[The dynamic of biochemical stress reaction inductors in various tactics for surgical treatment of patients with a combined trauma of cranium and lower limbs ]. / Dinamika biokhimicheskikh induktorov stress-reaktsii pri razlichnoi taktike khirurgicheskogo lecheniia bol'nykh s sochetannoi travmoi cherapa i nizhnikh konechnostei.

In 31 patients after a craniocerebral trauma combined with a trauma of locomotor system (CCCT), and in 28 patients with only a limb fractures a time course (1, 3, 7, and 14 days) of biochemical stress reaction inductors (cortisol, serotonin, histamine, lipid peroxidation products) in various tactics of surgical treatment was studied. It was established that CCCT in a significantly stronger degree increases cortisol and lipid peroxidation products' levels than an isolated locomotor system trauma. An early postponed surgical intervention in lower extremities in CCCT results in the same increase in the biochemical stress reaction inductors as a late postpone surgical intervention in the lower extremities. In an early postponed osteosynthesis in CCCT patients, a mean term of hospital stay was 67 days, and in a late postponed one 117 days. The disability period was correspondingly 200 vs 315 days.

[Therapeutic exercises in the rehabilitative treatment of patients with diaphyseal fractures of the leg bones]. / Lechebnaia gimnastika v vosstanovitel'nom lechenii bol'nykh s diafizarnymi perelomami kostei goleni.

The results of exercise therapy were compared in patients with diaphysial leg fractures operated by standard technique and those operated by the technique of closed blocking intramedullary osteosynthesis (CBIO). After CBIO rehabilitation was more successful and required less time. This arises from the fact that in blocking osteosynthesis soft tissues of the damaged segment are not cut while intraosseous blocking screws exclude shortening of the leg and rotation instability of the fragments. That's why it is not necessary to fix the leg with a circular gypsum bandage which allows early intensification of exercise load.

[Surgical treatment of trochanteric fractures of the femur in middle-aged and elderly patients using a bunch of metal rods]. / Operativnoe lechenie verte'lnykh perelomov bedrennoi kosti u bo'lnykh pozhilogo i starcheskogo vozrasta puchkom metal- licheskikh sterzhnei.

The authors describe their experience in the treatment of 55 patients with trochanteric fractures of the femur operated with a bundle of elastic rods (after Ender). Their mean age was 80 (61-98) years. The control group comprised 83 patients who had received conservative treatment and 53 patients who had been treated surgically with a three-blade nail with diaphyseal plate. The method is characterized by low traumatism and is accompanied by little blood loss, that is why no hemotransfusion was made in most cases. The danger of infection at the fracture site is minimal as it in not exposed. A sufficiently stable fixation of the fragments allows to make an early activation of the weakened patients, which is necessary for the prevention of hypostatic complications. The operation is simple and easy; it may be successfully mastered by broad sections of the doctors; an electro-optical++ transducer is required in the operating room.