[Surgical treatment of humerus condylar fracture].

55 patients with intra-articular condyles fractures of humerus were operated in terms 1998 to 2013 year in the Clinic of Traumatology and Orthopedics of the Presidential Administration. All patients were operated by using of perosseous osteosynthesis method with external fixing device design A.I. Gorodnichenko. Indications for osteosynthesis were open and closed fractures of C1,2,3 types accordingly to AO Classification. Closed, atraumatic and reliable fixation of bone fragments intensifies patients faster, improves their life quality, decreases time of hospitalization and minimizes complications rate. Fractures consolidation was achieved in all cases. It was observed such complications as soft tissue inflammatory around shafts in 4 (7.3%) observations. Long-term results were studied in 51 (92.7%) patients including 9 (17.6%) patients with excellent results, 24 (47.1%) patients with good results and 18 (35.3%) patients with satisfactory results. It was not detected unsatisfactory results. The method permits early reconstructive treatment of patients and improves functional results in case of condyles fractures. This preserves active moving function of damaged elbow from the first day after operation and during all period of treatment.

[Intramedullary ostheosynthesis of femoral acetabular fractures in elderly patients].

Results of surgical treatment of 45 patients, aged 75-104 years, with acetabular fractures were analyzed. All patients received the intramedullary ostheosynthesis with the use of TRIGEN INTERTAN fixation system. The long-term follow up results were obtained from 35 patients. Thus, the excellent result was registered in 12 (34.3%) patients, good - in 14 (40%), and satisfactory result was noted in 9 (25.7%) of these patients. The obtained results pemit to recommend the intramedullary fixator for the treatment of of femoral acetabular fractures in elderly patients with concomitant ostheoporosis.

[Transosteal ostheosynthesis of distal shoulder fractures].

92 patients with distal intra- and periarticular fractures of the shoulder bone were treated with the use of transosteal ostheosynthesis device of Gorodnichenko A.I. Atraumatic and secure fixation of bone fragments allowed fast recovery, which served as a prophylaxis of contractures and osteoarthrosis. Fracture consolidation was registered in all cases. Among complications was only soft tissue inflammation around pins in 5 patients. Good results were registered in 51 (68.9%) patients and satisfactory in 23 (31.1%) patients. The method of transosteal ostheosynthesis allowed earlier rehabilitation and thus, led to better functional results of intra- and periarticular fractures, due to the preservation of motional possibility from the first postoperative day.

[The transosseous osteosynthesis by intra- and periarticular fractures of the knee joint].

105 patients with intra- and periarticular fractures of the knee joint were operated on with the use of nail and spin-nail apparatus constructed by A.I. Gorodnichenko. The possibility of atraumatic closed bone fragments fixation allowed quick patients' activization, and, as follows, improved their life quality, decreased the hospital stay and minimized complication rate. Fracture consolidation was achieved in all cases, the only complication registered was skin inflammation around the nail in 5 patients.

[The transosseous osteosynthesis of proximal humeral metaepiphyseal fractures in elderly patients].

93 elderly patients with proximal metaepiphyseal fractures of humerus underwent the transosseous osteosynthesis with the use of device, constructed by A.I. Gorodnichenko. 1 year follow-up results were obtained in 44 patients. Good and satisfactory results were registered in 33 and 11 patients, respectively. The use of the method allowed better long-term treatment results and higher quality of life of the operated patients.

[Deep veins thrombosis prophylaxis in patients with fractures of long bones of the lower limbs].

Analysis of the complex deep veins thrombosis prophylaxis, considering also pulmonary thromboembolism prevention, in 1180 patients (694 male and 486 female) with closed long bones fractures of the lower limbs. Thrombosis prophylaxis aimed venous blood flow acceleration, liquidation of blood congestion and fibrinolysis stimulation performed with the use of physical factors (nonspecific prophylaxis) and hemostasis normalization (specific prophylaxis). The study revealed that prophylactic measures in patients at low thrombotic risk can be limited to nonspecific prophylaxis. Whereas patients at high and medium thrombotic risk need anticoagulant and disaggregant therapy. The use of standard heparin should be justified only in the absence of other drugs because of the high rate of hemorrhagic complications (42,9%). Any low-molecular heparin is effective for the deep veins thrombosis prophylaxis, though Clexane showed to be the most effective (no complications in 87,5%, deep veins thrombosis in 7,9%, hemorrhagic complications in 5,0%, no registered cases of pulmonary thromboembolism).

[Endoprosthetic hip replacement in elderly patients with femoral neck fractures].

96 primary endoprosthetic hip replacements were performed in elderly patients with femoral neck fractures. The average age of the patients was 82,7 years. In cases of senile osteoporosis cement <> prosthesis was applied, when there were no signs of osteoporosis defined, non-cement <> construction was used. 53 (55,2%) patients were postoperatively followed-up during 1 to 7 years. Excellent result was achieved in 17 (32,1%) patients (>90 points on Harrison's scale), good result was registered in 21 (39,6%) patients (80-89 points), considered to be satisfactory (70-79 points) - in 15 (28,3%) patients.

[Use of modern fixators in trochanteric fractures treatment].

Results of surgical treatment of trochanteric fractures in 225 aged patients are presented. The DHS system was used in 115 (51,5%) patients, core system constructed by A.I. Gorodnichenko was used in 56 (24,9%), PFN and PFN-A fixators used in 45 (20%) and 9 (4%) patients were treated with the use of DCS system. Follow-up results after 1 year were studied in 183 (81,3%) patients. Excellent results achieved in 145 (79,2%) cases, satisfactory outcome registered in 38 (20,8%). Authors recommend PFN and PFN-A fixators, as well as the A.I. Gorodnichenko's core system for the surgical treatment of trochanteric fractures especially in aged patients with concomitant ostheporosis.

Non-invasive interactive neurostimulation in the post-operative recovery of patients with a trochanteric fracture of the femur. A randomised, controlled trial.

We undertook a trial on 60 patients with AO 31A2 fractures of the hip who were randomised after stabilisation of the fracture into two equal groups, one of which received post-operative treatment using a non-invasive interactive neurostimulation device and the other with a sham device. All other aspects of their rehabilitation were the same. The treatment was continued for ten days after operation. Outcome measurements included the use of a visual analogue scale for pain, the brief pain inventory and Ketorolac for post-operative control of pain, and an overall assessment of outcome by the surgeon. There were significantly better results for the patients receiving treatment by active electrical stimulation (repeated measures analysis of variance, p < 0.001). The findings of this pilot trial justify a larger study to determine if these results are more generally applicable.

[Transosseous osteosynthesis with Gorodnichenko's devices in the treatment of polytrauma]. / Chreskostnyi osteosintez apparatami konstruktsii Gorodnichenko v lechenii postradavshikh s politravmoi.

From 1997 to 2003 eighty-three patients with poly- and multiple fractures underwent transosseous osteosynthesis with rod and pin-rod Gorodnichenko's devices, without drilling of bone marrow canal. Primary osteosynthesis was performed during 48 hours after trauma. The new pin apparatus of external fixation were the best method of osteosynthesis of poly- and multiple fractures in patients with polytrauma. This policy permitted to achieve good and satisfactory results in 94.3% patients with polytrauma.

[Injuries of the menisci in patients with deforming gonarthrosis]. / Povrezhdeniia meniskov u bol'nykh deformiruiushchim gonartrozom.

The authors present their observations concerning the difficulties in the diagnosis of the injuries of the menisci of the knee joint associated with deforming arthrosis which have quite a number of similar clinical signs with injuries of the menisci. The importance of an arthroscopic study of the meniscus of the knee joint is demonstrated for revealing the lesion as well as a possibility of solution to the problem of partial meniscectomy. The expediency of such tactics is confirmed by the results of the treatment of 28 patients, in 10 of whom lesions of the inner menisci were revealed and partial meniscectomies were performed. The remaining 18 patients were given sanation of the joint cavity. The results of the treatment with a follow-up period up to 5 years were evaluated as good.

[Surgical treatment of gonarthrosis deformans in middle-aged and elderly patients]. / Operativnoe lechenie deformiruiushchego gonartroza u lits pozhilogo i starcheskogo vozrasta.

For treatment of deforming gonarthrosis in old and senile patients the authors developed and successfully applied extra-articular surgical methods. In stage I-II of the disease--prolonged osteotomy of the tibial bone was made; in disorders of the extremity axis--the correcting osteotomy of the tibial bone was made. According to the authors' opinion restorative treatment in the postoperative period is very important.