RELEVANCE The overall incidence of Achilles tendon rupture has been increasing in recent decades due to population aging, the growing prevalence of obesity and increased participation in sports. Achilles tendon ruptures are common injuries of the musculoskeletal system, and according to various authors, they account for 47% of all ruptures of human tendons and muscles, about 18 cases per 100 thousand people per year. Despite the abundance of various options of tendon suture in surgery, a wide choice of suture material and the use of precision techniques in tendon reconstruction, the proposed methods of macroscopic reconstruction of the tendon apparatus do not solve the problem of tendon suture failure.CONCLUSION Despite the abundance of proposed accesses to the Achilles tendon, the optimal one for all types of injuries has not yet been developed. Currently, there are no clear recommendations for choosing a specific method of treating an Achilles tendon rupture.

The treatment of traumatic soft tissue detachments is an urgent problem for a first-level trauma hospital. This paper provides an analysis of the literature sources of the PubMed database, which are devoted to the classification, diagnosis and treatment of traumatic skin detachments. It was revealed that most of the works are publications of 1–2 clinical cases, only a few works are retrospective studies of patient groups. Currently, there is no generally accepted classification of traumatic detachment of soft tissues, due to the complexity and mosaic nature of pathoanatomical signs. According to the tactics of treatment, there is a difference in approaches for low-energy trauma (sports injury) and high-energy impact (traffic accidents, falls from a height). In the first case, the treatment methods are compression therapy, physiotherapy, and in rare cases, puncture. In the second case, puncture and drainage are the main method of treatment, and in persistent recurrent cases, chemical ablation or open surgery to excise the capsule in combination with vacuum drainage are the methods of treatment. Methods of endoscopic treatment of the walls of the detachment, ligation of the lymphatic vessels around the detachment, and the use of blockable sutures for obliteration of the detachment cavity are currently new methods of treatment, which effectiveness requires further study.

The purpose of this work was to study the history of the development of traumatology-orthopedics at the N.V. Sklifosovsky Research Institute for Emergency Medicine.Traumatology as an independent discipline began to form at the N.V. Sklifosovsky Research Institute for Emergency Medicine during the reign of Professor S.S. Yudin (chief surgeon since 1928), who invited the famous Argentinean traumatologist-orthopedist Professor Lelio Zeno to work at the institute.In 1932, the trauma department of the N.V. Sklifosovsky Research Institute for Emergency Medicine was headed by Professor V.V. Gorinevskaya. She organized a 100-bed trauma clinic for the treatment of injuries to the head, spine, limbs, chest and abdominal cavity. She is rightfully considered one of the founders of trauma science in the USSR.With the development of traumatology and orthopedics as an independent specialty in 1961, two clinics were formed at the institute. The first trauma clinic was run by Dr. med. sciences professor I.I. Sokolov. The second clinic was headed by Dr. med. Sci. P.N. Petrov.In 1971, Dr. med. Professor, Honored Scientist of the Russian Federation, Academician of the Russian Academy of Medical and Technical Sciences of the Russian Federation V.P. Okhotsky was appointed the head of the traumatological service of the institute and the chief traumatologist of Moscow (from 1971 to 2001). With his active participation in Moscow, the reorganization of outpatient care was completed, work was widely launched on the medical aspects of the prevention of road traffic injuries and the introduction into practice of the most rational methods of diagnosis and treatment of patients with injuries of the musculoskeletal system. In the N.V. Sklifosovsky Research Institute for Emergency Medicine A.G. Suvalyan introduced the method of intramedullary osteosynthesis of long tubular bones (humerus, femur and tibia). Under the guidance of prof. V.P. Okhotsky the dissertation researches of A.G. Suvalyan, M.A. Suvalyan and S.S. Myakota were carried out. The expediency of early surgical intervention on the extremities in case of combined traumatic brain injury and multiple trauma of the extremities has also been proven, new functional methods of treatment of diaphyseal fractures of the shoulder, lower leg, spine and intra-articular injuries have been developed.In close scientific cooperation with scientists from other clinics of the institute, a comprehensive method of treating open injuries of the limbs has been developed (dissertation researches of I.F. Byalik, I.Yu. Klyukvin, O.P. Filippov, M.V. Zvezdina, R.S. Titov). Much scientific work has been carried out to improve the diagnosis and treatment of intra-articular injuries of the knee joint (dissertation researches by M.A. Malygina, O.P. Filippov, A.Yu. Vasa).From 2001 to 2016 the head of the department of emergency traumatology of the musculoskeletal system was a student of prof. V.P. Okhotsky – Dr. med. sciences, Professor, Academician of the Academy of Medical and Technical Sciences of the Russian Federation I.Yu. Klyukvin. Since 2016 the department is headed by Dr. med. sciences Alexey M. Fine.The scientific developments of the employees of the Department of Emergency Traumatology have a practical orientation. Every year, the department’s employees successfully perform more than 2500 surgical interventions using advanced low-traumatic techniques, making extensive use of the achievements of biotechnology.

Introduction. Injuries to the brachial plexus are one of the most severe types of injuries to the nerves of the upper limb, and variants with the separation of the roots from the spinal cord represent a very difficult category of injuries to treat. Among patients who have received such injuries, there is a very high incidence of disability, since it is possible to achieve only partial restoration of the function of the upper limb. Recently, the method of transposition of functioning muscles has been growing in popularity due to its reliability and relatively short recovery time of function.The purpose of the work is to analyze the literature data on the possibility of using the method of transposition of functioning muscles in the complex treatment of victims with brachial plexus injuries.The authors have searched PubMed and RSCI databases over the past 25 years for keywords: peripheral nerve damage, tendon transposition, transposition of functioning muscles, nerve injury, brachial plexus injury, spinal cord root avulsion. In the selected 23 most relevant papers, the muscles used for transposition, indications and timing of operations, results and complications were analyzed, compared with other methods of surgical treatment of brachial plexus injuries. The analysis of studies has shown that the transposition of functioning muscles allows in most cases to restore the target movement to the useful level of M3–M4 on the MRC scale, is a more reliable method and allows achieving better results, especially in patients with severe complete injuries of the brachial plexus. An important disadvantage of free hip thin muscle transplantation operations is the risk of microanastomosis thrombosis, which requires detailed preoperative planning and good microsurgical technique of the operating team.Conclusion. Free transplantation of 2 functioning muscles is currently the method of choice for restoring upper limb movements in patients with complete brachial plexus injuries.