New Method Of Surgical Treatment Research Articles

A Successful Case of Using a New Method of Surgical Treatment of Patients with Transsphincteric Pararectal Fistulas

INTRODUCTION: Surgical treatment of high transsphincteric and extrasphincteric pararectal fistulas (PFs) is one of the unsolved problems of modern coloproctological practice. Currently, there is no uniform approach in treatment of these kinds of PFs. AIM: To present a clinical case of successful application of the developed method of treatment of high transsphincteric PFs using resorbable АПТОС® threads with notches and antibacterial coating. The paper presents a case of application of the developed method for the treatment of high transsphincteric PFs using resorbable АПТОС® threads with notches and antibacterial coating in a patient admitted to a surgical department on a planned basis with complaints of the presence of a skin defect in the perianal area with permanent purulent discharge, periodic elevation of body temperature to 37.5°С–38.0°С accompanied by pain in the anus area. Detailed description of surgical intervention method is given. Within the first 3 days after the surgical intervention, low-grade body temperature persisted (37.3°С–37.5°С). The pain syndrome was most pronounced throughout the first postoperative day, in the following days analgesics were not required. On the 7th day, the patient was discharged in satisfactory condition under supervision of a surgeon at the local clinic. On the control examinations at 1 and 6 months, no data on recurrence, anal incontinence were obtained. CONCLUSION: The presented clinical case demonstrates reasonability and effectiveness of the method developed by authors for surgical treatment of high transsphincteric PFs with use of resorbable АПТОС® threads with notches and antibacterial coating.

CLINICAL CASE OF A NEW METHOD FOR SURGICAL TREATMENT OF HILL-SACHS REVERSAL FRACTURE IN OLD-ENGINED POSTERIOR SHOULDER DISLOCATION.

The article presents a clinical case in which the use of a new method of surgical treatment of a HILL-SACHS type reversal fracture in chronic posterior shoulder dislocation is considered. In this clinical case, we proposed an operational-biomechanical theory, the main goal of which is surgical treatment of a HILL-SACHS reversal fracture with stabilization of the shoulder joint by moving the tendon of the long head of the biceps to the impression zone and fixing it with anchors. The outcome of this clinical case is the absence of clinical symptoms of instability of the shoulder joint and restoration of function of the shoulder joint in the late postoperative period.

New method for surgical treatment of pancreatic head cysts

Aim. To evaluate the clinical efficacy of a new method for drainage of pancreatic head cysts. Materials and methods. The results of treatment of 3 patients with pancreatic head cysts were analyzed in a new way. In all patients, cysts developed against the background of recurrent pancreatitis; the etiology of pancreatitis was alimentary. All cysts were located in the pancreatic head, mainly on its posterior surface, communicating with the ductal system. Results. No intra- and postoperative complications were revealed. Patients were discharged from hospital on the 8–12th day after surgery. In all observations, good results were obtained: no pain syndrome reported; psychological status and food intake normalized. α-amylase in urine and plasma has not increased. No recurrence of cysts and no hospitalizations for acute pancreatitis were reported. Conclusion. The developed method for treating pancreatic head cysts communicating with the ductal system proved to be physiological, low-traumatic and can be used in surgical practice.

Academician Fyodor Grigorievich Uglov (1904–2008)

An outstanding surgeon, a prominent scientist, a teacher, a talented leader, Academician of the USSR Academy of Medical Sciences (1967), Academician of the Russian Academy of Sciences (1991), Winner of the Lenin Prize (1961), winner of the international prize of the Holy All-Laudable Apostle Andrew the First-Called and the Center of National Glory of Russia «For Faith and Fidelity» with the award of the Order of Andrew the First-Called on a blue moire ribbon (2003), laureate of the Academician A. N. Bakulev Prize (2004), Professor Fyodor Grigorievich Uglov was born on October 5, 1904 in the village of Chuguevo, Kirensky district, Irkutsk region. In 1923, Fyodor Grigorievich entered Irkutsk University, then transferred to Saratov University and graduated with honors in 1929. He studied at the internship at the clinic of Professor V. A. Oppel (1931–1933). In 1937, he entered the postgraduate course of the Department of Surgery of the Leningrad State Institute for Advanced Medical Training named after S. M. Kirov. He defended his PhD thesis in 1939 and his doctoral dissertation in 1949. Fyodor Grigoryevich Uglov worked at the Department of the Academician N. N. Petrov until 1950. The next 58 years of Fyodor Grigoryevich’s working activity was associated with the Medical University named after Academician I. P. Pavlov (1 LMI, Pavlov University). During this period of time, he performed unique operations, developed new methods of surgical treatment of diseases in almost all sections of surgery. Being an excellent teacher, Fyodor Grigoryevich Uglov brought up excellent surgeons. Many of them became doctors of sciences, academicians, and heads of surgical departments. Fyodor Grigoryevich also founded a bright school of thoracic and cardiac surgeons.. Academician F. G. Uglov died on June 22, 2008 and was buried on June 25, 2008 at the Nikolsky Cemetery at the Alexander Nevsky Lavra in St. Petersburg.

Robotic surgery in endometrial cancer: first Polish experience.

In Poland, robotic surgery is nowadays perceived as a new method of surgical treatment in endometrial cancer patients. We aim to present the first Polish group of endometrial cancer patients treated using robotic surgery. The analysis was based on 79 patients with mean age of 59.72 ± 11.709 (range 27-83) years and endometrial cancer scheduled for surgical treatment. Mean BMI was 31.38 ± 8.78 (range 19.03-65.97)kg/m2. The data were collected based on a questionnaire consisting of 19 questions concerning the patient's perception of robotic surgery before the procedure. Patients with a family history of neoplastic diseases indicate precision of movements as the most important reason for choosing robotic surgery (p = 0.0035). Patients after surgery procedures in the past named shorter hospitalization as a major benefit (p = 0.0037). Patients who chose robotic surgery for financial reasons stressed the cosmetic effect as a priority (p = 0.0319). Shorter length of hospital stay, less blood loss, enlarged view, and good visualization were statistically significant reasons for choosing robotic surgery (p < 0.05). Women who consider work, good material status, and well-being as the most important aspects of their lives cited the cosmetic effect as a benefit of robotic surgery (p = 0.0029 vs. p = 0.0074 vs. p = 0.01745, respectively). In the follow-up after operations, no patients regretted choosing robotic surgery. Good visualization, precise movements, less blood loss, and cosmetic effects are the most frequent reasons for choosing robotic surgery. Even patients after other types of surgery in the past decided on robot-assisted radical hysterectomy because of the clear benefits of this approach.

Current State Diagnosis and Treatment of Abdominal Echinococcosis (Literature Review)

The essence of this article is about the state of diagnosis and treatment of echinococcosis of the abdominal cavity, namely the hepatoduodenal region. In this work, we studied the existing problems in the diagnosis and treatment of echinococcosis based on those studied and described in scientific works by various authors. And as sources showed us, the treatment of echinococcosis remains an incompletely resolved problem, despite a lot of work. The advantages and disadvantages of surgical interventions have been studied. The main surgical directions in the treatment of this pathology in hepatobiliary surgery, from minimally invasive interventions to traditional, radical methods of surgery, have been identified. Each method of operation made its contribution to the treatment of echinococcosis and determined its limits in application for a particular patient. Data from domestic and foreign literature have given their assessment that at the moment there is no gold standard in the treatment of echinococcosis of the hepatobiliary region. Many authors believe that the best treatment method is minimally invasive interventions, since they do not particularly affect the quality of life of patients in the long term, but there are disadvantages. Traditional methods of surgery are highly traumatic for patients, which worsens the quality of life. In this regard, the percentage of complications does not tend to decrease. As a result, it was found that there is no single gold standard for surgical treatment, which leaves the question open, relevant and requires research to develop new diagnostic algorithms, new methods of surgical treatment to improve the quality of life of patients with echinococcosis of the hepatobiliary region.

Modern concept of neovascular glaucoma (review)

The aim of this study is analysis of current methods for diagnosis and treatment of neovascular glaucoma to assess their effectiveness, and based on these data, further development of a method of surgical treatment based on morphological factors involved in its progression. The review was performed using the domestic RSCI database and the international PubMed database, with the search keywords being neovascular glaucoma, secondary glaucoma, ophthalmic hypertension. An analysis of 39 literature sources was performed. The search depth was 13 years (20092022). Variants of neovascular glaucoma development of and of its diagnosis were considered, it was noted that it is necessary to pay attention to the study of minimally invasive methods for diagnosing the anterior segment using optical coherence tomography, which will help in the future to choose the right tactics for medical or surgical treatment. Particular attention is paid to the analysis of surgical treatment methods, which often turn out to be ineffective and require re-operations. It is necessary to develop a new method of surgical treatment of neovascular glaucoma, which provides the most sparing approach to surgical treatment, which will improve the anatomical and functional results and help reduce the number of intra- and postoperative complications and provide a longer period without re-operations.

History of Aortic Aneurysm Surgery From the Beginning to the Current Situation

Many years of experience in the treatment of aortic aneurysm has a history of half a century. Each decade of this most difficult section of surgery is characterized by changes in the concept and the introduction of new methods of surgical treatment. Surgery for aortic aneurysms has gone through several stages: from non-reconstructive to X-ray endovascular methods, open methods with optimizations still remain the “gold standard” for the treatment of aortic aneurysms. This article gives a history of progress in aortic reconstructive surgery. The history of the treatment of patients performed by the great innovators of their time, vascular surgeons, who have contributed to the modern and world history of the aorta, is described.

Accompanying Therapy in the Surgical Treatment of Pathological Fractures of the Long Bones and Chronic Fractures of the Trochanteric Region

The article presents a study of palliative surgical treatment of patients with pathological fractures of the long bones and chronic trochanteric fractures. Those patients are not indicated for special oncological treatment. Therefore, the article does not provide staging of malignant neoplasms. The surgical treatment was aimed at improving the quality of life of palliative patients, and accompanying therapy in the form of the Altaicae extract adaptogen and the neutral anolyte led in our study to an increase in the effectiveness of surgical treatment of such a severe contingent of patients.INTRODUCTION According to domestic and foreign literature, the number of oncological diseases in young and old people is growing. There is a trend to neglecting the disease and late visits to doctors. Almost all types of cancer of various localization and other malignant tumors metastasize to the bones. An increase in the number of pathological (metastatic) fractures of the trochanteric region and the long bones was also noted. Surgical treatment of patients with such a severe type of fractures leads to an aggravation of the already existing immunodeficiency and, as a rule, creates the prerequisites for the occurrence of infectious complications in the postoperative period. The choice of a conservative method of treatment often does not justify itself as well, it leads to diagnostic and therapeutic errors, and in the future — to chronic pathological fractures.AIM To improve the effectiveness of surgical treatment and the quality of life of palliative patients with pathological (metastatic) fractures of the long bones and chronic trochanteric fractures using original authors’ accompanying therapy.MATERIAL AND METHODS 177 patients were examined and divided into two groups the main and the control groups. 72 patients were included in the main group, and 105 patients in the control group. There were 110 men and 67 women. The patient age ranged from 35 to 90 years. The main group received surgical treatment with the use of new accompanying therapy along with the basic one, and the control group received only surgical treatment and basic therapy.RESULTS In the main group patients with chronic pathological fractures of the trochanteric region, who underwent endoprosthetic replacement, osteosynthesis, a new method of surgical treatment of metastatic fractures of the long bones and the authors’ accompanying therapy, the effectiveness of surgical treatment increased significantly compared to the comparison group. As a result, most of the unwanted symptoms disappeared, time spent in hospital decreased, the psychoemotional status and immunity improved, the functional state of the body was optimized, and the quality of life improved.CONCLUSION The use of new accompanying therapy, the authors’ method of surgical treatment of patients with pathological (metastatic) fractures of the long bones, chronic fractures of the trochanteric region allows us to successfully and effectively operate on such severe patients and perform a fast track surgery program in the early postoperative period.

New method of surgical treatment of glaucoma

Background. Fistulizing operations are the most commonly used types of surgery for both primary and secondary glaucoma. The development of cicatricial blockade in the area of surgical intervention is considered one of the reasons for the decrease in the hypotensive effect of surgical treatment of glaucoma, for which antiglaucoma drainages are widely used.&#x0D; Aim. To evaluate the hypotensive efficacy of sinustrabeculectomy with implantation of drainage from collagen hemostatic sponge using Maklakov tonometry and quality of life indicators in patients with primary open-angle glaucoma in the course of surgical treatment.&#x0D; Material and methods. The study involved 52 people (52 eyes) (mean age 64.14.4 years) with a diagnosis of primary open-angle glaucoma. The inclusion criteria were the age of 4080 years, the diagnosis of glaucoma for more than 6 months, the ineffectiveness of local drug therapy, and the absence of severe concomitant ophthalmic pathology. All patients underwent surgical treatment of glaucoma: sinustrabeculectomy with posterior scleral trepanation and implantation of drains in the form of 42.5 mm strips from a collagen hemostatic sponge under the scleral flap in three zones: in the distal and lateral zones of the flap. In the postoperative period, the level of intraocular pressure was assessed on the 30th, 90th and 180th days. The patients' quality of life was assessed using the GQL-15 questionnaire. Statistical processing of materials was carried out using the Statistica 8.0 software package (Statsoft, Inc., USA), comparison in dynamics was carried out using Student's parametric t-test. The normality of the sample distribution was controlled using the ShapiroWilk test. Significance of differences in indicators was considered established at a significance level of p 0.05.&#x0D; Results. The surgical treatment of patients contributed to a decrease in intraocular pressure from 42.46.5 to 13.44.9 mm Hg (p=0.0000) and improved quality of life according to the GQL-15 questionnaire from 28.64.3 to 19.31.9 points (p=0.0224) on day 30 after surgery. During the observation period, the level of intraocular pressure remained within the normal range, amounting to 16.94.3 mm Hg on the 90th day, and 18.14.6 mm Hg on the 180th day.&#x0D; Conclusion. The modified method for the treatment of glaucoma leads to a long-term (6 months) effective reduction in intraocular pressure in patients and an improvement in their quality of life.

Laser sculptural uvulopalatoplasty as a new method of surgical treatment of snoring and obstructive sleep apnea syndrome

Laser sculptural uvulopalatoplasty as a new method of surgical treatment of snoring and obstructive sleep apnea syndrome

ИРУРГИЧЕСКИЙ СПОСОБ ЛЕЧЕНИЯ ХРОНИЧЕСКОГО КОПРОСТАЗА У БОЛЬНЫХ ДОЛИХОСИГМОЙ

The study refers to medicine, namely to surgery: endovideosurgery. Colon pathology is one of the most urgent and socially significant problems of modern health care, because. leads to a decrease in the working capacity of the population employed in production. Minimally invasive colon surgery has a big advantage: faster recovery, shorter hospital stays and better cosmetic results, faster return of patients to work. The purpose: to improve the results of endovideosurgical treatment of patients with chronic colostasis and dolichosigma. Practical significance: improving the quality of life by developing selection criteria for performing the developed method of operation and its implementation in the complex treatment of colostasis in dolichosigmoid. The results of the proposed endovideosurgical method for the treatment of chronic constipation in dolichosigmoid: the number of postoperative patients referred for MSEC decreased by 2 times; the average stay of patients in the clinic was 8-9 days, the activation of patients is carried out on the 2nd day after the operation; control after a month: normalization of stool up to 1 time per day (before the operation, delays reached up to a month), improvement in general well-being, improvement in memory, attention, absence of signs of chronic fatigue, improvement in general appearance (hair shine, improvement in color and skin condition); significant improvement in quality of life; control after a year: complete restoration of the passage of intestinal contents. Weight gain by 10-12 +/- 0.7 kg. Indicators of clinical and laboratory researchers are within the normal range. Full social rehabilitation. Conclusions. The authors proposed a new method of surgical treatment of chronic colostasis in patients with dolichosigma. The results of the scientific study can be used in the surgical treatment of chronic constipation with dolichosigmoid (dolichocolon) by the laparoscopic method. In the postoperative period, starting from the 3rd day, the restoration of the colon microflora is noted. The dynamics of the immunological status indicates a positive effect of the restoration of the microflora and physiology of the colon in the postoperative period.

The role of the Academician of ASMDM C. Țîbîrnă in the development of oncological surgery in various locations (head/neck, thoracoabdominal, liver surgery, etc.)

The idea of the state scientific program comes under the name „Modern personalized surgery in the diagnosis and complex treatment of tumors in children”. On March 24-25, 2022, at the Academy of Sciences of Moldova, the National Scientific Conference with International Participation „Modern Personalized Surgery for Adults and Children. Surgery of the future”, dedicated to the Honorary Member of the ASM, university professor, illustrious surgeon Constantin Țîbîrnă, founder of the local surgery. C. Țîbîrnă, being a polyvalent surgeon, during his activity developed local oncological surgery in various locations (head-neck, thorocoabdominal, liver surgery, etc.). The following were analyzed: indices of mortality incidence and cancer prevalence in the Republic of Moldova during the years 1980-2020.Thus, during this period there was a clear increase in morbidity rates due to malignant tumors in the Republic of Moldova. In 1980, about 5860 of primary patients (149.0 per 10 0000 population) were registered. Over 30 years, in 2020 the number of patients will increase to 9391 (264.4 per 100,000 habitants). Mortality during this period had a stable increase. In 1980, 3515 patients died for malignant tumors (95.0 per 100,000 population), in 2020 mortality rates increased to 4867(136.9 per 100,000 population).Regarding the prevalence indices, it should be mentioned that in 1980, 26,715 of patients (668.3% 000) were registered in the Cancer Registry of the Republic of Moldova. In 2020, the prevalence indices was doubled - 50,980 (1433.9‰000). This index demonstrates to us the efficiency of the oncological assistance of the Oncological Institute team in the treatment of cancer in the Republic of Moldova.The existence of the European Society of Oncological Surgery (ESSO) as well as the World Federation of Surgical Oncology Societies (WFSOS) confirms the recognition of the specialty of oncological surgery.About 7,700 patients are treated annually for surgery. In the oncology clinic more than 65% perform typical operations. Wide and combined surgeries prevail in university clinics (360 patients). In his activity, the famous surgeon C. ȚÎbîrnă perfected the oncological surgery in the torocoabdominal region, at the Republican Clinical Hospital (prof. N. Gladun, acad. V. Hotineanu and prof. A. Hotineanu). In the Oncology Clinic he developed new methods of surgical treatment of local tumors spread in the head and neck region (acad. Gh. Ţîbîrnă and associate professor A. Țîbîrnă). As a result he proposed:To include in the current nomenclature of the Ministry of Health - „Overspecialization in cancer surgery”, which will create the legal framework for the operation of this specialty.To organize the Oncological Surgery Society of the Republic of Moldova and the oncological surgery department within USMF „N. Testemitanu”.

ANTI-RECURRENCE PLASTIC FOR ANTERIOR ABDOMINAL WALL HERNIAS

Summary. The purpose of the study is to find new methods of surgical treatment of hernias, aimed at reducing the frequency of recurrences.&#x0D; Research materials and methods. The paper analyzes the results of examination and surgical treatment of abdominal hernias in 39 patients.&#x0D; Research results. An analysis of the surgical treatment of patients with abdominal hernia using the author’s technique of anti-recurrence plastic surgery by applying a semi-purse suture to the terminal areas of the line of sutures on the aponeurosis was carried out.&#x0D; Conclusions. The use of our method of antirelapse plastic surgery is pathogenetically justified and does not have a negative effect on the course of the postoperative period in operated patients.

РЕСПУБЛИКАДАГЫ САН СѲѲГҮНҮН ПРОКСИМАЛДУУ БѲЛҮГҮНҮН СЫНЫКТАРЫН ЗАМАНБАП ДАРЫЛОО АБАЛЫ (соңку адабияттарга сереп)

This article provides a review of modern literature over the past 15 years of the use of new methods of surgical treatment and their authors in the treatment of fractures of the proximal femur in the country. The use of new methods of surgical treatment of fractures of the proximal femur directly depends on the morphology of the fracture, bone density, while the advantages of each technique and their effect on the process of consolidation of the fracture site have been scientifically proven by the authors. In addition, scientists were noted who made a significant contribution to the formation and development of traumatology as a specialty in the Kyrgyz Republic.

Surgical correction of asymmetric keeled deformity of the chest in children (literature review)

Introduction. The purpose of the literature review on surgical treatment of patients with asymmetric keel deformity chest in children - to determine the optimal methods of surgical correction of this pathology.Material and methods. Taking into account the shape, localization and type of severity of the asymmetric keel deformity the data of surgical treatment of children with asymmetric chest deformity using widely known methods of thoracoplasty have been studied. In a comparative aspect, the data on the use of the minimally invasive D. Nuss technique and its modifications are analyzed.Results. It was found that thoracoplasty by the Bairov method is the least effective, in addition, after them the greatest number of postoperative complications (10.5%) in the form of hemo-, pneumo- and hydrothorax was recorded, which significantly increased the period of hospital stay and subsequent rehabilitation of patients. The use of minimally invasive interventions, on the contrary, turned out to be the most effective of all the methods used to correct chest deformities and is characterized by a low percentage of complications, however, long-term postoperative analgesia occurs.Conclusion. Thus, at the present time there is no consensus on the priority of methods of surgical correction of ACDGC, which necessitates further research in this area and improvement of existing and development of new methods of surgical treatment of the pathology in question.

Algorithm of surgical tactics and surgical treatment of cholelithiasis complicated by multiple choledocholithiasis

Objective: Biliary stone disease is now one of the most common diseases, affecting 10-20% of the world's population. One of the most important problems in biliary tract surgery is the treatment of choledocholithiasis, which occurs in 10 to 38% of biliary stone disease according to different authors. Our research has allowed us to outline the most rational ways of treating patients in modern conditions. In our research, we focus on “the golden mean'” - a combination of staged minimally invasive interventions and standard interventions. Aim of our study was to evaluate the results of postoperative complications using the developed algorithm of surgical tactics and choledochoduodenoanastomosis from a minimally invasive approach. Methods: Overall, 35 patients who underwent surgical treatment of cholelithiasis, cholangitis, benign genesis obstructive jaundice (BGOJ) were included to the study. All patients were divided into two groups (main group and comparison group) depending on the method of treatment used. The study group consisted of 17 (48.6%) patients who underwent bile outflow restoration of choledochal outflow obstruction of the terminal section (choledochodenoanastamosis according to the developed by us procedure (Kazakhstan patent №108142, Algorithm of diagnostics and surgical treatment tactics of benign genesis obstructive jaundice - Author's certificate № 24754. Control group consisted of 18 (51.4%) patients who underwent cholecystectomy, choledocholithiasis by Jurash-Vinogradov and applied conventional algorithm of diagnostics and treatment of multiple choledocholithiasis with benign genesis obstructive jaundice. We assessed complications of procedures according to Clavien-Dindo and pain intensity level using visual analog score in both groups. Results: When using the proposed algorithm and new methods of surgical treatment in patients in the study group the rate of complication was lower in the study group as compared to control group (p=0.04): there was no deficiency and bleeding from the anastomosis, while in control group they turned out to be in 1 case. Complications in the form of seroma in 2 cases and bleeding into the subcutaneous tissue of the postoperative wound were in 1 case, being the same as in control group. No mortality was recorded in any group. The pain level was lower in the study group as compared to control group (p&amp;lt;0.05). Conclusions: Thus, the application of our algorithm for the diagnosis and surgical tactics of treatment of obstructive jaundice of benign genesis makes it possible to determine the tactics of surgical treatment of patients with obstructive jaundice. The developed technique for the surgical treatment of choledocholithiasis in cholelithiasis ensures the restoration of bile outflow in the duodenum, normalizes its morphofunctional state, prevents the development of various postoperative complications, in particular, there was no leakage and bleeding from the choledochoduodenoanastomosis in the main group.

Surgical treatment of the humeral head osteochondral defects in chronic shoulder dislocation: Literature review

Background. The shoulder joint is the one most amenable to dislocation. Dislocation of the humeral head is complicated by combined injuries of the shoulder joint, and if the patient does not seek treatment on the first day after the dislocation, irreversible changes in bone and soft tissue structures are formed.The aim of this review was to analyze modern methods of diagnosis and treatment of patients with defects in the articular surfaces of the scapula and humerus head with chronic shoulder dislocations.Material and methods. To search for literature data, we used the electronic databases MEDLINE, PudMed, eLIBRARY with a selection of sources published from 2000 to 2020. The analysis was carried out on works devoted to the diagnosis, surgical treatment and complications of traumatic shoulder dislocations.Results. When analyzing the literature on the surgical treatment of shoulder dislocations, we did not find clear criteria for planning the extent of surgery. The obtained results of surgical treatment testify to well-studied technologies for treating osteochondral defects of the humeral head up to 25 % of its total area. In the presence of a defect of 50 % of humeral head area or more, satisfactory results are shown when carrying out arthroplasty of the joint using a reverse endoprosthesis. However, the treatment of defects ranging in size from 25 to 50 % is still an unexplored problem. There are single techniques using allografts, mainly in English-speaking countries and, to a lesser extent, on the territory of the Russian Federation. Thus, the search for an algorithm for choosing a surgical treatment based on multi-layer spiral computed tomography and/or magnetic resonance imaging data, and the development of a new method of surgical treatment taking into account the obtained data are priority areas in modern traumatology and orthopedics.

To the pathogenesis and treatment of myopia and its consequences L. Мiillеr (Wien. kl. Woch., 1926, №.12)

L. Miiller (Wien. Kl. Woch., 1926, No. 12) reports on his new method of surgical treatment of myopia, which is the result of his research into the causes of myopia.

Analysis of demographic, social and economic impacts of proximal femur fracture's surgical treatment for geriatric patients in Russia

Objective. Evaluation of influence on mortality, life expectancy and related costs in the Russian Federation of methodical changes in the organizing surgical treatment of proximal femur fracture (PFF).Material and methods. The mathematical modeling methods were applied for evaluation of impacts, related to methodical changes in the organizing surgical treatment of PFF, including the calculation of life expectancy. It is assumed, that 95% of all patients over 60 years old with PFF would receive a surgical treatment. Calculations were perform in 3 stages: calculation of death causes, related to PFF, calculation of life expectancy change in population and calculation of direct and indirect medical and non-medical costs and social assistance for patients with PFF.Results. Mortality rate from PFF in model is decreased by 51%, which is equal to 55 648 saved lives. Life expectancy indicator increases by 0.3 annually during the transition to new methods of surgical treatment for the patients with PFF. Number of disabled patients is decreasing by 74 179 people annually. Taking into account all the effects, revealed in the modeling, the financial savings are estimated at 12.3 billion rubles or 32% of current expenditures from all funding sources on treatment and social assistance of patients with PFF.Conclusion. Implementation of this new approach to surgical treatment of patients over 60 years old with PFF shows a positive influence on dynamic of demographical indicators of population in general. Despite changes in structure of expenses and increase direct medical costs, new approach in surgical care will lead to a major cost reduction as well as significant improvement of treatment results for geriatric patients with PFF.