RESUMEN
The authors consider that puncture decompression of the intervertebral disc with using the endoscopic technique and laser evaporation is a method allowing to rapidly and effectively help patients with the root syndrome. All the manipulations are made with local anesthesia. The patients started walking on the second day after operation.
Asunto(s)
Vértebras Lumbares/cirugía , Osteocondritis/cirugía , Sacro/cirugía , Espondilitis/cirugía , Adulto , Cadáver , Endoscopía/métodos , Estudios de Evaluación como Asunto , Femenino , Humanos , Disco Intervertebral/cirugía , Desplazamiento del Disco Intervertebral/cirugía , Terapia por Láser/métodos , Masculino , Procedimientos Quirúrgicos Mínimamente Invasivos/métodosRESUMEN
The paper presents the results of plastic operations on 54 trochanterian bedsores in 48 patients with complicated spinal injury. Early positive results were obtained in 100% of cases when various modifications of a skin-subcutaneous flap was applied in 16 patients with 17 bedsores. There were relapses in 4 patients following a year. A full-layer skin-subcutaneous-fasciomuscular flap was employed in 33 patients with 37 bedsores. A poor result, namely flap non-acceptance, was seen in one case. Late relapses were absent. It is most expedient to use full-layer flaps in the treatment of bedsores in the tronchaterian area in terms of its anatomic features.
Asunto(s)
Úlcera por Presión/cirugía , Traumatismos Vertebrales/complicaciones , Colgajos Quirúrgicos , Estudios de Seguimiento , Humanos , Úlcera por Presión/etiología , Factores de TiempoRESUMEN
Experimental studies have revealed that a pulse surgical laser based on alumo-yttrium garnet with neodymium ensures bloodless diskectomy and evaporation of a pulposus nucleus in the volume sufficient for decompression of the intervertebral disk. Biomechanical studies of spinal resistance following puncture endoscopic laser decompression of the intervertebral disk (PELDID) and microsurgical laser diskectomy (MLD) have demonstrated that these surgical interventions fail to disturb the stability of the spinal portion operated on. A total of 75 patients with radicular syndrome were operated on with the proposed procedures: 32 with PELDID and 43 with MLD. The subsequent studies have shown that 69 (92%) patients returned to previous work at week 7 and 5 (6.7%) at week 9 of postoperation. The major manifestation of radicular syndrome--leg pain--was eliminated in 100% after MLD and in 96.9% after PELDID.
Asunto(s)
Discectomía/métodos , Vértebras Lumbares/cirugía , Osteocondritis/cirugía , Estudios de Seguimiento , Humanos , Laparoscopía , Terapia por Láser , MicrocirugiaRESUMEN
A classification of tendinous and ligamentous implants has been proposed on the basis of their baseline and final strength, taking into account the matrix properties of a material. The experiments on the knee joints and Achilles tendons of laboratory animals have revealed the matrix properties of carbon-containing fiber. Biological reconstruction of tendon ligaments occurs in parallel to the degradation of biodestructive carbon-carbonic fiber (BCF) which is absent in the Vitlana (polymer carbon fiber) implants. The expediency of extra- and intraarticular implantation of the Vitlana and extraarticular one of BCF has been evidenced. The use of the Vitlana implants is found justifiable to replace Achilles tendon defects. Due to the occurrence of complications, it is not advisable to use BCF for intraarticular management of and plastic operations for Achilles tendon defects.
Asunto(s)
Bioprótesis , Prótesis de la Rodilla , Ligamentos Articulares/cirugía , Tendones/cirugía , Tendón Calcáneo/cirugía , Animales , Perros , Humanos , ConejosRESUMEN
A group of "Intost" materials based on carbon were developed by the I. M. Sechenov Moscow Medical Academy jointly with the Research Institute of Graphite. After experimental studies the materials were authorized for use in clinical practice for implantation. A concept of the design of endoprostheses of the joints from "Intost" was developed, on the basis of which unipolar combined endoprostheses of the hip joint (127 cases), metatarsophalangeal articulation (27 cases), humeral and metacarpophalangeal articulations (two cases each), and condyles of the tibia (5 cases) were made and applied in clinical practice. A detailed analysis is given of ten years of experience gained with the use of the combined unipolar endoprosthesis of the hip joint manufactured from "Intost-1" and "Intost-3". Long-term beneficial results were obtained in 95% of patients. Endoprosthesis is recommended for the treatment of fractures and false joints of the neck of the femur in elderly and senile patients.