, LEPORIDAE

Авторами описан связочный аппарат у представителей 6 семейств млекопитающих. Разработана схема развития связочного аппарата млекопитающих в филогенетическом аспекте, позволяющая оценить значение связочного аппарата таза в родовом процессе.

Te inf uence of ergonomic factors on the formation of occupational risk of health disorders of agricultural machine operators

Introduction. T e leading place in the structure of occupational morbidity of agricultural machine operators is occupied by vertebroneurological diseases, the development of which can be associated with the impact of ergonomic factors of labor activity. T e aim of the study is to assess the ergonomic factors of working conditions on mobile agricultural machinery and to identify their impact on the formation of health disorders of agricultural machine operators. Materials and methods. Complex physiological and ergonomic researches at operation of tractors and combine harvesters of old samples of domestic production including an assessment of the organization of workplaces on compliance to requirements of ergonomics and anthropometric data of workers, temporary, statodynamic, biomechanical characteristics of working poses and movements, a functional condition of machine operators (130 people aged 20–45 years with professional experience of work not less than three years) in dynamics of a work shift are carried out. Anthropometric studies were conducted among male machine operators (663 people) aged 18–59 years and with experience in the profession for more than three years. Results. The discrepancy between the size and space-layout parameters of workplaces ergonomic requirements and anthropometric data of machine operators, causing the formation of uncomfortable working positions, increasing physical activity and the severity of the labor process. A high degree of correlation between changes in the parameters of the neuromuscular system and the severity of the discrepancy between the ergonomic parameters of anthropometric characteristics of machine operators (r=0,7). T e results of the research allowed to determine the priority measures for the prevention of vertebroneurological diseases in agricultural machine operators. Conclusions. T e organization of workplaces on domestic tractors and combine harvesters of old samples does not meet the ergonomic requirements and anthropometric data of machine operators, which is the reason for the formation of an uncomfortable working posture, increased statodynamic physical activity, early development of fatigue and fatigue in the process, which can cause the development of pathological conditions of the spine and ligamentous apparatus. Ergonomic improvement of workplaces is one of the priority measures to preserve the health of agricultural machine operators.

ЭФФЕКТИВНОСТЬ ПРИМЕНЕНИЯ ТРОМБОЦИТАРНОГО ФАКТОРА РОСТА (PRP) ПРИ КОМПЛЕКСНОМ ЛЕЧЕНИИ ДИСФУНКЦИИ ВНЧС.

Background. Joint pain is often associated not only with disc displacement but also due to the level of inflammatory mediators in the synovial fluid. Injections of platelet growth factor not only expand the joint cavity, performing a purely mechanical function but also create a high concentration of growth factor in the synovial fluid, which favorably affects the cartilage tissue, joint capsule, ligamentous apparatus. &#x0D; Objectives ― to study the effectiveness of platelet growth factor in the complex treatment of patients with TMJ malfunctions. &#x0D; Methods. A clinical examination of two groups of patients (50 people) aged 18 to 67 years with a malfunctions of TMJ was conducted. Were used in all patients in the complex: splint therapy, myogymnastics, and manual traction drive. For the first group (25 people), concentrated growth factor in the liquid phase (PRP) was used in the treatment. For the second group (PRP) was not used. The patients were divided into two groups randomly. &#x0D; Results. The results of the study were carried out according to the following criteria: pain in TMJ with a maximum opening of the mouth, protrusion, laterotruzii, sound phenomena in TMJ, myofascial pain (palpation), the presence of deviation/deflection of the lower jaw, incisional distance. &#x0D; Conclusions. 1. Complex therapy, including splint therapy, myogymnastics, manual traction of the disc, the use of platelet growth factor, showed good results in the treatment of TMJ malfunctions. 2. According to all the studied criteria (pain in TMJ with a maximum opening of the mouth, protrusion, laterotruzii, sound phenomena in TMJ, myofascial pain (palpation), the presence of deviation/deflection of the lower jaw), the most effective result of treatment was obtained after 1 month.

The infl uence of osteopathic correction on the restoration of the functions of the ankle joint with partial damage of its ligaments

Introduction. In recent times there has been is a signifi cant increase in the level of injuries. According to the national and foreign authors, every year up to 20 % of patients coming to the trauma center are patients with injuries of the ankle joint. Among the injuries of the soft tissue structures of the ankle joint, isolated injuries of the capsular ligamentous apparatus, merit the most attention. They present up to 70–75 % of all ankle joint traumas. Traumas of the soft tissue structures of the ankle region often have serious consequences, such as chronic instability of the ankle joint, formation of periarticular pathologic ossifi cation, chondral bodies. Osteopathic techniques can help to reach more complete restoration of the functions of the limbs in rehabilitation of patients with lower limb injuries.Goal of the study — to justify the necessity of use of osteopathic methods in complex treatment of patients with injuries of the capsular ligamentous apparatus of the ankle joint.Materials and methods. The results of treatment of 30 female patients aged from 50 to 60 years with acute partial injuries of the capsular ligamentous apparatus of the ankle joint of the I and II degrees were examined. All patients were divided into two equal groups regardless of gender, age, severity and nature of injury by random sampling: the main group (n=15), who received osteopathic correction against the background of standard treatment and the control group (n=15) who received standard treatment only. During the treatment the range of movements in the foot was assessed by the amplitude of fl exion, extension, pronation, and supination in all the patients, with the use of the goniometer. Additionally, the length of the ankle circumference was measured. The intensity of the pain syndrome was also assessed in points with the help of the visual analogue scale (VAS). Examination of patients was carried out in 1–2 days after the removal of the gypsum bandage and in 6 weeks after the removal of the gypsum bandage.Results. After the treatment all the patients presented a decrease in the circumference of the ankle joint, an increase in the amplitude of fl exion, extension, pronation, and supination. At the same time, after the osteopathic correction, the volume of movements was signifi cantly higher than after the standard treatment. The study of the subjective perception of pain has allowed to establish almost complete recovery of comfortable movements in the ankle joint by the end of the treatment in patients who underwent osteopathic correction.Conclusion. Methods of osteopathic correction in treatment of patients with partial injuries of the capsular ligamentous apparatus of the ankle joint allow to reach the restoration of joint functions in a larger volume than standard methods of treatment.

Assessment of Noninvasive Low-Frequency Ultrasound as a Means of Treating Injuries to Suspensory Ligaments in Horses: A Research Paper

Therapeutic ultrasound is a noninvasive technique, which is well tolerated by horses, does not need sedation, and can easily be performed in a routine clinical setting. Twenty-three client-owned sport horses were recruited at Clinica Equina San Biagio and included in this case study. Treatment of the injured suspensory ligament apparatus was administered using an EQ Pro, low-frequency therapeutic unit (38 kHz). The noninvasive treatment consisted of massaging the injured area in combination with a traditional ultrasound gel while maintaining the head of the device in direct contact with the injured area. The results indicate that 20 of the 23 horses in this study benefitted from EQ Pro treatment and, following a routine rehabilitation program, returned to competition status: a success rate of 87%. Furthermore, treatment duration was 3.3 ± 0.4 weeks on average, with a healthy outcome as assessed by ultrasound at 6.8 ± 1.9 weeks. Among the 23 horses in this study, 65% of them benefitted from EQ Pro treatment of a duration of just ≤3.3 weeks. It is concluded that EQ Pro therapy is a promising and effective form of treatment for horses with suspensory ligament injury. It is furthermore rapid and easy to use in the Equine Veterinary Clinic setting and does not require sedation. Future studies should now focus on the mechanisms by which this new treatment activates the healing process of the suspensory ligaments of injured horses.

Visi deformity after wrist fracture: Case report

Background: Distal radius fractures (fractura radii loco typico) are an everyday task for a surgeon that deals with injuries. Oftentimes complicated associated injuries of the ligamentous apparatus occur, which are hard to recognise and demand appropriate care. If such injuries remain unrecognised, they lead to more serious functional disorders, which is why the purpose of this report is to point out a rare and serious complication of distal radius fracture.Case presentation: We report the case of a 20-year-old man who suffered a fracture of the radius and developed a serious associated ligamentous disorder that was discovered relatively late.Conclusion: Ligamentous injuries associated with distal radius fractures represent a serious diagnostic challenge and, due to their consequences, also a serious clinical challenge. They are often hard to recognise and get discovered late. If the treatment shows no improvement, diagnostic images should be carefully analysed, and the physician should be well acquainted with relevant pathological conditions.

Биомеханическое обоснование техники виса в скалолазании

Цель работы – выявить основные кинематические характеристики виса в скалолазании у спортсменов разной квалификации и теоретически обосновать правильную технику выполнения данного движения. Материал и методы. Была проанализирована техника выполнения виса в боулдеринге 20-ти ведущих скалолазов Мира и Украины и 20-ти начинающих скалолазов-любителей мужского пола. Возраст спортсменов 22,4±3,2 года, длина тела 178,5±12,5 см, масса тела 72,2±8,5 кг. В демонстрации различных моделей выполнения виса принял участие квалифицированный спортсмен. С помощью компьютерной программы Kinovea 0.8.15 были проанализированы кинематические характеристики двух моделей техники (модель 1 – характерна для начинающих спортсменов, модель 2 – характерна для квалифицированных спортсменов) на основе определения величины углов между плечом и надплечьем, а также между поясничным отделом позвоночника и вертикальной осью. Результаты. Выявлены основные кинематические параметры виса в скалолазании для различных моделей техники, характерных для спортсменов разной квалификации. Показано наличие достоверных различий (р&lt;0,001) в величине углов между плечом и надплечьем, между нижним отделом позвоночника и вертикальной осью в фазе фиксации виса. Угол между плечом и надплечьем в первой модели техники составил 1460, во второй модели техники данный угол составляет 970. Угол между поясничным отделом позвоночника и вертикальной осью составил в первой модели 110, во второй модели данный угол составил 280. Дано теоретическое обоснование правильной техники виса в скалолазании с точки зрения законов механики и законов взаимодействия сил в кинематической цепи. Выводы. В первой модели вис осуществляется в основном за счет связочного аппарата суставов плечевого пояса при минимальном включении мышц, что опасно травмированием связок плечевого сустава. Во второй модели вис обеспечивает также включение мышц туловища и ног, что снижает нагрузку со связочного аппарата и понижает вероятность травмирования связок плечевого сустава.

The use of fiberotomy patients before and after orthodontic treatment tight regulations incisors

Relevance of the research topic. The frequency of the spread of the crowded position of the teeth in the frontal parts of the jaws among other dental anomalies, according to R. Ferro (2016) is 48% of the number of all examined by him. Due to the wide prevalence of anomalies in the optimization of orthodontic treatment of patients with a crowded position of the teeth continue to attract researchers. Studies of a number of authors have shown, the prevalence of malocclusion is an average of 33.7 per cent. The frequency of anomalies of occlusion, combined with the close position of the teeth in the anterior region is increased to 59-73%. The role of the third molars in the formation of the crowded position of the teeth continues to be clarifed. The goal is to increase the effciency of orthodontic treatment of patients with kuchennym the position of the teeth in the frontal parts of the jaws due to ulzibat and vibropneumotables.Materials and methods. In the study, analysis of histological preparations 35 patients aged 16-25 with kuchennym position of the cutters who underwent orthodontic treatment by the conventional method with the use of permanent equipment. Three groups were identifed: 1st-control, 2nd-before applying non – removable equipment performed fbrotomy and 3rd-after removal of non – removable equipment performed fbrotomy according to the standard procedure in the Department of maxillofacial surgery and dentistry Sammu. Results. In the examined three groups of patients, the revealed structural changes in the gingival mucosa indicate its damage and the presence of chronic productive inflammation as a response to physiological response to hardware orthodontic treatment. The results of comparison of microphotographs of multilayer flat epithelium of the mucous membrane of the alveolar process of the jaws in three groups of patients were the answer to the task of the study.Summary. The histological structure of the attached mucous-periosteal cover of the alveolar process of the upper and lower jaw in the area of the crowded position of the teeth before orthodontic treatment was studied for the frst time with the help of morphological methods of research this allowed to reveal distinctive morphological features in this group of patients. In the comparative aspect, the morphological structure of the mucous-periosteal cover of the alveolar process of the upper and lower jaw after orthodontic treatment and in the retention period in the main and control groups of patients was studied, which deepened the knowledge of the processes of ligamentous apparatus restructuring depending on the method of treatment.

The Diagnosis and Treatment of Acute Dislocation of the Acromioclavicular Joint.

The acromioclavicular joint (ACJ) is one of the more common sites of shoulder girdle injury, accounting for 4-12% of all such injuries, with an incidence of 3-4 cases per 100 000 persons per year in the general population. Current topics of debate include the proper standard diagnostic evaluation, the indications for surgery, and the best operative method. This review is based on publications retrieved by a selective literature search. Mechanical trauma of the ACG can tear the ligamentous apparatus that holds the acromion, clavicle, and coracoid process together. Different interventions are indicated depending on the nature of the injury. In recent years, the horizontal component of the instability has received more attention, in addition to its vertical component. Persistent instability can lead to chronic, painful limitation of shoulder function, particularly with respect to working above the head. Surgical stabilization is therefore recommended for high-grade instability of Rockwood types IV and V. Modern reconstruction techniques enable selective vertical and horizontal treatment of the instability and have been found superior to traditional methods, particularly in young athletes. Arthroscopic techniques are advantageous because they are less invasive, do not require removal of implanted material, and afford the opportunity to diagnose any accompanying lesions definitively and to treat them if necessary. Surgery for acute injuries should be performed within three weeks of the trauma. For chronic injuries, additional tendon augmentation is now considered standard treatment. High-grade ACJ instability is a complex and significant injury of the shoulder girdle that can cause persistent pain and functional impairment. The state of the evidence regarding its optimal treatment is weak. Large-scale, prospective, randomized comparative studies are needed in order to define a clear standard of treatment.

Структура и содержание физической реабилитации детей грудного возраста при дисплазии тазобедренного сустава

Hip joint dysplasia among children - congenital hypoplasia of femoral head, or congenital increased mobility of the joint due to the weakness of the ligamentous and muscular apparatus. Such a violation of the hip joint elements development (one or both) leads to an incorrect interposition of the joint structures, whereby the femoral head is displaced relative to the articular surface, formed subluxation, pre-dislocation or joint dislocation. This is a severe and common disease of the musculoskeletal system. Since medical treatment for dysplasia among newborn is not provided, and surgery is required only in extreme cases, therefore, active methods in the fight against this pathology are: specific orthopedic devices, physiotherapy, massage and exercise therapy. Thanks to these components, treatment therapy will strengthen the muscles, accelerate recovery, it will be fast and unobtrusive for the child. In this regard, we have developed the structure and content of physical rehabilitation for infants with hip joint dysplasia. This course was designed for four weeks and was developed a set of rehabilitation measures. The content of the course of physical rehabilitation includes orthopedic correction with the help of special devices, massage, therapeutic gymnastics in combination with fitball gymnastics and therapeutic swimming, physiotherapy. To assess the effectiveness of the physical rehabilitation program developed by us, we conduct an ascertaining pedagogical experiment - testing, clearly demonstrating the functional and motor state of the hip joints of the subjects before the beginning of the forming pedagogical experiment and at its end.

Treatment of uncomplicated vertebral compression fractures

To compare the outcomes of surgical (vertebroplasty) and conservative treatment in management of pain syndrome in patients with uncomplicated spine injury. The study involved 60 patients with stable uncomplicated compression fractures of vertebral bodies in the thoracic and lumbosacral spine. These patients were subdivided into two groups. Group 1 consisted of 30 patients who had undergone unilateral transpedicular percutaneous vertebroplasty; Group 2 involved 30 patients who had undergone a course of conservative treatment. The medical records and the catamnestic follow-up data of patients treated at the Neurosurgery Department of the Research Clinical Center of JSC Russian Railways in 2015-2017 were analyzed for this purpose. No statistically significant differences in sex, age, and level of injury were revealed between the study groups. A comparative analysis of treatment outcomes demonstrated that pain intensity assessed using the VAS scale was significantly reduced after one-year follow-up in both groups as compared to the baseline. A statistically significant decrease in pain intensity in the group of patients who had undergone vertebroplasty was observed as early as one month after the injury. No significant intergroup differences were observed in the long-term follow-up period (3 and 6 months) for this parameter. In five out of 60 patients, examination 12 months after the injury revealed that vertebral body height decreased by up to 10%. No statistically significant correlation with the treatment method was observed. Vertebroplasty provides a statistically better pain relief during the first month after spine injury as compared to conservative treatment. For patients, this means earlier activization and quicker return to daily routines and work.

PHYSIOTHERAPEUTIC CORRECTION OF ANTIOXIDANT INDICATORS OF HOMEOSTATIC STATUS IN PATIENTS WITH DISCOGENIC PATHOLOGY

Aim: study of the results of lymphatic drainage and detoxification properties of a therapeutic complex in the form of galvanopharmacological technique with 1 % terrilytin and 0.5 % aspirin, therapeutic exercise and skull traction tongs in patients with discogenic lesions of the cervical spine for achieving analgesic and anti-inflammatory effects, restoration of impaired functions and compensatory-adaptive reactions. Methods: the levels of lipid peroxidation were investigated, MRI was conducted on the "Gyroscan T5-NT" scanner (Philips), ultrasonic dopplerography of extracranial vessels was made using "Sonoline Antares" system (Siemens), REO of cervical vessels using "Megas" system (Italy) was conducted before/after application of the following methods: therapeutic exercises, neck massage, ascending lymphatic galvano-pharmacological technique with 0.5 % aspirin and 1 % terrylitin liquid in 10 ml of distilled water in a course of 7-10 procedures. Results: 35 % of patients were found to have the first degree of osteochondrosis; 37 % of patients had the second and 28 % of patients had the third degree. After a course of therapeutic complex with ascending lymphatic galvano-pharmacological therapy a significant increase in the level of SOD (from 7.86 ± 0.41 to 9.69 ± 0.45 units/ml; p = 0.0003); a reduction in the levels of MDA (from 2.51 ± 0.18 to 2.01 ± 0.11 nmol/l; p = 0.05) and diene conjugates (from 1.31 ± 0.15 to 0.89 ± 0.11 mlxmg; p = 0.0009) were stated. The therapeutic complex with ascending lymphatic galvano-pharmacological technique effectively eliminated pain syndrome, improved the levels of lipid predoxidation and neck/head vascular performance in 75.6 ± 4.3 % of patients. Conclusions: ascending galvano-pharmacological technique with the use of developed therapeutic complex in patients with discogenic lesions of the cervical spine promotes an effective lymphatic detoxification, an improvement of humoral transport, analgesic and anti-inflammatory effects, restoration of impaired functions of the muscular and ligamentous apparatus and the formation of compensatory-adaptive reactions.

Role of risk factors in development of chronic posttraumatic instability of ankle joint

Injuries of the ankle joint (AJ) are the most common traumas of musculo-skeletal apparatus and a common reason for seeking medical advice. Overstrains of the ligament apparatus of AJ are the most common mechanism of traumas in running, sporting activity, in unexpected fallings into rough surfaces or getting with a heel into ribbed coverings of metroescalators, in a sharp stoppage of public transport, in wearing footwear on high heels, etc. 20-40% Of patients develop a clinical presentation of a chronic instability of the ankle joint. In the article the analysis of the literature data on the role of risk factors in development of a chronic posttraumatic instability of the ankle joint is given. In result the authors make the conclusion that the influence of the internal risk factors on development of a chronic posttraumatic instability of the ankle jointis studied insufficiently, and further investigations in this direction are required. This scientific trend is important and is of high practical significance, since its results could be used for elaboration of the algorithm of organ-saving operations which will permit to optimize medico-surgical approach, to reduce the number of patients with disability and to return patients to their professional and sporting activity.

Role of risk factors in development of chronic posttraumatic instability of ankle joint

Injuries of the ankle joint (AJ) are the most common traumas of musculo-skeletal apparatus and a common reason for seeking medical advice. Overstrains of the ligament apparatus of AJ are the most common mechanism of traumas in running, sporting activity, in unexpected fallings into rough surfaces or getting with a heel into ribbed coverings of metroescalators, in a sharp stoppage of public transport, in wearing footwear on high heels, etc. 20-40% Of patients develop a clinical presentation of a chronic instability of the ankle joint. In the article the analysis of the literature data on the role of risk factors in development of a chronic posttraumatic instability of the ankle joint is given. In result the authors make the conclusion that the influence of the internal risk factors on development of a chronic posttraumatic instability of the ankle jointis studied insufficiently, and further investigations in this direction are required. This scientific trend is important and is of high practical significance, since its results could be used for elaboration of the algorithm of organ-saving operations which will permit to optimize medico-surgical approach, to reduce the number of patients with disability and to return patients to their professional and sporting activity.