Background. To date, the problem of choosing the optimal graft for anterior cruciate ligament (ACL) reconstruction and the methods for its formation is one of the main trends in the surgical treatment of patients with anterior knee joint instability.The aim. To compare the results of the anterior cruciate ligament reconstruction using the known method and the new proposed method for autograft formation.Materials and methods. The results of treatment of ACL injury in 44 patients were assessed. In the main group (19 patients), an original technique of ACL reconstruction from 1/2 of the width of m. peroneus longus tendon was used. In the control group (25 patients), ACL reconstruction was performed using a graft from the m. semitendinosus tendon prepared by the Lubowitz method.Results. The mean difference in the circumference of the distal third of the hip in the main group was 1.57 ± 1.162 cm and was statistically significantly better than in the control group, where the mean difference in the hip circumference was 4.74 ± 1.7207 cm.The range of motion of the knee joint in the main group 3 months after the surgery was 128.42 ± 9.287°, and in the control group mean flection was 109.6 ± 9.120°.The functional results in the main group were assessed by the Lisholm scale and were statistically significantly better than the results in the control group. The functional results by the AOFAS (American Orthopedic Foot & Ankle Society) scale in the main group were 100 points before the surgery and at all terms after the surgery: this indicates that the use of 1/2 of the width of m. peroneus longus tendon does not cause the its functional impairement.Conclusion. Anterior cruciate ligament plasty with use of 1/2 of the width of m. peroneus longus tendon prepared by the proposed method showed statistically significantly better results compared to the preparation of autograft from semitendinous muscle tendon using known method.

ВВЕДЕНИЕБольшинство людей так или иначе сталкиваются в жизни с проблемами коленного сустава, которые чаще всего возникают вследствие занятий спортом или в результате работы, связанной с физическим трудом. Среди всех повреждений коленного сустава доля повреждений передней крестообразной связки (ПКС) достигает 65 % [4,9,19].Основной контингент пациентов с повреждения-ми передней крестообразной связки составляют лица молодого трудоспособного возраста, ведущие физиче-ски активный образ жизни, занимающиеся спортом. Доля таких пациентов в общей структуре лиц с по-вреждениями ПКС достигает 58 %. В результате травм коленного сустава у них развиваются посттравмати-ческая передняя нестабильность, синовит, гонартроз,

We studied the use of Ortho-SUV hexapod in the treatment of 15patients with lower limb false joints. All patients were at active working age – from 22 to 50years. In 12patients, the period from the moment of trauma was 1 to 3years, in 3patients – 3 to 6years. 5patients had femoral false joints, 10patients – shin false joints. In 98% of cases, the formation of false joints was caused by inadequate treatment of initial trauma. In 100% of cases, false joint localized at diaphyseal level and was accompanied with shortening of injured segment for 2.5±1.0cm in 13patients, and for 0.5 and 0.8cm in 2cases. We also registered recurvatum and valgus deformity in 5patients, recurvatum and varus deformity in 8patients, and antecurvatum and varus deformity in 2patients. Combined contracture in knee and ankle joint was found in 90% of patients. Using combined transosseous osteosynthesis along with Ortho-SUV hexapod allowed us to correct hip deformity for 35±10days and ankle deformity – for 20±5days on the average. When shortening of femoral bone for more than 5.0cm, the deformity was corrected in two stages. At the first stage, we reconstructed the length of a segment using methods of transosseous osteosynthesis at discrete-continuum distraction. At the second stage, we corrected deformity using Ortho-SUV hexapod within specified time limits. Duration of femoral and shin false joint consolidation was 194±16days. We registered inflammatory complications in the areas of transosseous elements contacting soft tissues in 3(0.2%)patients. These complications didn’t have an effect on the treatment results.

Rotator cuff ruptures are the most common injuries of shoulder joint with an incidence of about 20 %. This pathology is more common in adults over 60 years of age because it is caused by degenerative changes in the tendon. Massive injuries account for 10–40 % of all rotator cuff injuries. Currently, there is no unified surgical tactics for the treatment of patients with massive ruptures of rotator cuff tendons.The aim. To assess the efficiency of transposition of the latissimus dorsi tendon in patients with massive ruptures of the rotator cuff tendon.Materials and methods. The study included 15 patients with Patte stage III massive ruptures of the rotator cuff who had transposition of the latissimus dorsi tendon.Results. The article presents clinical cases of surgical treatment of patients. The following criteria were assessed: mean age; time since injury; duration of the surgery; blood loss volume; functional results by the ASES (American Shoulder and Elbow Surgeons) Shoulder Score. Taking into account the ASES Shoulder Score indicators 1 year after the surgical treatment, the following results were obtained: excellent results – in 9 (53.3 %) cases; good results – in 1 (13.4 %) case; satisfactory results – in 5 (33.3 %) cases.Conclusion. When preserving the articular cartilage, the method of choice in the treatment of patients with massive ruptures of rotator cuff tendons is transposition of the latissimus dorsi tendon. At the same time, an incomplete restoration of the function of the injured limb was registered in 33.3 % of patients, which requires further study and modification of the known method of transposition of the latissimus dorsi tendon.

Rotator cuff tears are the most common cause of shoulder pain and dysfunction in older patients. Tear with retraction greater than 5cm or with the involvement of two and more tendons are considered massive. According to the literature, the incidence of massive injuries of the rotator cuff ranges from 10 to 40%. The formation of massive injuries is a long process leading to a pronounced pain syndrome, loss of function and, as a result, to pseudo-paralysis of the affected limb. There is no consensus concerning the treatment of this category of patients. Conservative methods of treatment are applicable for patients with a low activity. Among the surgical methods of treatment, the preference is given to the proximal capsule reconstruction, subacromial balloon arthroplasty, reverse arthroplasty and muscle-tendon transfers. However, today there is no single tactic of surgical treatment of patients with rotator cuff massive tears. We propose a new surgical method for this shoulder joint pathology arthroscopically-associated transposition of the tendon of the latissimus dorsi muscle using an autograft of the long peroneal muscle tendon. As a description of the new method, we present a successful clinical case of the treatment of a patient with chronic massive rotator cuff injury of the right shoulder and secondary upper subluxation of the right humerus head. This method allows to increase the efficiency of treatment of a massive tear of the rotator cuff tendons, to restore the correct biomechanics of the shoulder joint, to reduce the pain and to restore the function of the affected limb.