Osteoplastic correction of the pelvic ring in old injuries of the sacroiliac and pubic joints aggravated by a large divergence of the pubic symphysis.

Surgery to treat old injuries of the pelvis was performed to reconstruct the pelvic ring (its anterior and posterior compartments) using autoplastic materials and various fixators. The reconstructive operation for extensive disjunction of the pubic symphysis and sacroiliac joint is performed in three stages. The first stage is to attain the greatest possible elimination of complete dislocation of the pelvis, producing a closer apposition of pubic bones, with the aid of an external pivotal fixator. The second stage of the surgical restoration of the structure is aimed at stabilization of the posterior elements, which bear the main static load; for this purpose, arthrodesis of the sacroiliac joint is performed. In the third stage, bone is transplanted for fusion of the anterior elements of the pelvic ring. Fifty-seven operations were performed on 23 patients. Good results were observed in all of the patients. One group (13 of 23) returned to their previous activities; this alone is evidence of the value of the multistage method of surgical reconstruction of the pelvic ring for treatment of chronic injuries.

[Transosseous osteosynthesis of trochanteric fractures in patients of older age groups]. / Chreskostnyi osteosintez vertel'nykh perelomov u bol'nykh starshikh vozrastnykh grupp.

The article deals with experience in the treatment of 45 elderly and senile patients with acetabular fractures of the femur by means of transosseous osteosynthesis. Besides treatment by G. A. Ilizarov's method, a special device elaborated in the Department of Transosseous Synthesis, the Central Institute of Traumatology and Orthopedics, was applied in 29 patients. With this, the design and the method of osteosynthesis are described. The method suggested by the authors for osteosynthesis of acetabular fractures of the femur by means of external transosseous osteosynthesis combines two factors which are important in traumatological practice: stable fixation of the fragments and mild character of the trauma inflicted by the operative intervention, which is significant in the treatment of feeble elderly and senile patients.

[Conduction anesthesia in orthopedic operations in injuries of the extremities]. / Provodnikovaia anesteziia pri ortopedo-travmatologicheskikh operatsiiakh na konechnostiakh.

An analysis of results of using conduction anesthesia for various operations on extremities of 274 patients of different age groups has been made. Complete effects were achieved in 91% of the patients, 5% of the patients were potentiated with neuroleptanalgesia drugs because of insufficient anesthesia, in 2% of the patients general anesthesia was used. The method of conduction anesthesia makes it possible to use a conveyer method of bringing patients to the operating room. It is more economical as compared with narcosis, easy in use. It may be recommended for wider use.

[Anesthesia in the surgical treatment of fractures of the proximal end of the femur]. / Obezbolivanie pri operativnom lechenii perelomov proksima'lnogo otdela bedrennoi kosti.

The article generalizes experience in anesthesiological management of 178 elderly and old-aged patients with fractures of the proximal segment of the femur in endoprosthesis with a Mura-Cito prosthesis, 3-flange nail, Shesterni's fixation device, arched nail, etc. In contrast to endotracheal anesthesia and local anesthesia with neuroleptanalgesia potentiation, prolonged epidural anesthesia in 51 patients produced adequate intra- and postoperative anesthesia without causing respiratory complications and depression and facilitated early activation of the patient. Prolonged epidural anesthesia had advantages over other types of anesthesia in this category of patients.