the effectiveness of new methods of the Achilles tendon reinforcement. Material and methods The experimental part of the work was performed in 3 stages using 60 biomannikins with intact Achilles tendon. A Krakow suture was used at stage 1 for a group of 20 tendons and a force that would result in rupture of the tendon was measured. Reinforcement was performed using the plantaris tendon (technical innovation offered at the Samara State Medical University) at the 2nd stage and the force required for the appearance of signs of rupture was subsequently measured. A portion of the peroneus longus tendon (RF patent No. 2616767) was used for reinforcement at the 3rd stage and the force measurement produced. Results The mean force required to rupture the Krakow suture applied to the tendon at the first stage was 11.5 kg., The force required to rupture the suture reinforced with the plantaris tendon at the second stage measured 33.4 kg. The force required to rupture the suture reinforced with a portion of the peroneus longus tendon at the third stage was 37.3 kg. Conclusion The new techniques offered to reinforce the Achilles tendon with the plantaris tendon and a portion of the peroneus longus tendon at the distal base facilitated increase in the strength of the injury site by 195.6 % and 214.4 %, respectively.

Abstract. Introduction Treatment of patients with acute fractures of the patella is the task of the trauma and orthopedic service and should provide restoration of the integrity of the bone tissue and the extensor apparatus of the knee joint for its early mobilization. There is an opinion that conservative treatment cannot meet requirements of patients’ quality of life, and therefore, most traumatologists are inclined to surgically treat patellar fractures. Purpose Based on the available literature data, to determine the most rational way to treat patients with patellar fractures Materials and methods Available studies published in the last 10 years were analyzed. The databases NCBI Pubmed, Healio Orthopedics, Medline were searched. Results Such osteosynthesis methods as patella suture, osteosynthesis with plates, special internal devices, external fixation devices, Kirschner wires and wire cerclage, various screws were covered. The question of clinical application of patellectomy was touched upon; the contribution of the Department of Traumatology, Orthopedics and Urgent Surgery of the Krasnov Samara State Medical University to the development of operative techniques of osteosynthesis of the patella, the basic concepts of scientific research, and also the most optimal ways of treating patients with patellar fractures were described. Conclusion The conservative method of treating patients with patellar fractures is most relevant if there are contraindications to surgery. It inevitably leads to persistent arthrogenic contracture. The best functional results of treatment have been achieved with surgical treatment due to the possibility of early mobilization of the knee joint. According to the data of available studies, plates and screws as well as osteosynthesis with Kirschner wires and wiring cerclage show maximum stability. There is evidence of a direct correlation between the risk of developing infectious complications and pain in the postoperative period and the number of elements of subcutaneous metal implants. Thus, the most optimal way to treat closed fractures of the patella is osteosynthesis with the use of wires and wire cerclage according to the tension band principle.