В статье рассмотрена проблема лечения пациентов с подагрической артропатией стоп. Произведен обзор возможных способов хирургической коррекции последствий обсуждаемой патологии. Рассмотрена структура реконструктивных и паллиативных вмешательств особенности клинической диагностики и терапевтической составляющей в пред-и послеоперационном периоде. Произведена сравнительная оценка результатов хирургического лечения подагрической артропатии. Ключевые слова: плоскостопие, вальгусное отклонение первого пальца стопы, рентгенограмма, артропатия.

В статье рассмотрена проблема предоперационного планирования в хирургическом лечении больных с поперечным плоскостопием. Произведен обзор возможных деформаций при поперечном плоскостопии. Рассмотрены особенности клинической диагностики и специфических тестов. отдельно в статье приведен анализ рентгенограмм в дорсо-плантарной проекции. Произведена сравнительная оценка возможных отклонений измеряемых показателей от референтных значений. Ключевые слова: плоскостопие, вальгусное отклонение первого пальца стопы, рентгенограмма.

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The article considers the problem of broad forefoot, which is one of the most frequent deformities of the musculoskeletal system. Aim - to improve the results of treatment of patients with transverse platypodia by the use of new methods of surgical interventions, and to improve the tactics of postoperative management of such patients. Material and methods. The study involved analysis of the results of treatment of 375 patients. For evaluating the long-term outcomes of treatment, methods of evidence-based medicine were used, reflecting a reduction in the relative risk of interventions and an increase in their relative benefit. Results. The study of the long-term results of treatment showed that there were good and satisfactory outcomes in 92.7% cases (267 patients) and only 7.3% of unsatisfactory results (21 patients) in the main group; in comparison group - 74.7% (65 patients) and 25.3% (22 patients) respectively. The evaluation of the adequacy of anesthesia on the first day after the operation revealed good and satisfactory quality of anesthesia in the first group in 89.9% patients (259), in the second - only in 55.2% patients (48). Conclusion. The use of the above mentioned methods of surgical treatment and enhancement of tactics of postoperative management improve outcomes of patients with transverse flatfoot, and, consequently, are recommended for widespread use in clinical practice.

EVALUATION OF THE RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH FOREFOOT PATHOLOGY Kotelnikov G.P., Lartcev Y.V., Rasputin D.A., Bogdanov A.A. Samara State Medical University, Samara, e-mail: d_rasputin@mail.ruThe article deals with the estimation of remote results of surgical treatment of patients with pathology of the anterior foot. Proposed improve scale evaluation of treatment, which is in contrast to the generally accepted and most frequently used in clinical practice, the AOFAS scales and Groulier takes into account the subjective evaluation by patient and physician. A comparative research study involving 128 patients. All patients were interviewed on three scales of evaluation of treatment results. When evaluating the percentage of positive ratings exhibited by the doctor and patient is almost identical (91,4% 89,8%, respectively). However, further analysis shows that the percentage of good ratings, patients exhibited much higher (76,5 %) than physicians (64.8 %). All of this suggests that today doctors are more demanding and picky about the results of surgical treatment than patients. The introduction into clinical practice of the improved scale evaluation of treatment, it is advisable to further improve the choice of method of surgical treatment for different types and degrees of deformation of the anterior foot.