Skvortsov A.
Doctor of Medical Sciences
Chief Researcher
State Autonomous Healthcare Institution “Republican Clinical
Hospital of the Ministry of Health of the Republic of Tatarstan”
Khabibyanov R.
Doctor of Medical Sciences
Chief Researcher
State Autonomous Healthcare Institution “Republican Clinical
Hospital of the Ministry of Health of the Republic of Tatarstan”
Gilmutdinov M.
Candidate of Medical Sciences
Associate Professor, Department of Pediatric Surgery
Federal State Budgetary Educational Institution of
Higher Education “Kazan State Medical University”
of the Ministry of Health of Russia
Maleev M.
Candidate of Physical and Mathematical Sciences
Leading Researcher
State Autonomous Institution of Health “Republican Clinical
Hospital of the Ministry of Health of the Republic of Tatarstan”

Abstract
Law G.A. Ilizarov states that “the structure, shape and volume of the musculoskeletal system is determined by the load.” Accordingly, the load on the operated limb during the formation of a distraction regenerate during lengthening or healing of a bone fracture should be carried out after the end of the pain syndrome on days 4-5 after osteosynthesis. When a dosed load is applied to the limb, microcirculation of the limb is restored, the process of consolidation of fragments is optimized, in other words, dosed axial load is an important part of rehabilitation.
In addition, after application of the Ilizarov apparatus for various injuries and diseases of the lower limb (in particular, with shortening of the limb segment), a frequent complication is the development of equinus deformity of the foot. This occurs especially often when segments of the lower limb lengthen and shorten. Prevention of this type of postoperative complication is to position the patient’s foot in relation to the axis of the leg at an angle of 900 and hold it in this position for the entire period of lengthening the limb segment. The authors have developed and used in the clinic an orthopedic foot support, the purpose of which is to prevent delayed consolidation of fragments by restoring the physiological load on the operated limb and preventing the development of an equinus position of the foot.

Keywords: equinus foot deformity, prevention

Skvortsov A.
Doctor of Medical Sciences
Chief Researcher
State Autonomous Healthcare Institution “Republican Clinical
Hospital of the Ministry of Health of the Republic of Tatarstan”
Khabibyanov R.
Doctor of Medical Sciences
Chief Researcher
State Autonomous Healthcare Institution “Republican Clinical
Hospital of the Ministry of Health of the Republic of Tatarstan”
Gilmutdinov M.
Candidate of Medical Sciences
Associate Professor, Department of Pediatric Surgery
Federal State Budgetary Educational Institution of
Higher Education “Kazan State Medical University”
of the Ministry of Health of Russia
Maleev M.
Candidate of Physical and Mathematical Sciences
Leading Researcher
State Autonomous Institution of Health “Republican Clinical
Hospital of the Ministry of Health of the Republic of Tatarstan”

Abstract
Functional insufficiency of the abductor muscles of the thigh in pathology of the hip joint is manifested by the Duchenne-Trendelenburg symptom (inability to keep the pelvis from lateral tipping during a single-support period of standing). Insufficiency of the abductor muscles of the hip, which is the cause of impaired support ability and gait, occurs in various diseases of the hip joint, therefore its preoperative and postoperative determination is of great importance both in the correct choice of treatment for patients and in terms of prognosis of the adequacy of the applied treatment method. The authors proposed a method for x-ray myographic examination of muscles in patients with various diseases of the hip joint. Conducting an X-ray contrast study of the abductor muscles of the thigh allows us to obtain additional valuable information about the condition of these muscles, about changes in their shape, structure, points of attachment, degree of atrophy, which is necessary to know when planning surgical interventions in the area of ​​​​work of the muscles, and also allows for a timely course of drug treatment, electrical stimulation, physical therapy with dosed training of weakened and atrophic muscles.

Keywords: pathology of the hip joint, X-ray contrast study of the hip abductors

Skvortsov A.
Doctor of Medical Sciences
Chief Researcher
State Autonomous Healthcare Institution “Republican Clinical
Hospital of the Ministry of Health of the Republic of Tatarstan”
Khabibyanov R.
Doctor of Medical Sciences
Chief Researcher
State Autonomous Healthcare Institution “Republican Clinical
Hospital of the Ministry of Health of the Republic of Tatarstan”
Gilmutdinov M.
Candidate of Medical Sciences
Associate Professor, Department of Pediatric Surgery
Federal State Budgetary Educational Institution of
Higher Education “Kazan State Medical University”
of the Ministry of Health of Russia
Maleev M.
Candidate of Physical and Mathematical Sciences
Leading Researcher
State Autonomous Institution of Health “Republican Clinical
Hospital of the Ministry of Health of the Republic of Tatarstan”

Abstract
During reconstructive and restorative operations on the hip joint for its various diseases (congenital and pathological hip dislocations, aseptic necrosis, Perthes disease, etc.), it is necessary to unload the hip joint and ensure postoperative decompression of the femoral head. For this purpose, the Ilizarov apparatus is used, consisting of a pelvic arch and a pin osteofixation system.
The main disadvantages of the proposed method of fixing the arc support in the ilium are the unstable rigidity of the support fixation, clinically manifested in its two-plane mobility, and the impossibility of giving the limb an abduction position in the hip joint, which is necessary after performing reconstructive interventions on the hip joint using the Ilizarov apparatus.
In order to eliminate this drawback, a method of applying a pelvic arc support of the Ilizarov apparatus is proposed in the treatment of diseases of the hip joint. For the purpose of osteofixation, we chose a hybrid system, which in clinical practice has shown its advantages over existing wire structures.

Keywords: hip joint, surgical treatment, external fixation device