The stress-strained state in a finite element model of C III/C VII vertebromotor segments was comparatively analysed in conditions of modelling of different variants of bisegmental anterior interbody fusion of C IV/C VI with help of vertical cylindrical mesh implants, including two new techniques developed. It was revealed that the configuration of the implants and peculiarities of their placement in the interbody space played an important part in the distribution and change of values of the stress-strained state for bodies of the vertebrae, which were stabilized.

In order to study the state of articular structures, the knee joints of adolescents with complaints about persistent arthralgia and without any clinical signs of gonitis were examined with use of ultrasound. The article contains results of examination of 299 people (the basic group), 96 cases with signs of connective tissue dysplasia without joint syndrome (the comparison group) and 100 clinically healthy adolescents (the control group). The basic group revealed a lower altitude and a less degree of destruction of the articular cartilage, signs of an inflammatory process and irregular bone surfaces. Changes in the knee joint structure make it possible to believe that the morphological disturbances, observed in adolescents, agree with the concept of the formation of degenerative processes in adults.

The articled deals with the history of organization and development of orthopaedic-traumatological aid to children in Kharkiv, this aid being given at first by Prof. Fink Yu. Further development of the specialized aid to children was connected with Sytenko Institute of Spine and Joint Pathology, which was founded in 1907 as the Medical-Mechanical Institute. It was here that, for the first time in the country, outpatient reception of children was isolated, children’s orthopaedic department was organized, new methods of conservative and surgical treatment of orthopaedic pathology in children were developed. The article describes achievements of the Institute in treating severe diseases and injuries of the locomotor system in children, as well as the contribution of children’s medical establishments of Kharkiv to the development of the specialized aid to children.

The article describes results of an experimental study of morphological peculiarities in the area of interbody fusion in the conditions of the fixing of vertebral bodies with a plate after removal of an intervertebral disk. The experiment was made on the caudal spine of 6 laboratory rats. It was revealed that in order to achieve interbody fusion it was necessary to perform total diskectomy in combination with resection of the vertebral end plates.

The article contains an analysis of the results of treatment of 780 patients with diaphyseal fractures of extremity bones from 2006 to 2010. A detailed study of the structure of diaphyseal fractures, a distribution of the patients by the type and mechanism of the injury according to AO/ASIF classification, by methods of their surgical treatment and by follow-up years are given. The causes, which led to unsatisfactory results of treatment in patients with diaphyseal fractures, were revealed.

Replacement arthroplasty is connected with a high risk of complications, deep vein thrombosis and pulmonary embolism being the most dangerous of them. Today low molecular weight heparins are regarded as the «gold standard» for preventing venous thromboembolic complications in case of orthopaedic interventions. The purpose of the present work was as follows: to study the effect of enoxiparin on the haemostasis system and assess its possible use in patients after total hip joint arthroplasty. Indices of clinical and biochemical analyses of blood and urine and coagulogrammes were estimated. The drug did not produce any negative effect on the indices of clinical and biochemical analyses of blood and urine. A higher content of the intravascular thrombopoiesis marker – reaction of the fibrin-monomer complex, fibrinolytic activity, D-dimer – was revealed. Anti-factor Xa activity was at the level, recommended for high risk patients. Hence, enoxiparin at a dose of 40 mg subcutaneously once a day improves indices of the haemostasis system during the postoperative period, does not cause any side or adverse effects and can be recommended for preventing thromboembolic complications in patients after hip joint arthroplasty.

The article deals with the history of the opening of the first hand surgery centre in Ukraine. The part played in its foundation by Prof. Kolontay Yu.Yu. is described. Landmarks in the development of the Centre and the contribution of its staff into the formation of hand surgery in Ukraine are specified.

The examination involved 34 patients with diabetic neuroosteoarthropathy (DNOAP). The acute stage was diagnosed in 7 (20.6 %), subacute in 12 (35.5 %), and chronic in 15 (44.1 %) cases. Ten patients had trophic ulcers of feet in their histories, 24 revealed them on examination. The purpose of the present work was as follows: to stop the foot deformity progression and bone destruction, to heal trophic ulcers, to improve the weight-bearing capacity of the extremity and to restore the act of walking with help of modern methods of treatment and orthopaedic provision. Indications for using orthoses were revealed in 29 (85.3 %) patients with DNOAP. Fixing with a plaster bandage was performed in 5 cases at the acute stage, a total contact orthosis was made for 18 patients (12 with the subacute stage and 4 with the chronic one), an unloading total contact orthosis was used in 2 patients with the acute stage, and an orthosis for the foot with orthopaedic footwear was made in 11 patients with the chronic stage. As a result of the complex of treatment and orthopaedic provision of the patients, trophic ulcers healed in 100 % of cases, the weight-bearing capacity of the extremity increased in 95.8 %, the patients’ mobility became better in 75 %, and their psychoemotional state improved in 66.7 %. All the patients demonstrated better indices of biomechanics. Hence, treatment combined with orthopaedic provision in DNOAP made it possible to heal trophic ulcers and stop progression of foot deformity.

Ukrainian and foreign scientific sources, dealing with use of biogenic, bioinert materials and other components of tissue-engineering structures in osteoplastic surgery, are analytically reviewed. Classifications of osteoplastic materials and detailed information about variants of their influence on reparative regeneration of the bone tissue are presented, as well as the most promising directions of regenerative medicine are described. Despite a large number of designed implants and appearance of a new field, tissue engineering, at present there is not any single “gold standard” in treatment of bone tissue defects, each drug having its positive and negative properties. Hence, the positive clinical result can be achieved only in case of an adequate choice of an implant depending upon a concrete clinical situation and with strict observance of demands of technologies for its use.

The article describes results of experimental researches, which were conducted on 40 white laboratory rats at the age of 6 months. Bone regeneration was studied in a perforated transcortical defect, made in the proximal tibial metaphysis, under the effect of Calcemin drug. Unlike other agents, studied before, Calcemin produced a systemic effect on the bone tissue owing to the fact that besides calcium and phosphorus this drug contains microelements, which improve metabolism of normal bones and promote their regeneration. It was found out that Calcemin stimulated reparative osteogenesis and resulted in the formation of bone tissue within the shortest terms.

Radiograms of 189 patients of different age groups with dysplastic syndromes (varus, valgus and dysplasia of the femoropatellar joint) were retrospectively analysed with the purpose of improving results of diagnosis and prognosis for the development of dysplastic gonarthrosis. Parameters of the knee joint were measured in the frontal and sagittal planes. In order to reveal a dependence of the development of arthritic changes upon the state of anatomical parameters of the knee joint, the distribution of gonarthrosis in the age groups was analysed. It was found out that there was a mathematical dependence of the stage of arthrosis upon anatomical parameters of the knee joint. A mathematical equation was formulated, and it helped to reveal the expected stage of arthrosis. The obtained results make it possible to detect the stage of arthrosis with a high degree of probability by anatomical indices in patients with dysplastic changes in their knee joints.

The effect produced by a change in the anteroposterior inclination of the tibial plateau on the knee joint stability and a displacement of the contact loading area on the inner tibial process was experimentally analysed. Two cadaver preparations of the knee joint served as the material. A change of the tibial plateau inclination in conditions of corrective osteotomy has steady influence on the knee joint kinematics. In case of an injury of the anterior crucial ligament against a background of medial gonarthrosis it is possible to use closed wedge osteotomy in combination with a decreased retrad inclination of the tibial plateau, thereby compensating to some extent for anterior instability of the knee joint. An increased retrad inclination of the tibial plateau results in an anteriad displacement of the tibia and can be used to compensate for posterior instability.

The stress-strained state in a finite element model of C III/C VII vertebromotor segments was comparatively analysed in conditions of modelling of different variants of bisegmental anterior interbody fusion of C IV/C VI with help of vertical cylindrical mesh implants, including two new techniques developed. It was revealed that the configuration of the implants and peculiarities of their placement in the interbody space played an important part in the distribution and change of values of the stress-strained state for bodies of the vertebrae, which were stabilized.

The article deals with results of a numerical simulation and a mathematical analysis, using the finite element method, of the stress-strain state in the “lumbar spine – sacroiliac joint – pelvis” system with different variants of inclination of the sacrum and lumbar lordosis in conditions of unilateral blocking of the sacrum. Peculiarities of the maximum and minimum stress in the area of the sacroiliac joint in case of a unilateral blocking and different variants of inclination of the sacrum and lumbar lordosis are shown.

The article deals with results of using dabigatran etexilate mesylate, a direct inhibitor of thrombin, with a preventive purpose following primary hip joint arthroplasty. After an examination, performed on 30 patients, the efficacy of dabigatran etexilate mesylate for reducing the manifestation rate of thrombosis of veins on the lower extremities was confirmed. Besides, no significant changes in the haematological and biochemical indices of blood against a background of its use were observed.

The method of synovial fluid phasometry for differential diagnosis of pathological states in the knee joint was assessed and an algorithm of the research was developed. The study involved 30 patients; of them, pyogenic arthritis of the knee joint was diagnosed in 10 cases, and synovitis with deforming arthrosis of degrees II-III in 20 ones. Results of the research indicate that there are reliable differences between values of statistic moments of orders 1-4 in two groups, thereby making it possible to objectively differentiate the above knee joint pathology very quickly.

The designed hip prostheses with split sleeves, which make it possible to regulate their volume parameters, enable doctors to perform rehabilitation of geriatric patients, disabled people during their primary prosthetics as well as a complex bulk of patients with vascular pathology on a higher level, to increase mobility of injured people and their independence in regulating the size of their sleeve, and to provide the patients with a more comfortable use of prostheses.

Anatomic-functional peculiarities of tibiofibular syndesmosis and its part in the preservation of functional stability of the ankle joint, as well as anatomic deviations in the joint in cases of neglected damages of tibiofibular syndesmosis, are analysed. Clinical, radiological and tomographic criteria for the objective assessment of the tibiofibular junction, as well as modern tendencies in surgical treatment of neglected damages of tibiofibular syndesmosis, are elucidated.

A relationship between changes in the cervicodiaphyseal angle and stress in the femoral head and neck was assessed with help of the finite element method. It was revealed that a change of the cervicodiaphyseal angle from 120º to 160º resulted in increases of the stress-train state and stress concentration area along the superior and inferior surfaces of the proximal femur versus the normal angle. A higher stress produced an excess pressure on vessels in the femoral neck, thereby later possibly causing bone tissue dystrophy in the femoral head.

In order to study some pathogenetic factors of different variants of spondylolisthesis, the authors analysed transformation parameters of lumbar vertebral bodies and sacrum, vertebral pedicles, arches and articular processes. The parameters of vertebral segment remodelling in patients with dysplastic and degenerative variants of spondylolisthesis principally differed and could serve as a differential criterion for identifying dysplastic and degenerative types of spondylolisthesis. The revealed differences explain distinctive features in the mechanisms of displacement in patients with degenerative spondylolytic and lysis-free spondylolisthesis.