Background. Acromioclavicular dislocation is a fairly common traumatic injury of the musculoskeletal system, and according to different authors varies from 2 to 26.1 % dislocations of other localizations, and is about 10 % of all acute injuries of the shoulder girdle, taking 3rd place after dislocations of shoulder and forearm. The social significance of this damage is determined by the occurrence mainly among young working-age men. The work was aimed to identify factors that cause unsatisfactory anatomical and functional results after surgical treatment of acromioclavicular dislocations. Materials and methods. This retrospective study (2015–2020) included 93 patients who had surgical intervention for acromioclavicular dislocation. Surgical stabilization of the acromial end of the clavicle was done by Hook Plate and by Weber technic. Results. The outcome of research shows that 49.5 % of cases had good results, 31.2 % — satisfactory, and 19.3 % — poor. There is a direct correlation between unsatisfying outcome and increased severity of the injury. The study found that 9.7 % of unsatisfying results were associated while using Weber’s technic in the Tossy II, while in Tossy III, it was 27.0 %. A similar correlation was found while using Hook Platе, in the case of Tossy II, unsatisfying results were in 15.8 % of cases and Tossy III — 29.4 %. Conclusions. The reason for the unsatisfying results of the surgical acromioclavicular dislocations treatment is the severity of damage and the absence of an algorithm for diagnosis and management of this injury. In Tossy III dislocations, the use of stabilization methods as Weber’s technic, Hook Plate, or suturing damaged acromioclavicular ligaments did not demonstrate satisfying effectiveness.

The aim: Improving treatment outcomes in patients with segment tibial bone tissue loss after fractures by improving the ring fixators technology. Materials and methods: The study includes the data of 77 patients. The patients were distributed between two groups: the main and control one, using random numbers table. The inclusion criteria were: patients’ consent, their age over 18 years, tissue inflammation episodes, fibular defects 4-5cm in size and disseminated scar lesions. RF was applied with the proposed improvements. Finally, a semi-rigid external fusion system Softcast / Scotchcast was used to prevent deformation of the regenerate and create optimal conditions for fusion of fragments. Results: The following results were obtained for the Modified Functional Evaluation System by Karlstrom-Olerud: positive treatment outcomes in the main group made up 97.1%, and 92.9% in the control one. Though, the specific gravity of good and excellent outcomes in the main group was 82.8%, while in the comparison group – just 45.2% Conclusions: Along with considerable positive advantages of the “Ilizarov’s” apparatus, some disadvantages have been noted. Elimination of the drawbacks is stipulated for the practical needs, which requires further scientific study.

The aim — to determine sonographic criteria for the pathological changes formation in stenosing ligamentitis depending on the stage of the process.Materials and methods. An ultrasonography of the tendon‑ligament complex of the metacarpophalangeal joint was performed in 57 patients at different stages of the pathological process. Scanning was performed in the sagittal and frontal planes at rest and during movement in the interphalangeal joints. The annular ligament A1, the flexor tendon and the surrounding soft tissues (tendon sheath, volar plateau) was evaluated. The thickness of the annular ligament was measured over the upper part of the tendon (volar surface). The conditional norm was similar indicators of the contralateral limb in the absence of clinical manifestations of any pathology in this segment. The distribution of patients according to the degree of the pathological process was as follows: stage 1 — 4 (7.1 %), stage 2 — 24 (42.1 %), stage 3 — 29 (50.8 %).Results and discussion. At the first stage of the disease, the use of ultrasound can exclude the presence of other pathological conditions with similar clinical manifestations. The ratio of the thickness of the ligament A1 and flexor tendons is from 0.09 to 0.12. Ultrasonic signs of the second stage of stenosing ligamentitis are a thickening of the annular ligament and flexor tendon and thinning of the tendon in the critical zone with preserved tendon mobility during the performance of the functional test. The ratio of the thickness of the annular ligament A1 and the flexor tendon is from 0.21 to 0.35. The third stage of stenosing ligamentitis is characterized by a thickening of the annular ligament and flexor tendon , as well as a thinning of the tendon in the critical zone in the absence of tendon mobility during the performance of the functional test. The ratio of the thickness of the annular ligament A1 and the flexor tendon is from 0.39 to 0.67.Conclusions. Ultrasound study in patients with stenosing ligamentitis of the fingers along with a clinical study are the main methods of diagnosis and verification of the process stage. The study allows to assess changes in annular ligament A1 and flexor tendons both in the area of the ligament itself (thinning of the tendons, hourglass‑shaped deformation) and in adjacent areas (thickening of the tendons), objectively determine the parameters of the tendon‑ligament complex. The main criterion for establishing the stage of the process is the index of the ratio of the annular ligament A1 thickness and the tendons in the critical zone, which can be calculated by the proposed formula.

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changes of annular ligament at stenosing ligamentitis of the fingers of the hand. National Medical University named after O.O. Bohomoltsia, Donetsk National Medical University named after M. Gorky, State Enterprise "Institute of Traumatology and Orthopedics" of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine. ABSTRACT. Background. According to the data of the world literature among the diseases of the tendon-ligament apparatus of the hand, the processes of stenosis of the fibrous channels amount to 43.8%, and the stenosing ligamentitis of the fingers of the hand-up to 22.3% of cases. The pathogenesis of the disease is not fully established. Objective. To complete knowledge of the pathogenesis of stenosingligamentitis of the fingers of the hand through histological and morphometric studies. The study material was biopsy specimens of the altered ring-shaped ligament in 57 adult patients received during surgery. For a comparative assessment of morphological changes, 11 ring-shaped ligaments in corpses without a common pathology and local manifestations of the hand were examined. Results. In untreated patients (group I), with an increase in the duration of the disease, signs of lymphocyte-cell infiltration, edema of the ring-shaped ligament and distroficdegenerative changes accompanied by a decrease in the fibrillar component and the appearance of chondrogenic foci increased. In patients of the second group, the pathological process was characterized by the lymphocyte-fibroblastic phase of independence from the duration of the disease. At the same time, changes in the cellular composition of fibrous connective tissue prevailed. Conclusion. In patients of group I, an increase in the specific area of the main amorphous substance was determined 7.92 times and 2.57 times the macrophage-lymphocytic infiltrates of endothendinia and perithendinium, and in endothendia they were accompanied by collagenolysis and foci of ectopic chondrogenesis. In patients of group II, the proportion of the area of endothendia increased by 42.46% due to early violations of the architecture of the ligament fibers and lymphocytic infiltration; in the epithendia, the hypercellular regions were determined with dense hyperchromicfibrocytes. After 12 months The specific area of the endothendia increased by 4.76 times.