ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS

METHODS OF REINNERVATION AFTER AMPUTATIONS IN PATIENTS WITH THE CONSEQUENCES OF COMBAT INJURIES (LITERATURE REVIEW)

Olexandr Burianov — 2025-06-29

The full-scale aggression of the Russian Federation against Ukraine has significantly increased the number of cases and the structure of factors leading to the performance of such surgical interventions as amputation. There are no reliable statistics on the number of limb amputations performed since the beginning of the full-scale invasion of the Russian Federation into the territory of Ukraine due to objective factors, however, according to preliminary estimates, their number exceeds 50 thousand people. One of the significant problems after limb amputations is pain syndrome, which is observed in 60 to 86 % of patients, which is divided into two types: residual limb pain (RLP) and phantom limb pain (PLP). This problem is relevant for modern world orthopedics and traumatology, the solution of which requires a multidisciplinary approach, and further study will allow to improve treatment tactics and improve the final results. The purpose was to determine the optimal surgical technologies for performing amputations in victims with combat injuries and analyze modern reinnervation methods by studying literary sources. Methods. An assessment of modern publications, systematic reviews, and current recommendations published recently was conducted, which are devoted to methods of treatment and prevention of neuroma formation in limb amputations. A search was conducted in the PubMed, Scopus, Web of Science, and Google Scholar, databases using the following terms: «amputation», «RPNI», «VDMT», «TMR», «phantom», «clinical effectiveness», «post-amputation pain», «BNA», «ANA», «RLP», «PLP», «stump neuroma», «symptomatic neuroma», «pain neuroma». Relevant articles were included after reading the full text and determining the necessary parameters. The review was prepared in accordance with the recommendations of the “Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines”. onclusions. The results of scientific studies indicate that reinnervation methods (TMR, RPNI, VDMT) are clinically more effective than traditional amputation. These methods can be used with equal effectiveness both for the prevention of late post-amputation complications (symptomatic neuromas, phantom limb pain, residual limb pain) and for their treatment.

RISK FACTORS OF RECURRENCE LUMBAR INTERVERTEBRAL DISC HERNIATION AFTER PRIMARY ENDOSCOPIC TRANSFORAMINAL DISCECTOMY. PART 1 (LITERATURE REVIEW)

Vira Kolesnichenko — 2025-06-29

Percutaneous endoscopic transforaminal discectomy (PETD) is a minimally invasive technique that improves clinical outcomes. However, limited visibility of the surgical field and the widespread use of endoscopic technology have led to complications after discectomy, among which recurrence of lumbar disc herniation is the main reason for repeated surgical interventions. The aim is to study epidemiological risk factors that potentiate the recurrence of lumbar intervertebral disc herniation after primary percutaneous endoscopic transforaminal discectomy. Methods. The study material is professional articles containing the definition of epidemiological risk factors for recurrence of lumbar disc herniation after primary PETD, for the period 2015–2024. A systematic review of relevant literature sources was performed using the following keywords: "recurrent lumbar disc herniation", «risk factor for recurrent lumbar disc herniation», "minimally invasive lumbar spine surgery", "percutaneous endoscopic lumbar discectomy», "percutaneous endoscopic transforaminal discectomy», "re-discectomy". Results. Research data on the reliability of the relationship between the recurrence of lumbar disc herniation after primary PETD and epidemiological risk factors are contradictory. The most significant among them was older age, ruptures of the annulus fibrosus. Conclusions. The most reliable epidemiological risk factors for rGMD of PVC after primary PETD are age > 50 years, body mass index > 25 kg/m2. The reasonable time for performing primary PETD of lumbar disc herniation from a medical and financial point of view is ≤ 8 weeks from the moment of clinical manifestation of the disease.

OSTEOARTHRITIS AND GERIATRIC SYNDROMES: FEATURES OF THE RELATIONSHIP AND MANAGEMENT OPPORTUNITIES (LITERATURE REVIEW)

Alina Iniushyna — 2025-06-29

Osteoarthritis (OA) is one of the leading age-associated musculoskeletal isorders, the prevalence of which is increasing due to population aging. The aim of this study is to analyze current literature data regarding the relation and management possibilities of OA and common geriatric syndromes. Methods. A systematic literature review was conducted using analytical methods across scientific databases such as PubMed, Web of Science, Scopus, and Google Scholar for the period 2019–2024. The search was performed using the keywords: “osteoarthritis,” “sarcopenia,” “sarcopenic obesity,” “dysmobility,” “malnutrition,” and “undernutrition.” Results. Typical geriatric syndromes (sarcopenia, sarcopenic obesity, dysmobility syndrome, and malnutrition) are the common phenomenons among OA patients. These conditions share common pathophysiological mechanisms that mutually aggravate each other’s course. The analysis of current literature revealed a lack of comprehensive studies on the combination of OA with geriatric syndromes, especially in the Ukrainian scientific space. This article provides an overview and analysis of current scientific data regarding prevalence, risk factors, pathophysiological mechanisms, diagnostic features, clinical manifestations, as well as potential approaches to treatment, prevention, and rehabilitation of patients with OA in combination with the most common geriatric syndromes. Conclusions. The literature analysis demonstrated bidirectional interaction mechanisms between OA and other geriatric syndromes, highlighting the importance of developing effective strategies for early detection, prevention, and management of such patients within a multidisciplinary approach.

Clinical case of reconstruction of gunshot foot injury using the alt free flap technique

Igor Khomenko — 2025-06-29

With the onset of the full-scale war in Ukraine, the number of wounded individuals with soft tissue defects has significantly increased, necessitating the use of plastic surgery techniques for wound closure. However, to date, this surgical treatment method has not been widely adopted in military medicine due to the limited number of qualified specialists, the technical complexity of such procedures, and the need for specialized surgical department resources. Objective. To explore alternative surgical treatment approaches for patients with extensive foot defects using a free anterolateral thigh (ALT) flap to improve the functional, aesthetic, and weight-bearing properties of the foot. Methods. A single-stage reconstructive plastic surgery using a free composite flap (ALT free flap) was performed on a 49-year-old male serviceman due to the long-term consequences of a mineblast injury. The injury resulted in a chronic combined nonhealing granulating wound on the plantar surface of the right foot, comprising 60 % hypertrophic keloid scar tissue and 40 % non-healing granulating wound. To restore the anatomical integrity of the affected soft tissue, a free anterolateral perforator thigh flap (Anterolateral thigh flap) was used. Results. The transferred ALT flap successfully integrated into the plantar surface of the foot without complications. In the early postoperative period, venous congestion and epidermolysis were observed. This clinical case demonstrates that reconstructive plastic surgery using an ALT flap is an optimal approach for restoring the function of the damaged foot. Conclusions. The use of a free ALT flap addresses the issue of insufficient local donor site availability for volumetric, aesthetic, and functional reconstruction. Additionally, it enables microsurgical anastomosis at a favorable istance from the compromised area with impaired tissue trophism, which helps reduce technical difficulties and the rate of postoperative complications.

CAVERNOUS MEDULLARY HEMANGIOMA OF THE DISTAL LEFT FEMUR: A CASE REPORT

Igor Shevchenko — 2025-06-29

Bone hemangiomas occur in only one percent of primary bone neoplasms, and their diagnosis is difficult. The location of these benign neoplasms in long bones is even more rare. Objective. To describe the features of the diagnosis and surgical treatment of a woman with cavernous medullary hemangioma of the distal femur. Methods. The main diagnostic methods were computed tomography, radiography, and histopathological examination of the surgical specimens. Treatment was surgical removal of the neoplasm followed by rehabilitation with dosed loading of the limb. Results. A 45-year-old woman presented to the clinic with persistent aching pain in the left knee joint that did not stop after taking analgesics. Radiologically and using magnetic resonance imaging, an area of destruction and a neoplasm of irregular shape with clear uneven contours were found in the distal epimetaphysis of the left femur. Over 2 years of observation, the volumetric neoplasm did not increase on the radiographs, but the pain syndrome did not disappear and intensified during physical exertion. The results of the trephine biopsy did not allow to determine the exact diagnosis. Surgical treatment was carried outby means of parietal resection of the pathological focus of the distal part of the left femur and combined replacement of the defect with bone allograft with cement and fixation with a plate and screws. Morphological changes detected in the surgical specimens during histopathological examination corresponded to the diagnosis of cavernous hemangioma of the bone. At six months postoperatively, the patient demonstrated nearcomplete painless weight-bearing on the operated limb with minimal use of a cane, and the knee joint’s range of motion was fully restored. Conclusions. Cavernous hemangioma of the femur is difficult to diagnose using trephine biopsy alone; accurate diagnosis is typically possible only through analysis of the surgical specimen. Surgical treatment enabled painless weight-bearing on the left limb by the sixth month of follow-up.

Alexander Evgenievich Loskutov

Association of Orthopedic Traumatologists of Ukraine — 2025-06-29

May 26, 2025 marks the 75th anniversary of the birth and 52 years of medical, scientific, pedagogical and public activity of the Head of the Department of Traumatology and Orthopedics of the Dnipro State Medical University, Academician of the National Academy of Medical Sciences of Ukraine, Doctor of Medical Sciences, Professor, Honored Worker of Science and Technology of Ukraine, laureate of the State Prize of Ukraine Oleksandr Yevgeniyovych Loskutov.

WAYS TO IMPROVE THE RESULTS OF TREATMENT OF SEVERE COMBINED PELVIC INJURIES IN MODERN CONDITIONS

Volodimir Burluka — 2025-06-29

Objective. To analyze the treatment of victims with severe combined pelvic trauma in the conditions of the existing trauma care system in Ukraine and to identify ways to improve the results of treatment of such injuries. Methods. The work was based on a study of the results of treatment of 406 victims with unstable pelvic injuries in polytrauma (UPIP) (ISS ≥ 17 points). Of these, 249 (61.3 % ) patients died in different periods of traumatic illness (TI). Two clinical groups were formed: the first — 137 (33.7 % ) patients, in whom differential surgical treatment tactics were performed based on the developed scales for assessing the severity of injury, the prognosis of the course of TI depending on its periods, as well as the proposed modern methods of diagnosis and surgical treatment of injuries of the pelvis and other anatomical areas, the second — 269 (66.3 %) patients, in whom generally accepted surgical treatment tactics were used. Results. Active surgical tactics using a differential approach allowed to increase the number of internal (combined) metal osteosynthesis in this category of victims from 40.4 to 72.1 %, to reduce the proportion of conservative treatment from 53.7 to 30.6%, and the active implementation of an improved protocol scheme for surgical treatment of victims with NUTP during hospitalization allowed to reduce mortality in the acute period of TC (up to 48 hours) from 77.7 to 63.9 %, p < 0.05, overall mortality from 69.9 to 44.5% (p < 0.01). Conclusions. The timing of delivery of a victim with a severe combined pelvic injury to a specialized trauma department is crucial at the prehospital stage of saving the patient's life. The tactics of surgical interventions for injuries of extrapelvic localization, unstable pelvic fractures, pelvic organ trauma in the acute period of TI should be based on urgent indications, aimed primarily at stopping intrapelvic bleeding, the possibility of conducting single-stage or sequential emergency external fixation of the pelvic ring.

THE EFFECT OF TIME SINCE INJURY ON THE PROGRESSION OF ROTATOR CUFF ARTHROPATHY OF THE SHOULDER (RETROSPECTIVE STUDY)

Sergiy Bohdan — 2025-06-29

Rotator cuff disease is a disease of the shoulder joint, which is c haracterized b y i nsufficient f unction o f t he r otator c uff of the shoulder, degenerative changes in the joint capsule and migration ( displacement) o f t he h umeral h ead. T he o bjective of the study is to investigate the influence of time since injury on the progression of rotator cuff arthropathy of the shoulder joint. Materials and methods. We included 91 patients in the study who, at the time of examination, had rotator cuff arthropathy of varying degrees. The age of the patients ranged from 35 to 80 years. The average age was (48.2 ± 19.8) years. The inclusion criteria for the study were as follows: the presence of rotator cuff arthropathy of any degree, clear indication to the patient of the time since the injury, the presence of an MRI scan with a magnetic field strength of 1.5 Tsl, age 35 to 80 years, the absence of concomitant pathology of the shoulder (homarthrosis, calcifying tendinitis and any bone pathology of the proximal epimetaphysis of the humerus. The degree of rotator cuff arthropathy, damage to the soft tissue structures of the shoulder joint, and the time from injury to the patientʼs visit were determined. Results. The vast majority of patients had stage 2 rotator cuff arthropathy — 60.4 %, a slightly smaller number of patients had stage 1. rotator arthropathy — 23.1 %, patients with 3–5th degree. rotator arthropathy was significantly less — a total of 16.5 %. With an increase in the average terms from the moment of injury, the degree of rotator arthropathy increases. For the development of rotator arthropathy of the 1st degree, an average term of (5.16 ± 1.54) months after injury is required, while for the development of rotator arthropathy of the 4th degree, an average term of (11.25 ± 4.6) months after injury is required. Conclusions. There is a weak (r = 0.31; p = 0.051), but significant dependence of the influence of the term from the moment of injury on the degree of rotator arthropathy. Thus, with an increase in the terms from the moment of injury, the degree of rotator arthropathy of the shoulder joint may also increase.

PREDICTOR SCALE OF UPPER EXTREMITY FUNCTION RECOVERY IN MILITARY TRAUMA OF THE UPPER ARM (OFFER TO USE)

Sergiy Strafun — 2025-06-29

Objective. To determine the prognostic value of the extent of damage in military trauma to the upper arm for surgical intervention to improve the results of restoring upper limb function. Methods. A retrospective analysis of 30 cases of military trauma of the upper arm in combatants of the Armed Forces of Ukraine was conducted from the stage of admission to our hospital for treatment until 4 months after surgery. Functional outcomes were assessed using the Oxford Shoulder Score (OSS) scale 4 months after surgery. A previously developed scale was used to predict the recovery of upper limb function after military trauma of the upper arm to predict the consequences of surgery. Results. All 30 patients had a gunshot injury to the upper arm as a result of a shrapnel or bullet wound received during combat missions in the war on the territory of Ukraine. All 30 combatants received qualified medical care, underwent staged surgical interventions and a course of rehabilitation recovery. Based on the data of a retrospective analysis of patients, the correlation of rehabilitation results according to the OSS scale and the results of the assessment according to the scale-predictor of recovery of upper limb function in case of gunshot injury to the upper arm is traced. Conclusions. The results obtained after the assessment using the predictor scale serve as an aid in deciding on the feasibility and scope of surgical intervention. The decisive factor is the professionalism of the doctor and the patient's willingness to take risks to restore limb function in severe injuries of the upper arm in a large scope of trauma.

TOTAL WRIST ARTHRODESIS EFFICIENCY IN VARIOUS UPPER LIMB ORTHOPEDIC PATHOLOGIES

Serhii Tymoshenko — 2025-06-29

Wrist arthrodesis for different pathologies has important specific features and yields varying functional outcomes. Objective. Based on the analysis of functional parameters dynamics to assess the total wrist arthrodesis efficacy for different upper limb pathologies. Methods. An analysis was performed on the dynamics of cylindrical grip strength and upper limb disability (qDASH score) before and one year after total wrist arthrodesis in 49 patients with various conditions, including wrist osteoarthritis, chronic brachial plexus injuries, distal radius giant cell tumor, rheumatoid arthritis, and wartime wrist joint injuries. Results.Wrist arthrodesis improved cylindrical grip strength in patients with degenerative wrist osteoarthritis by a median of 14 kg (range: 7–15 kg; IQR: 1 kg), in tumors by a median of 10 kg (range: 8–11 kg; IQR: 1,5 kg), and in consequences of wartime injuries involving joint surface defects by a median of 4 kg (range: 2–39 kg; IQR: 3 kg). In cases of rheumatoid arthritis, the median improvement was 3,4 kg (range: 2–9 kg; IQR: 2 kg). Effectiveness was minimal in patients with chronic brachial plexus injuries. The greatest reduction in upper limb disability (qDASH score) was observed in patients with of wartime wrist trauma consequences, with a median improvement of 40 points (range: 0–68 points; IQR: 27 points). In wrist osteoarthritis, the median improvement was 20 points (range: 9–39 points; IQR: 9 points), while relatively minor improvements were noted in patients with tumors, rheumatoid arthritis, and brachial plexus injuries. Total wrist arthrodesis is an effective surgical procedure; however, depending on the pathology, the indications, surgical conditions, techniques, and outcomes differ significantly and are notably varied.

SHORT-TERM OUTCOMES OF USING CUSTOM 3D PRINTED BASE PLATES IN REVERSE SHOULDER ARTHROPLASTY FOR PATIENTS WITH GLENOID CAVITY DEFECTS

Vasyl Makarov — 2025-06-29

Objective. To conduct a retrospective analysis of the short-term clinical and radiographic outcomes of reverse total shoulder arthroplasty using custom glenoid base plates in patients with glenoid cavity defects. Methods. We retrospectively studied the surgical outcomes of 10 patients with defects of the glenoid cavity who underwent reverse total shoulder arthroplasty using individual glenoid base plates. The average follow-up period postsurgery was (2.6 ± 1.6) years. The mean age of the patients was (62.4 ± 5.6) years, including 7 women (70 %) and 3 men (30 %). Two patients (one woman and one man) underwent RTSA on both shoulders, resulting in a total of 12 RTSA procedures performed on 10 patients. All patients underwent shoulder joint imaging using spiral computed tomography, modeling of the individual base plate implant for the glenoid part of the endoprosthesis, and fabrication of the implant using 3D printing with titanium powder. The function of the shoulder joint was evaluated using the Constant-Murley Shoulder Score (CMS). Results. The mean cortical index was 0.38 ± 0.06. Lateralization and distalization angles were measured at 80° ± 5.6° and 55° ± 8.2°, respectively. The average active range of motion for external rotation was 60° ± 5.5°, flexion and elevation of the upper limb at the shoulder joint (including the scapula) was 135° ± 8.4°, internal rotation was 85° ± 3.4°, and abduction of the shoulder joint (including the scapula) was 145° ± 10.2°. The mean score on the CMS scale was 85. Conclusion. The retrospective analysis demonstrates a significant reduction or complete absence of pain syndrome along with improved functional outcomes in patients after RTSA with glenoid cavity defects when using custom base plates for the glenoid part of the reverse shoulder endoprosthesis.

MANIFESTATIONS OF HETEROTOPIC OSSIFICATION IN PATIENTS WITH RADIAL HEAD FRACTURES COMBINED WITH FOREARM DISLOCATIONS

Yevgen Matelenok — 2025-06-29

Heterotopic ossifications (HO) is one from the negative consequences of the joint injuries, and they are especially significant for fractures and fracture-dislocations of the elbow, reaching 37 %. Objective. To study the frequency of occurrence and form of manifestation of HO in patients with fractures of the radial head (RH) in combination with dislocations of the forearm under the conditions of restoration of the head and the impossibility of its preservation. Methods. The study is based on a retrospective analysis of clinical observation material of 48 patients with dislocations of the forearm in combination with fractures of the RH, among which during surgical treatment in 39 patients the head of the radius was preserved (1st group), in 9 patients it was not possible to save the head (2nd group). Results. In 9 patients (23 %) of the 1st group and in 5 (56 %) of the 2nd group for an average period of 6 months, X-ray examination revealed manifestations of HO. Surgical interventions were performed later than 48 hours. It is noteworthy that among patients of the 1st group, HO, which caused limitation of the range of motion in the joint, occurred in 2 cases out of 9, that is, in 22 %, and among patients of the 2nd group, significantly more often — in 4 out of 5 patients, that is, in 80 % of cases. Differences between these indicators in groups are statistically significant (p < 0.05). The functional assessment of the elbow joints by the Mayo Clinic Score in groups was significantly higher in the patients of the 1st group — (87 ± 9) points compared to (49 ± 16) in the patients of the 2nd group (p < 0.05). Conclusions. In patients with fractures of the RH in combination with dislocations of the forearm in cases of impossibility of preserving the head, the formation of HO in the area of the elbow joint is observed more than twice as often compared to patients with preserved head (56 % vs. 23 %). HO of forms II and III are observed more than three times more often in patients with fractures of the RH in combination with dislocations of the forearm in cases of impossibility of preserving the head compared to cases of its restoration (80 % vs. 22 %). Given the high risk of HO in the elbow joint of patients with fractures of the RH in combination with dislocations of the forearm in case of impossibility of preserving the head, as well as in cases of postponement of the necessary surgical treatment for fractures in the elbow joint, it is necessary to take care of the available measures for the prevention of HO.

CRITICAL PARAMETERS OF TUNNEL POSITIONING IN ACL RECONSTRUCTION: A RETROSPECTIVE MRI ANALYSIS

Oleksandr Kostrub — 2025-06-29

Anterior cruciate ligament (ACL) rupture is one of the most common knee injuries requiring surgical intervention. The increasing number of revision surgeries indicates the potential presence of technical errors during primary reconstruction, emphasizing the importance of outcome analysis and careful surgical planning. MRI remains the gold standard not only for diagnosing ACL injuries and associated lesions, but also for evaluating postoperative changes. Objective. To assess MRI-based measurements of femoral and tibial tunnel inclination and entry point location as potential technical causes of ACL graft failure. Methods. A retrospective analysis was conducted on 105 knee MRI scans from patients following primary ACL reconstruction. The parameters evaluated included femoral and tibial tunnel inclination angles on coronal views, femoral tunnel entry point using a modified Bernhard and Hertel method, and tibial tunnel entry point assessed via he Amis and Jacob line. Results. A femoral tunnel angle within the 30°–50° range was found in 63 % of cases, with the optimal range of 32°– 39° observed in 21 %. In 16 % of cases, the angle exceeded 50°, and in 3 % it was less than 17°. The femoral tunnel entry point fell within the normal range in 46 % of cases, while in 42 cases it was located outside the defined measurement rectangle. Tibial tunnel position on sagittal projection was anatomically correct in 38 % of cases, anteriorly displaced in 21 %, and posteriorly displaced in 41 %. The optimal tibial tunnel inclination angle (≥ 65°) was found in 61 % of cases. Graft integrity was preserved in 24 % of cases with posterior tibial tunnel positioning, and in only 6 % with anterior placement. Conclusions. Technical errors in tunnel formation are a common cause of ACL graft failure. Accurate determination of the tunnel entry point is the most critical factor, while tunnel angle plays a secondary, yet diagnostically valuable, role. These findings highlight the need for meticulous planning, including the use of MRI and intraoperative navigation techniques to optimize tunnel placement.

Assessment of the accuracy of reproduction of the lower limb axis using an individual instrument during endoprosthetics with kinematic alignment of the knee joint

Maksym Golovakha — 2025-06-29

Objective. To assess the accuracy of reproduction of the kinematic axis of the lower limb using an individual instrument during total knee arthroplasty (TKA) by comparative radiographic analysis before and after surgery. Methods. Using radiographic analysis, an analysis of the knee arthroplasty of 10 patients operated on using an individual instrument was performed, the kinematic axis was restored (3 men and 7 women). The age range was from 56 to 71 years. Before surgery, patients underwent computed tomography of the lower limbs, and after it, radiography with vertical positioning of the feet. The individual instrument was manufactured using the original method. Results. A comprehensive assessment of the accuracy of reproduction of spatial landmarks of the lower limb during TKA was carried out using an individual surgical instrument developed on the basis of computed tomography and the principles of kinematic alignment. Analysis of deviations of the proximal medial tibial angle in the postoperative period revealed a mean absolute error of 0.15°, with a mean relative error of 0.74 %. At the same time, for the distal lateral femoral angle, an absolute error of 0.24° and a relative error of 0.27 % were established. Preoperatively, the mean value of the planned axis was 88.71°, postoperatively — 86.58°, which corresponds to a mean varus deviation of 2.15° and a relative error of 2.47 %. At the same time, it was found that the technical axis indicators were 88.55° before surgery and 86.67° after, respectively, with a mean varus deviation of 1.88° and a relative error of 2.28 %. Conclusion. A custom instrument allows for accurate reproduction of the kinematic axis of the lower limb, which can be crucial for achieving functional outcome and patient satisfaction.

RESULTS OF SURGICAL TREATMENT OF HIGH-GRADE SPONDYLOLISTHESIS

Andriy Mezentsev — 2025-06-29

Spondylolisthesis of Grade III–IV according to the Meyerding classification, referred to in English literature as “high-grade spondylolisthesis,” involves a significant degree of vertebral displacement and leads to substantial impairment of spinal function, gait disturbances, and early disability in patients. Despite the fact that clinical symptoms, classifications, and diagnostic methods have been known and established for quite some time, the issue of surgical treatment remains a subject of debate to this day. Objective. To evaluate the outcomes of surgical treatment in patients with high-grade spondylolisthesis. Methods. A retrospective analysis was conducted on the surgical outcomes of 24 patients with significant vertebral displacement who underwent intraoperative traction and transpedicular fixation using a “spine–pelvis” system. Pre- and postoperative radiographic measurements included the slip angle, pelvic incidence, lumbar lordosis, sacral slope, pelvic tilt, as well as evaluation of sagittal vertical axis alignment and pelvic tilt angle. Results. All patients demonstrated a reduction in slip angle and restoration of sagittal vertical axis alignment to within normal limits. Other parameters of spinopelvic balance were also moderately improved, thereby bringing sagittal spinal alignment closer to normal values and enhancing the biomechanical conditions for spinal function. Conclusions. The use of intraoperative traction via ligamentotaxis allowed for repositioning of the displaced vertebra and facilitated the placement of transpedicular screws. The combination of intraoperative spinal traction and pulling on transpedicular screws using reduction devices enabled correction of the displaced vertebra to Grade I–II according to Meyerding, thereby restoring the supportive function of the spine.

INTERLEUKIN-6 AND ACUTE PHASE PROTEINS AS BIOMARKERS OF SEPTIC OSTEOARTHRITIS

Sadrudin Magomedov — 2025-06-29

Septic arthritis (SA) is a severe and rapidly progressive joint infection and a potentially life-threatening condition that can affect all age groups. Due to the lack of effective methods for early detection and assessment of treatment outcomes, measurement f biochemical markers (biomarkers) is a promising method for monitoring the disease. The aim of the study was to determine the diagnostic significance of inflammatory biomarkers (IL-6, CRP, haptoglobin, ceruloplasmin) in patients with septic joint inflammation of various localizations. Methods. The study analyzed blood serum from 54 male and female subjects. Of these, 18 were conditionally healthy and entered group I (control), and 36 patients were diagnosed with septic osteoarthritis of joints of various localization in the skeleton. Of these, 18 had SA of the knee joint; 13 patients had SA of the hip joint and 5 had SA of the ankle joint. Results. Patients with septic arthritis of the knee and hip joints had significantly increased levels of IL-6 and acute phase proteins in the blood serum. We believe that it is the enhanced synthesis of the pro-inflammatory cytokine IL-6 and acute phase proteins that plays a significant role in the pathophysiology of the inflammatory response, which initiates a chain of reactions that lead to cartilage degradation and further complication of inflammatory processes in the joint. Therefore, these biomarkers can be tools for diagnosing the progression of this disease in both preclinical and clinical studies. The results obtained emphasize the importance of identifying inflammatory biomarkers for diagnosing the progression of septic arthritis in both preclinical and clinical studies to establish the stage of the disease and predict clinical outcome.

Current issues of modern traumatology and orthopedics

Maksym Golovakha — 2025-06-29

On April 11, 2025, a scientific and practical conference “Current Issues of Modern Traumatology and Orthopedics” was held in Zaporizhzhia, organized by the Zaporizhzhia State Medical and Pharmaceutical University together with the NGO “Zaporizhzhia Regional Association of Orthopedists and Traumatologists”.

To the 100th anniversary of Professor Yuri Yuliyovych Kollontai — memory of the teacher (1925–2025)

Staff of "Orthopaedics, traumatology and prosthetics" — 2025-06-29

May 8, 2025 marks the 100th anniversary of the birth of Yuri Yuliyovych Kollontai, an orthopedic traumatologist, an outstanding scientist, and the founder of the Ukrainian school of hand surgery and tendon alloplasty.