[Surgical treatment of sternal osteomyelitis and sternomediastinitis following cardiac surgery]. / Khirurgicheskoe lechenie osteomielita grudiny i sternomediastinita vsledstvie kardiokhirurgicheskikh operatsii.

OBJECTIVE: To analyze the incidence of cardiac surgeries and postoperative sternal osteomyelitis/sternomediastinitis, as well as treatment outcomes in these patients. MATERIAL AND METHODS: We summarized 171 patients with postoperative sternal osteomyelitis and sternomediastinitis. RESULTS: Organization of the Khabarovsk center for cardiovascular surgery in the Far Eastern Federal District was followed by 7.9- and 24.9-fold increase of the number of cardiac surgeries and CABG in 2005-2019, respectively. As a result, the number of patients with sternal osteomyelitis and sternomediastinitis after cardiac surgery increased from 0.50±0.10 to 1.59±0.17 cases per 100.000 (t=3.01; p<0.01). CPB and aortic clamping time (t=3.97; p<0.01), as well as surgery time (t=2.4; p<0.05) were significant risk factors of early postoperative complications. Two-stage surgical treatment of postoperative sternal osteomyelitis and sternomediastinitis (removal of ligatures and foreign bodies, sternal curettage with removal of sequesters at the first stage; resection of sternum with chest wall repair at the second stage) reduced hospital-stay from 31.9±13.4 to 29.2±10.8 days.

[Rehabilitation treatment of children with rheumatoid arthritis after operations on the hip joint]. / Vosstanovitel'noe lechenie detei s revmatoidnym artritom posle operatsii na tazobedrennom sustave.

The authors present their experience in the recovery treatment of 37 children suffering from rheumatoid arthritis after 40 treatment-and-prophylactic and reconstructive operations on the hip joint. The peculiarities++ of drug therapy and hormonal protection during the postoperative period are reflected. The terms of starting the performance of passive and active movements in the operated joint are given, as well as the terms of partial and complete loading of the extremity with regard to the state of the muscle function, the bone structure and the function of the operated and other affected joints. The sequence of using the methods of physiotherapy and therapeutic physical training is pointed out. The necessity of complex use of these means of treatment is stressed.