[Results of application of a new method for the treatment of hallux valgus of the first toe].

Background: The aim of the present article was to report our experience with the treatment of patients with hallux valgus and to perform comparative analysis of the results of the newly proposed and standard methods for its surgical correction. Methods: The data on 70patients (101 feet) with hallux valgus that were operated on between 2011 and 2015 in St. Petersburg Hospital No 2 using the new and standard methods were analysed. The functional assessment (AOFAS score) and X-ray examination were performed preoperatively, 3 and 12 months after the procedure. Comparative analysis between patients undergoing surgical correction by the new and standard methods has been undertaken. Results: We did not find any significant difference between the two groups in mean AOFAS score 12 months after surgery. Nevertheless, the function score of the patients treated by the newly proposed method (79.4±6.5 in 3 months) was significantly better than in those given the standard treatment (72.2±7.6 in 3 months). Mean intermetatarsal angle 12 months after surgery by standard and new methods was 9,7±0,7° and 8,6±0,7° (p<0.05), mean metatarsophalangeal angle 13,6±0,9° and 13,0±1,1° (p<0,05) respectively. Conclusion: According to the data obtained, the original method of hallux valgus surgical correction allows to improve its functional and x-ray results.

[THE USE OF THE METHOD FOR DETERMINING THE "ORTHOPEDIC INDEX" IN THE TREATMENT OF PATIENTS WITH FEMORAL NECK FRACTURE].

The choice of surgical strategy for the treatment of femoral neck fracture is a serious challenge to modern traumatology and orthopedics. Group I of this study was comprised of patients in whom orthopedic age was determined by our original method including assessment of the quality of life based on the SF-36 questionnaire. The somatic state of the patients was evaluated from the Charlson index and bone quality in the surgical area by densitometry. Patients of the control group were treated by the standard methods adopted in this country and abroad. It was shown that the difference between orthopedic and calendar ages results in the increase of the frequency of complications. The clinical and statistical results of the study indicate that the new method permits to reduce the number of revision interventions, decrease postoperative lethality, and improve the patients' quality of life.

[About the treatment of battlefield injuries of the musculoskeletal system with the help of new "Rod field package"].

Injuries of the musculoskeletal system are at 60% of all battlefield injures and take first place in modern military conflicts. The main antishock measures are: pain management, emergency bleeding control, bone fragment positioning and fracture fixation. Specialist of the centre of traumatology and orthopaedics of the Burdenko General Military Clinical Hospital in cooperation with specialists of department of battlefield surgery of Mandryka Clinical Research and Training Medical Centre analysed the most effective domestic and foreign external fixators and developed Rod field package (RFP). The above mentioned researched had two stages. On the first (analytical) stage specialists formulated requirements for idea rod field external fixator. On the second (experimental) stage tests with the help of plastic models of long bones were carried out. The performed analysis showed, that installation of the external fixator is easy and fast, the external fixator is light and has capabilities for 3D bone fragment positioning and fracture fixation, the external fixator is radiotransparent. Implementation of this package into the clinical practice of delivery of battlefield emergency surgical care may improve results of treatment.

[Hip replacement in military personnel].

Hip joint diseases and injuries are common for orthopedic pathology among military personnel. Hip replacement is one of the most frequent operations. Authors evaluated hip replacement in 136 servicemen treated at the center of traumatology and orthopedics of Burdenko General Military Clinical Hospital of the Ministry of Defense of Russia in 2010-2013. On the basis of the conducted analysis the main disease groups were revealed, peculiarities of pathology among this category of patients. Authors proposed surgical doctrine for the treatment of this contingent. Effective surgical treatment, in particular, hip replacement surgery, conducted with the use of the proposed principles, as a rule, fully functionally cured patients and contributes to return them in the system that contributes to the strengthening of defensibility of the country.

[About perfection of the complex system of the treatment of the wounded with the gunshot fractures of the limb's long bones].

The article deals with clinical study of treatment results of 106 wounded. The study was carried out with the help of different methods of correction of blood flow in the place of shotgun fracture of long bones in terms of application period. Developed system of incipient complex correction post shotgun circulatory injuries improves the results of treatment by 87.3 +/- 1.8% (p < 0.05), decreases the number of wounded with laps of blood flow in tissues by 34.1 +/- 1.1%, that is lower than 20% from normal level, and in 38.2 +/- 1.5% cases helps to avert the development of necrosis and wound abscess.