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The article analyzes a clinical cases of cardiac arrhythmia and amiodarone-induced thyrotoxicosis (AIT) in a patient with coronary artery disease (CAD). The article discussed the causes of cardiac arrhythmia and the treatment approach for CAD based on coronary angiography (CAG), as well as the efficacy of revascularization by coronary artery bypass grafting. The importance of hormonal tests and thyroid ultrasound before routine CAG is considered, and at least once in 6 months during amiodarone therapy. Differential diagnosis to clarify the type of AIT is carried out, as type I AIT is treated with tireostatics, and type II AIT with glucocorticosteroids. Comorbidity of somatic diseases in cardiological practice is one of the most crucial prognostic factors defining the outcome of the underlying disease. The article considers the choice of treatment approach for patients with CAD based on clinical tests.

Introduction It has been shown that titanium implants with a structured surface provide an increased rate of osseointegration what makes their application quite promising. The purpose of this work was to conduct a comparative evaluation of the efficiency of osseointegration of new percutaneous implants for prosthetics made of ultrafine-grained Ti Grade 4 alloy. Materials and methods The study was carried out on 12 male rabbits of the Soviet Chinchilla breed. Six rabbits of the control group had implants made of Ti6Al4V powder using selective laser sintering technology that were osseointegrated into the tibia, 6 rabbits of the experimental group had implants made of Ti Grade 4 by equal channel angular pressing. The formation of the "bone-implant" block was examined 26 weeks after the implantation. Results Histologically, after 26 weeks of the experiment, porous changes, enlargement of the Haversian canals, and pronounced osteoclastic resorption were not detected in the animals of the experimental group throughout the stump in the compact plate. Around the implant, a bony case repeating the bone shape was formed, represented by lamellar bone tissue. Using X-ray electron probe microanalysis, it was found that in the substrate formed on the surface of the implant in rabbits of the experimental group, there was significantly more calcium in all areas over the implant relative to the animals of the control group. In the control group, relative to the experimental group, an increased level of C-reactive protein in blood serum was retained longer. Complications and significant clinical and laboratory abnormalities were not found in both groups during the entire experiment. Discussion Our data are consistent with the results of other experimental studies, which unambiguously noted that titanium implants with a structured surface show increased osseointegration characteristics in comparative studies relative to implants without modification of the structure of the material of the threaded surface. The absence of complications and undesirable reactions of the animal organism also indicates the acceptable safety of the tested products. Conclusion Osseointegration of a percutaneous implant that has a mixed nanocrystalline and ultrafine-grained structure was more effective than the reference implant. This makes the use of such implant promising for solving clinical problems in prosthetics.

Background. The problem of improving the functional characteristics of implanted devices and materials used in traumatology and orthopedics is a topical issue. Aim of the study to study biocompatibility of bovine bone matrix xenomaterials modified by zoledronic acid and strontium ranelate when implanted into the bone defect cavity. Methods. The study was performed on 24 male rabbits of the Soviet Chinchilla breed. Test blocks of bone matrix were implanted into the cavity of bone defects of the femur. Group 1 animals (n = 8, control group) were implanted with bone xenogenic material (Bio-Ost osteoplastic matrix). Group 2 animals (n = 8) were implanted with bone xenogenic material impregnated with zoledronic acid. Group 3 animals (n = 8) were implanted with bone xenogeneic material impregnated with strontium ranelate. Supercritical fluid extraction technology was used to purify the material and impregnate it with zoledronic acid and strontium ranelate. Radiological, pathomorphological, histological and laboratory (hematology and blood biochemistry) diagnostic methods were used to assess biocompatibility. Follow-up period was 182 days after implantation. Results. It was found out that on the 182nd day after implantation the median area of the newly-formed bone tissue in the defect modeling area in Group 1 was 79%, in Group 2 0%, in Group 3 67%. In Group 2 the maximum area by this period was filled with connective tissue 77%. Median relative area of implanted material fragments in Group 1 was 4%, in Group 2 23%, in Group 3 15%. No infection or material rejection was observed in animals of all groups. There were no signs of intoxication or prolonged systemic inflammatory reaction. Laboratory parameters did not change significantly over time. One animal in each group experienced one-time increase in C-reactive protein level against the background of leukocytosis. Two animals in Group 1 had a slight migration of implanted material under the skin, one animal developed arthritis of the knee joint. Conclusion. Osteoplastic materials based on bovine bone xenomatrix and filled with zoledronic acid and strontium ranelate have acceptable values of biocompatibility including their safety profile.

Introduction Improving the results of treatment and rehabilitation is essential for polytrauma patients. The aim of the study was to prove the effectiveness of terahertz electromagnetic waves (TEW) in polytrauma patients early after traumatic event to improve immune parameters. Material and methods The study included 20 polytrauma patients who were divided into two groups. Patients of the treatment group (n = 10) received TEW early after traumatic event in addition to standard treatment using the damage control approach. Control patients (n = 10) received no TEW therapy in the complex of therapeutic measures. Immunological studies were performed during treatment. The effectiveness of rehabilitation was assessed at a long term using an evaluation scale. Results The mean rehabilitation score was significantly higher in the treatment group compared to the controls. The treatment group showed significantly higher production of TNFα and IL-2, spontaneous production of IFNγ by lymphocytes, phagocyte activity (NBT-test) and absorption activity of monocytes after the use of TEW in comparison with controls. An increased level of IgG and IgM was also noted in patients of the treatment group. Discussion The findings showed that the use of TEW in polytrauma patients early after traumatic event resulted in the increase in cytotoxic activity of lymphocytes and phagocytic cells. The immunostimulating effect of TEW was also achieved through boosting humoral immunity. Conclusion The TEW used early after traumatic event in polytrauma patients resulted in strengthening of the immune system which contributed to more effective rehabilitation.

of the efficacy and safety of xenogenic bone graft material impregnated with antibiotics, vancomycin or meropenem, in an experiment on a model of long bone defect healing in rabbits. Methods The study was performed on 28 male rabbits aged from 8 months to 1.2 years. All animals were modeled with a cavity defect of the right and left distal femoral metaphysis measuring 4 × 4 × 6 mm. Bone matrix blocks of the same size were implanted into the defect cavity. Animals of group 1 (n = 8, control) were implanted with a free “clean” bone block. Animals of group 2 (n = 10) with a bone block saturated with vancomycin. Animals of group 3 (n = 10) with a bone block impregnated with meropenem. To assess the effectiveness and safety of the material, clinical, radiological, pathomorphological, histological, and laboratory methods were used. Results X-ray signs of substitution of the studied materials in the defect in animals of group 1 were noted by 182 days, in group 2 – by 84 days, in group 3 – about 182 days. In each group, there was a complication, arthrosis of the knee joint (one animal in each group). According to the histological study, it was found that in groups 2 and 3, a complete elimination of xenomaterial in the middle part of the defect and its replacement with trabecular bone was noted by 182 days after implantation. The severity of irritating action of the materials in the animals of groups 2 and 3 did not exceed the control value. The laboratory blood tests in the animals of groups 2 and 3 also did not reveal significant differences with group 1. Conclusion The developed osteoplastic materials based on bovine bone xenomatrix, impregnated with vancomycin or meropenem, have acceptable safety and efficacy characteristics.

Introduction Among the ranges of electromagnetic waves used in clinical practice, electromagnetic waves of the terahertz range (EMWTHR) have promising applications. The experimental and clinical studies show that they are able to provide correction of the main pathophysiological disorders of a living organism such as hypoxia, hypercoagulation, and immunodeficiency. Purpose To study the effectiveness and safety of terahertz electromagnetic waves in the complex treatment of patients with the consequences of fractures of the humeral condyle Methods Clinical, radiological, physiological and laboratory studies were conducted in 30 patients with consequences of fractures of the humeral condyle (post-traumatic deformities, osteoarthritis of the elbow joint). Surgical treatment of patients with consequences of injuries of the elbow joint was classical and consisted of corrective osteotomies and osteosynthesis with the Ilizarov apparatus of the humerus and forearm. The main group consisted of 15 patients who underwent 10 sessions of EMWTHR exposure to the osteotomy zone, and 15 patients did not undergo physiotherapy. Results It was found that in patients of the main group, the average values of the intensity of pain and the deficit in the range of motion were significantly lower than the findings of the comparison group in the short term after treatment. The use of EMWTHR therapy led to differences in metabolic processes in the compared groups. There were no significant changes in radiological, physiological and laboratory parameters, as well as clinical signs that could be attributed to adverse events or complications associated with the use of EMWTHR. Conclusion The results of the comparative study allow us to recommend the EMWTHR therapy in the system of complex treatment of patients with the consequences of fractures of the humeral condyle and can be used as a means for local stimulation of reparative processes in target patients.

Introduction Optimization of the conditions of distraction osteogenesis using the method of G.A. Ilizarov remains an important challenge to ensure a reduction in the number of complications and an increase in the effectiveness of this technology. The aim of the study was to study the changes in the antioxidant/prooxidant balance in patients with acquired shortening of the lower leg bones at the stages of the Ilizarov lengthening procedure. Methods The antioxidant/prooxidant status was studied in 12 patients with shortening of one of the lower legs resulting from hematogenous osteomyelitis (group 1) and in 13 patients with post-traumatic shortening of one of the lower legs (group 2). The level of peroxidation products, the activity of superoxide dismutase and vitamins E and A in the blood of these patients were assessed in the dynamics of monofocal bone lengthening using the Ilizarov method. Results It was found that in patients with acquired shortening of the shin bones, regardless of the shortening etiology, during surgical lengthening, an increase in the level of peroxidation products in the blood was observed with a decrease in the level of vitamin E and an increase in superoxide dismutase activity. Discussion The data obtained, together with the current findings from fundamental research, allow us to note that the use of antioxidants (AOs) in patients undergoing segment length correction using the Ilizarov technology is possible from two positions. 1. The positive effect of AOs in terms of stimulation of distraction osteogenesis has been proven. 2. AOs have a systemic effect in the regulation of the recovery processes in the paraosseous tissues of the limb segment under lengthening. Conclusion Peroxidation is activated in the course of surgical lengthening of the lower leg bones in patients with acquired shortenings, regardless of the shortening etiology. The use of antioxidants in such patients can specifically inhibit peroxidation, thereby reducing the risk of provoking bone formation disorders.

Background. Infection of percutaneous implants in patients with limb amputation is the most common complication. This study aimed to evaluate the microbiological contamination of the implantation zone depending on the implant mechanical compression under the conditions of the additional external fixation. Methods. The study was performed on 36 male rabbits. The tibia of all the rabbits was sawn at the border of the upper and middle parts. The medullary canal was reamed and a percutaneous implant was placed in the tibial stump. The segment and the implant were fixed with an Ilizarov apparatus. An additional compression device was installed in 30 animals. We used 5 compression modes, accordingly, 6 experimental groups were formed, 6 animals in each: group 1 without compression, group 2 compression on the implant with force of 0.053 N/mm2, group 3 compression on the implant with force of 0.105 N/mm2, group 4 compression on the implant with force of 0.158 N/mm2, group 5 compression on the implant with force of 0.211 N/mm2, group 6 compression on the implant with force of 0.263 N/mm2. The restraint was removed 6 weeks after implantation for a total follow-up of 26 weeks. The microflora of the place where the implant enters the skin (the implant / skin interface) was investigated, the level of blood leukocytes and the level of C-reactive protein in blood serum were determined. Results. On days 9-10 after implantation, significant differences in the microbial landscape were found at the site of the exit of the metal implant in animals of different groups. The largest number of strains was found in animals of groups 1, 5 and 6, the smallest in groups 2 and 3. The most frequently detected strains: S. saprophyticus and Enterococcus spp. It was found that the greatest statistically significant increase in the level of CRP in the blood serum was observed in animals of group 6. The level of leukocytes in animals of all groups did not change statistically significantly relative to preoperative values. Animals with better osseointegration (groups 2 and 3 no cases of implant loss) showed a minimal number of growing strains. Conclusions. The microbiological profile of the implantation zone of percutaneous implants changes depending on the amount of mechanical compression. The optimal mode is 0.053-0.105 N/mm2.

Introduction The use of laboratory tests to monitor the treatment of patients with chronic osteomyelitis has a lot of clinical relevance. The purpose of the study was to identify laboratory tests for assessing metabolic processes in patients with purulent lesions of the foot bones for monitoring the dynamics of the recovery processes in the course of treatment. Methods The studies were carried out in 36 patients with chronic osteomyelitis of the calcaneus and adjacent bones of the foot of traumatic etiology. All patients were treated with the method of the Ilizarov transosseous osteosynthesis. Biochemical and coagulation parameters were studied. Results It was found that in patients with purulent lesions of the foot bones, the elevated levels of blood serum lactate were most frequently detected before surgery (52.8 %, 95 % CI: 36.6-68.6). The incidence of elevated CRP was 27.7 % (95 % CI: 14.6-43.3) on average, and one third of patients had elevated fibrinogen levels (33.3 %, 95-CI: 19.1-49, 3). During the treatment period, the incidence of elevated lactate levels in patients did not change but the incidence of elevated CRP levels increased significantly which was observed in 77.8 % of patients on the 3rd post-surgery day. By discharge from the hospital, elevated values of CRP and lactate occurred in 11.1 % of patients. It is assumed that the greatest diagnostic significance is the assessment of the level of lactate in the dynamics of the treatment in target patients. Discussion Based on the results of the studies, a laboratory sign was found that indicates the effectiveness of surgical treatment in patients with chronic osteomyelitis of the foot bones using the method of transosseous osteosynthesis. Such a sign is a decrease in the initially elevated concentration of lactate in the blood serum of patients in the postoperative period. The detected sign meets the requirements for its applicability in laboratory tests: 1) this sign is the most common in the target group of patients; 2) the dynamics of changes in the level of lactate correlates with the ongoing treatment; 3) this test is an indicator of a significant physiological process: oxidative metabolic processes in patients with the studied pathology.

Relevance Application of 3D printing using the method of selective laser fusion for production of intervertebral cages is a topical trend of the spinal surgery. Purpose Assessment of the efficiency and safety of original interbody fusion implant application made of titanium alloy according to 3D printing technology with selective laser fusion. Materials and methods The original flattened bean-shaped cages, with an integral side part and an internal configuration in the shape of three-dimensional 1.5 × 1.8 mm porous lattice were tested . The products were made of Ti6Al4V powder using 3D printing technology with selective laser fusion. Post-processing of the products surface included abrasive blast cleaning using the SLA method and sterilization with ethylene oxide. Experiments on modeling interbody fusion with replacement of intervertebral discs with cages at levels L4 – L5 and L5 – L6 were performed in 8 mongrels. Additional primary stabilization of the lumbar spine was produced with an external fixator within 30 days after implantation. The total follow-up period lasted 180 days. Radiography, scanning electron microscopy, roentgenospectral and biochemical analysis methods were applied. Results X-ray examination demonstrated the contact between the frontal surfaces of the cages and the bone tissue of the vertebral bodies and the development of fusion in all experimental animals. Biochemical analysis did not reveal the signs of intoxication, indicating the danger of the products application. The microrelief of the implants was characterized by microroughness ranged from 1to 50 μm. In the surface layer of products, in addition to the elements of titanium, aluminum and vanadium, the carbon, oxygen, silicon, trace amounts of other organic and inorganic elements were found. Newly formed bone trabeculae were macroscopically and submicroscopically visualized in the sawcuts of bone blocks in the porous lattice of the internal part of the implants. Conclusions Experimental testing of porous implants made of titanium alloy using selective laser fusion has shown their effectiveness in obtaining interbody fusion and acceptable safety.

Relevance. The main goals of successful prosthesis remain ensuring the osseointegration and infectious safety of implants.The purpose of the study — the comparative analysis of osseointegration of titanium and steel additive manufactured implants in the rabbit tibia under additional fixation by Ilizarov apparatus.Materials and Methods. The study was performed on 20 chinchilla male rabbits. The animals of the first group (n = 8 ) were implanted a stainless steel product EOS PH1 (EOS, Germany), the animals of the second group (n = 12) — a titanium alloy Ti6Al4V product. The implant was additionally fixed by Ilizarov apparatus. The implants were processed with additive technology by selective laser fusion at the EOSINT M 280 installation (EOS, Germany). The survival and safety of the implants were assessed using clinical, histological, laboratory and statistical methods.Results. The implant fall due to chronic inflammation was found in 2 animals of group 1 and none in group 2. The formation of weakly mineralized bone tissue on the surface of the implant was noted in 3 weeks in all cases. The bone became more mineralized by the 12th week of the experiment. However, in group 2, the calcium content and Ca / P ratio of the newly formed bone tissue at the 3rd and 12th week after implantation were significantly higher than in the animals of group 1. This indicated the greater maturity of the bone tissue in animals of group 2 at all stages of the experiment. In group 1, the compact plate osteoporosis and calcium-phosphorus balance disturbance were greater.Conclusion. The results of the study indicate that the survival rate (osseointegration) and safety of the product made of the titanium alloy were higher compared with the stainless steel product.

Purpose of the analytical review — to evaluate the application experience of bone xenografts in trauma and orthopaedics surgery. Methods. Data search was performed in the electronic databases of PubMed and eLIBRARY with depth of 20 years. Results. The authors identified 13 papers which described the application experience of bone xenografts in trauma surgery and orthopaedics. The highest efficiency (from 92 to 100%) was reported for cases of xenografts use to replace defects in intraarticular fractures and revision arthroplasty. Unsatisfactory outcomes were related to cases with no integration and graft rejection. The least efficiency (from 41,9 to 46,1%) was reported in reconstructive foot surgery. No effect of bone xenografts was observed for replacement of defects in cases of pseudoarthrosis. The most frequent complication was graft material infection. The summarized literature data provided the calculated share of complications following xenograft use of 7,53% (18 out of 239 cases, CI 5-95%, 4,53-11,21). Two areas were identified for improvement of technical and biological properties of bone xenografts: 1. Modification of original xeno-matrix (enhancement of purification technique, alteration of structure of chemical composition of the bone matrix); 2. Augmentation of matrix volume by additional elements (biologically active agents, stem cells). It’s noted that demand for xenografts in traumatology and orthopaedics can increase after refining and expanding the indications for clinical use. Conclusion. Bone xenografts used in the modern trauma surgery and orthopaedics to replace bone defects in revision arthroplasty as well as in certain fracture types. Such material is relatively safe and its ability to be modified allows to improve its biological properties.

Background. Stimulation of osteogenesis in the treatment of certain orthopedic and trauma pathologies is a necessary element to ensure the best clinical outcome. The purpose of the present analytical review is to analyze the literature data in respect of evaluating the approaches and possibilities to stimulate osteogenesis using direct current. Methods. The search for literature data was performed in the open electronic databases of scientific literature PubMed and eLIBRARY under the following keywords and their combinations: “osteogenesis”, “reparative osteogenesis”, “direct electric current”, “orthopaedics”, “traumatology”, “electric current” (in Russian as well as in English language ). Results. According to some fundamental research, the stimulating effect of direct current lies is both in stimulating differentiation and proliferation of osteoblasts, and in stimulating differentiation of stem cells, mainly mesenchymal stem cells of bone marrow and adipose tissue, in the process of osteogenesis. The following stimulating technologies were developed and clinically tested to date: 1 — direct exposure of bone to the direct current; 2 — capacitive coupled stimulation; and 3 — inductive coupled (electromagnetic) stimulation. Analysis of clinical practice demonstrated that the first technology is most effective in terms of osteoreparation, but less safe than technology 2 and 3. It should be noted that there are no clear indications and modes of application for the abovementioned methods. Based on the data collected in the present analysis, technology 1 is considered by authors as the most promising. Safety of technology 1 can be enhanced by application of metal implants as electrodes in case those are planned to be used for medical reasons: wires, rods, staples, fixators, etc. Conclusion. Use of electric current to stimulate bone formation is a promising method which requires clarification in respect of indications and application modes.

This review analyzes and assesses the existing methods and approaches to prediction and control of the course of distraction osteogenesis (DO). The analysis of the literature revealed few works that recommended specific predictors or methods for prognosis of the course of distraction osteogenesis at the stages of limb lengthening. The authors identified some diagnostic criteria for assessing the distraction regenerate as potential criteria for predicting its development and maturation. It was found that all available predictors and potential diagnostic criteria for assessing the state of the distraction regenerate in clinical practice are used to further correct the distraction regime (respectively, at the stage of distraction) and to determine the timing of the removal of the apparatus, as well as prognosis of recurrence, fracture, and deformity of the regenerate in the non-apparatus period. It was shown that all known diagnostic methods can be applied for the assessment and prediction of the DO course: radiological, physiological, ultrasound diagnostics, laboratory tests. It is stated that a quantitative assessment of the informative value of most of the known predictors of DO disorders is necessary from the point of view of the evidence-based medicine. Difficulties and problems of the development and application of prognostic tests for assessing DO are described. The directions to the development of this topic are proposed. Predicting the DO course is an essential element for monitoring the tissue repair of the segment under lengthening. Prediction and subsequent prophylaxis of DO disorders is a promising solution for optimizing and improving the quality of treatment of patients with orthopedic diseases by using the Ilizarov method of transosseous distraction osteosynthesis.

Objective To assess antimicrobial characteristics of original bone xenomaterial implants with vancomycin impregnated with different technologies. Material and methods Bone xenomatrix was modified with two technologies of vancomycin adsorbed on the surface of the material and vancomycin adsorbed in the volume of the material through intermediate carrier. Antibiotic was impregnated using supercritical fluid extraction with carbon dioxide. Antibiotic release from modified xenomaterial was evaluated and antimicrobial activity against S. aureus assessed in vitro. Results Elution of vancomycin over 24 hours from the material produced with absorption technology was 98 % of baseline content in the matrix. Residual content of antibiotic was 1.75 % on average. The use of intermediate carrier (L/D polylactide isomer) allows for obtaining material with gradual prolong vancomycin release. Major release (68.16 % from baseline content) of vancomycin occurred smoothly over the first 14 days. Bone block eluted 22 % of the residual antibiotic load by 30 days of incubation. The products impregnated with antibiotic using two different technologies exhibited evident antimicrobial activity against S. aureus. Conclusion Technologies developed to impregnate vancomycin in xenogenic bone matrix are practical to obtain new modified bone grafting material with evident antimicrobial activity.

Objective The purpose of the study was to explore bone formation processes and survival of percutaneous implants under various external compression of the bone. Material and methods 30 chinchilla male rabbits were used in the study. Tibia of the species was amputated at the upper third and an implant was surgically implanted with the distal part extending through the skin. A compression device was attached to the implant and loading provided to the bone next day after surgery. Five magnitudes of compression loading were used for animals subdivided into 5 groups comprising 6 species in each of the groups. Compression device with constantly maintained loading was attached to the limb during 6 weeks. Results Animals of groups I and II showed no case of the implant falling out throughout the whole period of observation. An implant fell out of the bone in one species of Group III after 56-day implantation, two and four species of Groups IV and V, correspondingly, 3 to 4 days after removal of compression device. Osseointegration was shown to improve in species of Groups I and II due to active angiogenesis in peri-implantation area. Conclusion Therefore loads of greater than 105260 Н/m2 applied to the bone result in decreased implant osseointegration whereas less intensive loading tends to improve osseointegration

Purpose To study concentrations of metabolites and growth factors as well as hematological parameters in patients with delayed lower limb fracture healing Material and methods Concentrations of several metabolites and growth factors as well as hematological parameters were studied in 13 patients with a delay in healing of femoral and tibial fractures after 7 to 11 months following injury. Seven patients with consolidated diaphyseal femoral and tibial fractures examined 10 to 12 months after the injury were a control group. Ten healthy subjects that did not have any history of fractures were a reference group. Results Unlike individuals of control and reference groups, patients with delayed fracture healing showed significantly higher concentrations of lactate, triglycerides, TGF-α and TGF-β2 in their serum while IGF-1 levels were significantly lower. Hematology tests did not show differences between the groups. Conclusion Local hypoxia, acidosis and expression of GFs that support osteolysis were the main pathophysiological processes that could cause the delay in long-bone fracture healing.

In recent years, invasions of aggressive alien species, such as a giant hogweed, have attracted the attention of many botanists. However, the response of individual plants to the presence of invaders has not been studied for most representatives of the cultivated and natural floras. The article presents the results of studying functional traits of the spring ephemeroid Corydalis nobilis when Heracleum sosnowskyi is introduced into experimental plots. Sharing a common locality with H. sosnowskyi causes a decrease in organic reserves of C. nobilis phytomass and reduced contribution of its leaves to the total mass of the aboveground parts of plants. We have revealed changes in the pigment complex of C. nobilis leaves, manifested as an increased content of the total chlorophyll in the beginning of the growing season. In the studied habitats, C. nobilis exhibits a competitive-ruderal life strategy. In general, H. sosnowskyi has an extremely adverse effect on C. nobilis and vitality of the latter.

Purpose – to evaluate effect of protein extracted from lengthened skeletal muscles on callus formation in dogs after tibia lengthening using Ilizarov method.Materials and methods. The authors studied properties of distraction callus formation in three groups of dogs after tibia lengthening by Ilizarov method. In the first group (n = 10) distraction was achieved at a rate of 1 mm in four stages during 28 days. In the second (n = 4) and third (n = 4) groups distraction was done at a rate of 1.5 mm in 6 stages per day within 20 days. Mean lengthening value in all groups amounted to 14,64±0,67% of the overall segment length. At the 10th day of distraction the authors introduced to animals of the second group into anterior tibial and gastrocnemius muscles of the lengthened segment at callus level the extract of sarcoplasmic proteins in amount of 1.5ml based on 1 mg of lyophilizate per 1 kg of body weight (protein concentration in injectate amounted to 30±2 gr/l). Animals in the third group received natural saline solution in the same manner. Extract consisted of lyophilized sarcoplasmic proteins harvested from anterior tibial muscle of animal at 14th day of lengthening by Ilizarov method (rate of 1 mm per day in 4 stages). Extraction was performed according to patented method (Russian Federation patent for invention №2476234) by consecutive muscle proteins sedimentation in KCl solutions of varied ionic strength. The lyophilizate was sterilized after obtaining and dissolved in normal saline solution prior to introduction.Results. Radiographic signs of anatomically solid callus in the first group were observed in the average at 33±1 day of fixation; in the second group – at 24±2 day; in the third group – at 39±3. Difference in mean values of fixation in animals of second group as compared to first and third groups was significant (р = 0,04). After extract introduction the animals of the second group demonstrated a greater growth of γ-globulins and α2-globulins fraction volumes.Conclusion. Skeletal muscles of limb segment lengthened by Ilizarov method produce specific factors that impact the process of distraction osteogenesis.

Aim - to study the dynamics of the recovery of energy resources in the tibialis anterior (TA) in dogs after shin fractures. Material and methods. The concentration of energy metabolism substrates, the rate of glycolysis and glycogenolysis in TA in 25 dogs during the treatment of tibial fractures by Ilizarov were studied. The values parameters in the experimental animals were compared with values in the intact (non-operated) dogs. Results. The level of glycogen and glucose decreased in TA within 14 days of fixation. On the 28th day of fixing the level of these metabolites corresponded to the level in intact animals. By the end of fixation the rate of glycogen utilization in TA of experimental animals was significantly reduced relative to intact animals, and the rate of glucose utilization was unchanged, though all glucose was almost entirely utilized by aerobic way. A month after treatment there was an increase of glycogen levels in the TA and activity of lactatedehydrogenase MM-isoenzyme. When glycogen solution added to the cell-free culture of muscle the its considerable utilization and the pyruvate accumulation were found. Conclusions. Anaerobic energy metabolism of in the TA of injured segment have prevailed before the 14-th day after the injury, the aerobic energy metabolism - after 28-days. The phenomenon of growth of anaerobic energy metabolism in TA of injured segment within three months after treatment was revealed.

Aim of the study the characteristics of changes of serum biochemical parameters in dogs with delayed maturation of the distraction regenerate after surgical lengthening the leg bones by Ilizarov. The comparative analysis of biochemical changes in blood serum of animals with delayed regenerated bone osteogenesis after surgical leg bone lengthening according to Ilizarov has been made in the work. The development of persistent and marked hypocalcemia, significant accumulation of blood serum nonoxidized degradation products during limb bone surgical lengthening according to Ilizarov have been revealed to be adverse signs evidencing of the high probability of the disorder of further formation of the regenerated bone and its subsequent maturation at the stage of fixation.