[A device for the temporary transcutaneous ligation of the major vessels of the extremities].
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Biomedical subjects
Publications and source records attributed to V S Dedushkin.
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Based on the experience gained with the surgical treatment of over 900 patients with different forms of degenerative dystrophic diseases of the hip joint the current principles of the choice of different types of surgical interventions were defined. As far as the patients with aseptic necrosis of the head of the femur are concerned, the main problem in this case lies in the early diagnosis of osteonecrosis. The surgical treatment is specified by the leading factor of the pathogenesis at every stage of the development of the process (vascular disorders, changes in the biomechanism of the joint). The planning of operations in patients with dysplastic coxarthrosis rests on the consideration of 8 basic factors that influence the disease by means of factorial analysis and determination of the prognostic estimations of the treatment efficacy.
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An experience with treatment of 176 patients having false joints with low osteogenic activity is presented. An investigation of peripheral blood supply by the method of angiography and rheovasography has shown considerable alterations of the arterial blood flow. The internal osteosynthesis with retained ++inter-fragment tissues was used, as well as the interosseous fixation with repeated alternations of distraction and compression. Union was diagnosed in 162 patients (92%).
The article analyzes causes of the development of false joints of the bones. In most of the patients (98.6%) there were local causes. One of the general causes is multiple endocrinopathy.
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On the basis of complex assessment of the results of supratrochanteric osteotomy of pelvis (30 operations) and osteotomy of pelvis with the subsequent intertrochanteric osteotomy (24 observations) in patients with dysplastic coxarthrosis at mean terms of observation, equalling to 90 months, have been determined efficiency and indications for these operations. Indications for pelvic osteotomy are formed on the basis of roentgeno-anatomic interrelations in hip joint, where the decisive part is played by the angle of vertical inclination of the cotyloid cavity and degree of coating of the head of the femur. Intertrochanteric osteotomy following the pelvic osteotomy is indicated at preserved pain syndrome, resulting from coxarthrosis, subsequent to the muscular system restoration.
On the basis of computer tomographic investigations of 28 patients with subcutaneous ruptures of the Achilles tendon in different terms after the injury and its restoration by means of open and transcutaneous suture there have been revealed possibilities of the method. Computer tomographic syndromes of the tendon damage (increase of diameter by 2-3 times, spherical form of the cross section, density decrease, presence of hematoma, deformation of the front outline of tendon) and the signs of its continuity restoration have been determined. Identity of the computer tomographic data of comparison of tendon centres by open and closed sutures has corroborated reliability of the obtained criteria. Computer tomographic investigations in dynamics testify to significant changes in damaged tendon and +para-tendon tissues as well as to the duration of the process of its healing.
Computer tomography data on 124 patients with degenerative-dystrophic diseases of hip joint of different etiology are presented. As indicated the results of investigations, computer tomography of hip joint is the effective method of early diagnosis of femoral head aseptic necrosis. Computer tomography application allows to detect precise location, size and character of the pathology process in hip joint and propose the optimal parameters of surgical correction. Femoral head densitometry in case of femoral head aseptic necrosis revealed the curves of two types: with unimodal and bimodal density distribution. Patients with bimodal histograms demonstrated worse results of surgical treatment.
For experimental verification of the authors' hypothesis on the role of the mechanism of adaptative disintegration in pathogenesis of trauma disease the essence of which consists in inadequacy of emergency adaptation of the organism to a critical and middle degree of the injury by the time and amplitude, an investigation on 89 rabbits has been performed with modeling of extensive wound of soft tissues of the femur. The correction of the neuroendocrine response of the organism to trauma by injection of synthetic opiopeptide dalargin++ was made. The use of dalargin changed quantitatively and qualitatively the neuroendocrine reaction to the injury and optimized the wound process and restoration of the homeostasis parameters.
Mass admission of patients with the crush syndrome to ++non-profile medical institutions allowed to detect three clinical forms of the crush syndrome. Adequate methods of surgical treatment are proposed for each of them.
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