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Objective:  to develop technology for high amputations of the lower extremities.Materials and methods. We analyzed the materials of the Nizhny Novgorod branch of the Federal State Unitary Enterprise “Moscow Orthopedic and Orthopedic Enterprise” Ministry of Labor of Russia for the period 2004–2018, the operation logs of the purulent surgery department of PIMU (1971–2018), and the electronic medical history “Program 1C” (2006–2012) and “Medialogue” (2013–2018) in all departments of PIMU, where high amputations of the lower extremities are possible performed.Results. Between 2006 and 2018, 391 lower limbs were cut off in 289 patients (above the knee – 128, below the knee – 263). With diabetic foot syndrome, 135 (34.5 %) amputations were performed, due to burns and frostbite, 73 (18.7 %) operations were made, while arterial atherosclerosis – 57 (14.6 %) operations, and the rest – about the consequences of injuries, tumors, malformations and vicious stumps. The number of amputations on the shin is 2 times more than on the hip. A technology has been developed for the formation of a new support and movement organ, including amputation of the lower leg, anesthesia, intensive care, and rehabilitation treatment. Conclusion. An analysis of the initial applications for prosthetics showed that the most frequent high amputations of the lower extremities are performed due to gangrene in arterial atherosclerosis (53.9 %) and diabetes mellitus (24.9 %). High amputations of the lower extremities at the hip level are performed in 60.4 % of patients and only in 30.1 % of patients – at the shin level. Malformations and diseases of the stumps of the thigh and lower leg are detected in 15.4 % of patients. The gold standard should be recognized as myoplastic amputation at the border of the upper and middle third of the shin with excision of the soleus muscle. Preservation of the knee joint creates the conditions for optimal prosthetics and timely social adaptation of patients.

Цель исследования: установить взаимосвязь нарушений системы гемостаза с выраженностью острофазного ответа при гнойном воспалении у больных с нейроишемической формой синдрома «диабетическая стопа» (СДС). Материалы и методы. Проведено изучение системы гемостаза, биохимических метаболитов крови, характеризующих состояние углеводного, белкового и липидного обменов, а также биохимического маркера воспаления — С-реактивного белка у 20 пациентов с нейроишемической формой СДС. Результаты. Установлена взаимосвязь нарушений системы гемостаза с выраженностью острофазного ответа, показателями липидного и белкового обменов у больных с СДС. Показано, что при нейроишемической форме СДС развиваются выраженные гемостазиологические и метаболические нарушения, которые имеют между собой высокую и среднюю степень сопряженности. Заключение. Гемостазиологические тесты могут использоваться в совокупности с показателями углеводного, белкового и липидного обменов для оценки тяжести патологического синдрома, назначения патогенетической терапии, оценки эффективности проводимого лечения. Aim: to determinate the interrelation between hemostatic disorders and the severity of acute phase response of purulent inflammation in patients with neuroischemic form of «diabetic foot» syndrome (DFS). Materials and methods. In 20 patients with neuroischemic form of DFS we studied hemostatic and biochemical blood parameters that characterize carbohydrate, protein and lipid metabolism, and biochemical marker of inflammation — C-reactive protein. Results. In patients with SDS we revealed the interrelations between hemostatic disorders and severity of acute phase response, lipid and protein metabolism. It was demonstrated that expressed hemostatic and metabolic disturbances with high and medium degree of conjugation progressed in patients with neuroischemic form of SDS. Conclusion. In conjunction with parameters of carbohydrate, protein and lipid metabolism hemostasiological tests can be used for assessment the severity of pathological syndrome, the appointment of pathogenetic therapy, the evaluation of treatment effectiveness. Aim: to determinate the interrelation between hemostatic disorders and the severity of acute phase response of purulent inflammation in patients with neuroischemic form of «diabetic foot» syndrome (DFS). Materials and methods. In 20 patients with neuroischemic form of DFS we studied hemostatic and biochemical blood parameters that characterize carbohydrate, protein and lipid metabolism, and biochemical marker of inflammation — C-reactive protein. Results. In patients with SDS we revealed the interrelations between hemostatic disorders and severity of acute phase response, lipid and protein metabolism. It was demonstrated that expressed hemostatic and metabolic disturbances with high and medium degree of conjugation progressed in patients with neuroischemic form of SDS. Conclusion. In conjunction with parameters of carbohydrate, protein and lipid metabolism hemostasiological tests can be used for assessment the severity of pathological syndrome, the appointment of pathogenetic therapy, the evaluation of treatment effectiveness.