Introduction Patella fractures account for one percent of all fractures. Arthritis, non-union and other complications which affect the function of the lower limb may develop in the long term. The aim was to develop the most optimal osteosynthesis techniques for patella fractures. Methods We analyzed long-term treatment results of 78 patients with patella fractures treated from 2017 to 2018 using the KOOS (The Knee Injury and Osteoarthritis Outcome Score) scale, clinical examinations and knee joint X-rays. Based on the methods of surgical treatment for patella fractures, we divided the patients into 5 groups: Weber tension band wiring for two-fragment fractures; cross-like osteosynthesis and other methods of patella osteosynthesis using K-wires and wire loops for multifragmental fractures of the patella; combined osteosynthesis (tension band wiring with an additional screw or cerclage around patella); partial patellectomy and the inferior pole osteosynthesis. Results A comparative analysis of patients' groups after surgical treatment of patella fractures using the KOOS scale showed the best results after Weber tension band wiring for transversal fractures (72 %). The results of patients with multifragmental fractures of the patella using K-wires and wire loops were positive in 64 %; after the restoration of the inferior pole in 68 %, after partial patellectomy in 57 %. Conclusion For transversal fractures of the patella, tension band wiring is the method of choice. With multifragmental patella fractures, good results are achieved by cross-like osteosynthesis and other methods using K-wires and wire bands. The use of patellectomy followed by wire loop locking should be avoided for all types of patella fractures. In fractures of the inferior pole of the patella, it is preferable to fix it to the main patella fragment.

Currently, one of the most important components of scientific activity is the writing and subsequent defense of a candidate's / doctoral dissertation. It is revealed that, despite the rapid digitalization of the educational process in the scientific paradigm of the whole world, including Russia, there is no single digital assessment of the dissertation. The current system of evaluation of a dissertation based on the one-dimensional designation "yes" or "no" does not allow to objectively and impartially determine the scientific value of the dissertation. The author proposed a methodology for evaluating dissertations on a one-hundred-point scale, where the researcher with the highest score on the defense of the dissertation (91-100) would be provided with financial support from the state to continue promising scientific research, while at the same time being an advantage in the competition for his election to the Russian Academy of Sciences. The author is critical of the conditions of the state and prospects of the development of science in Russia, considering it unfair to neglect the system of evaluation in the defense of dissertations, which leads to a constant outflow of young researchers abroad. In the perspective of applying the digital assessment of the dissertation, the support of talented scientists in obtaining high scores in the defense of the dissertation at the local, regional and federal levels is considered.

The problem of treatment of patients with multiple and combined injuries remains one of the most relevant in modern medicine. According to modern statistical data, amount of traumas is growing worldwide, and among the able-bodied population polytrauma is one of the main causes for disablement and death. About 5 million people worldwide are injured every year, of which 15–21% have multiple and associated injuries. To improve the quality of medical care for patients with polytrauma and decrease the level of disablement and deaths, it is necessary to study the problem of rendering medical aid to patients with multiple and combined injuries. The purpose — to assess various scales of the condition severity of patients with polytrauma. Material and methods. A retrospective analysis of 120 patients was carried out, who from 2017 to 2020 were treated at City Clinical Hospital named after A.K. Eramishantsev, of them 66 (55%) women and 54 (45%) men. The age group was 25–75 years old. Results. One of the most adequate methods of assessing the condition severity of patients with polytrauma is a score-based approach, which allows determining the correct treatment tactics. Correct treatment tactics can reduce the time of disability, mortality and disability of patients. In modern traumatology and orthopedics, ISS scale is considered the «gold standard» for assessing the condition severity, but many doctors and authors mark that this scale is insufficiently informative. Our comparative analysis revealed that the NISS scale has greater accuracy in predicting mortality than ISS, especially in critical patients and patients with blunt trauma. Conclusion. A clear definition of the polytrauma concept with a single score assessment system for assessing the condition severity will allow to standardize treatment tactics, conduct an adequate comparative analysis of treatment results, objectively resolve issues of organization and financial provision of medical care to seriously injured patients, improve the quality of medical care, reduce mortality and disability of the able-bodied population, and provide full recovery and return to normal standard of living. The creation of a unified assessment system is difficult, which is associated with the polyphocality of injuries. We believe that further in-depth studies of patients with multiple and combined trauma are needed to develop modern guidelines and clinical recommendations, as well as a unified single-score assessment system.

The problem of damage of clavicle and its ligamentous apparatus remains relevant because of the high frequency of these lesions, especially in young and active patients. Despite advances in science technology is a high frequency of unsatisfactory results. Authors, on the large clinical material, have analyzed the results of treatment of dislocations and fractures of the clavicle.Together with the national scientific production company «DEOST» the authors have developed and introduced into clinical practice new anatomically curved clavicular plate with monolithic middle part and cortical screws with low profile heads for osteosynthesis of the clavicle. Based on the analysis of 132 patients` treatment results, the authors concluded that osteosynthesis with curved plate, intramedullary pin Roskwood and hook plate for LCP clavicle gives the best results in complex fractures and fracture-dislocation of the clavicle.

The results of prevention and treatment of purulent and septic complications are presented. There were 21 patients with closed and open fractures and 21 patients with post-traumatic purulent complications and trauma sequelae. Thirteen patients had multiple and concomitant injuries. Treatment included the combination of surgical and conservative methods of fracture stabilization, antibiotic therapy as well as detoxication by efferent methods and immunocorrection.