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Acromegaly is a rare neuroendocrine disease caused by excessive production of growth hormone (GH), which acts as a trigger for cartilage tissue destruction leading to joint damage.Patients with acromegaly, especially in the active stage, often complain of joint pain in various locations. Joint pain can be one of the first symptoms of the disease, the intensity of which worsens without proper treatment. Increased production of GH leads to configuration changes in the joints, which in turn trigger destructive processes typical of degenerative diseases such as osteoarthritis. Despite successful treatment of acromegaly, joint-related issues can persist and significantly worsen the quality of life for patients. In this regard, the search for potential markers of early joint involvement in acromegaly is relevant for use in predicting the severity of arthropathy progression and monitoring this cohort of patients.This review provides a general overview of the effects of growth hormone on cartilage tissue, the characteristics of musculoskeletal pathology in patients with acromegaly and possible markers associated with early joint damage.

The aim of the study is to analyze the prevalence of functional and structural disorders of the musculoskeletal apparatus (MSA) and postural balance in adolescents in the Saratov region. Material and methods. The condition of the musculoskeletal system in adolescents of the Saratov region (n = 555) was studied as part of a one-stage study. The prevalence of pain complaints in various structures of the musculoskeletal system, body type, posture, shape of the pelvis and feet, the presence of trigger points, the function of the hip and shoulder joints, the volume of movement in various parts of the spine were analyzed. To assess the postural balance, the indicators of the statokinesiogram were studied. Results. A high prevalence of complaints of pain in the structures of the musculoskeletal system has been established. The most common structural changes are: scoliotic posture disorder, the shape of the shoulders, chest, shoulder blades, pelvis, feet. Among the functional disorders – limited mobility in the hip and shoulder joints, in the thoracic and lumbar spine. Trigger points were found mainly in the trapezius, pectoralis minor, scalenus, quadratus lumborum, sternocleidomastoid muscles. Statistically significant correlations were found between the parameters of the statokinesiogram and complaints of pain in the spine, structural and functional disorders of the musculoskeletal system. Conclusions. The results of the study indicate the need for an interdepartmental integrated approach to the prevention of diseases of the musculoskeletal system in adolescents. An important condition is the quality of preventive medical examinations, a personalized approach to physical education, optimization of the ergonomics of classrooms in schools, training the population in movement hygiene, and increasing commitment to a healthy lifestyle.

The aim: is to compare short-term results of home-based and outpatient programs of physical therapy among patients with frozen shoulder and concomitant thoracic myofascial pain syndrome. Materials and methods. The study involved 80 patients. The range of motion in the shoulder joint affected by capsulitis was assessed. A numerical pain scale was used to assess pain sensations when pressing on trigger points. Functional limitations in the shoulder were measured by means of the Oxford Shoulder Score (before and 1.5 months after the end of the physical therapy). Participants were divided into two groups: home-based group (HG) and outpatient group (ОG). All the patients were consulted by a physical therapist. ОG patients received end-range mobilization with the assistance of a physical therapist 5 times a week to improve shoulder joint mobility. Most of ОG participants received 15 procedures (3 weeks). Patients HG performed therapeutic exercises without any assistance at home. (twice a day, 3 weeks). In terms of trigger points therapy, the patients performed ischemic compression without any assistance. Results. Patients of both groups demonstrated positive dynamics of the studied indicators. Comparison of the short-term results of the therapy according to range of motion and pain showed better indicators in the ОG. Comparison of the initial results of the groups in Oxford Shoulder Score items did not reveal any significant differences. Total score was 18.2±6.5 points in ОG and 17.6±7.5 points in HG (p=0.715). Me (25%; 75%) values were 17.5 (12.5; 23.8) and 18 (13; 23.5) points, respectively. Comparison of the final results of the groups in Oxford Shoulder Score items revealed significant differences. Total score was 47 (47; 48) points in ОG and 33 (31; 35.75) points in HG (p

Introduction A coronavirus, SARS-CoV-2, called COVID-19 by the WHO has caused a pandemic of respiratory illness killed more than 6 million people. The severe infection has a significant negative impact on the entire musculoskeletal system. The objective was to summarize literature data on the mechanisms of the condition and identify musculoskeletal symptoms of COVID-19. Material and methods An internet search of PubMed, MedLine and eLIBRARY library databases using the search terms: COVID-19, aseptic osteonecrosis, post-COVID-19 syndrome, arthropathy, musculoskeletal system, spondylitis, osteoporosis was performed. Results and discussion Musculoskeletal symptoms of COVID-19 are reported in 31-59% of cases. Mechanisms of musculoskeletal involvement of coronavirus infection include cytotoxic effect of the virus on osteogenesis cells, vascular inflammation and coagulopathy, “cytokine storm”, side effects of drug therapy and hypoxia. According to an etiological factor, musculoskeletal manifestations of SARS-CoV-2 include autoimmune (reactive arthritis, sacroiliitis, ankylosing spondylitis, axial spondyloarthritis, psoriatic arthritis) conditions caused by impaired circulation of bone tissue (aseptic osteonecrosis), infectious (septic arthritis, spondylitis, spondylodiscitis) and metabolic (osteopenia, osteoporosis) conditions. Conclusion It has been established that COVID-19 infection has a negative impact on the musculoskeletal, endocrine and immune systems increasing the risk of degenerative diseases of the musculoskeletal system and infectious complications in orthopaedic patients early post surgery.

The high incidence rate and wide range of musculoskeletal pathologies determine the improvement of the diagnostic process. Late diagnosis leads to complications, which in turn increase the percentage of disability. Therefore, the search for the most informative method with the least radiation load on the patient remains an urgent problem for radiologists. Cone beam computed tomography (CBCT) is a modern and promising technique that has already found wide application in dentistry and otorhinolaryngology. Among the advantages of CBCT are: three-dimensional image; high spatial resolution; low radiation dose. Thanks to technical improvements in equipment and the introduction of new image processing protocols, it has become possible to expand the indications for conducting the researches, including the researches based on imaging of the upper and lower extremities. Based on the results of a CBCT study, we can evaluate: the shape and contour of the bone; solution of continuity of the bone and malposition of bone fragments; the structure of bone tissue and the pathological processes occurring in it (destruction, osteoporosis, osteosclerosis); joint congruence and changes in articular surfaces surrounding soft tissues. Therefore, CBCT can be introduced into the diagnostic process of bones and joints diseases. The use of this technique will find wide application in traumatology and orthopedics (fractures, dislocations, post-traumatic deformities, aseptic necrosis, osteoarthritis), rheumatology (rheumatoid arthritis, polyarthropathy, juvenile arthritis, gout), surgery (osteomyelitis), oncology (benign and malignant bone tumors) both in the adult population and in pediatric practice. This paper presents a review of the literature, which examines the degree of development of the issue of using CBCT and describes study protocols and protocols for processing the obtained images in the diagnosis of musculoskeletal diseases.

Introduction: Skeletal muscles damage (direct and vicarious) slows down the recovery processes in patients with injuries of the musculoskeletal system. It occurs in the early postoperative period as well. An increase in the rigidity of the skeletal muscle extracellular matrix can reduce pain, tissue swelling, and accelerate the recovery of contractility.Objective: The analyses of the effect of branched-chain amino acids (BCAAs) intake on the expression of IGF1 genes, type 1, 3 and 5 collagen, which are crucial in the composition of the skeletal muscle extracellular matrix, as well as on the muscle membrane damage against the background of chronic damage to skeletal muscles.Material and methods: 12 young healthy male subjects, skiers aged 19 (18; 22) received a placebo treatment (maltodextrin, 100 mg/kg body weight/day; n = 6) or a mixture of amino acids (leucine, isoleucine, valine – 50:25:20 mg/kg body weight/day respectively; n = 6). The treatment was received daily against the background of a large amount of aerobic high-intensity training (up to 22 hours per week). Before and after the amino acids intake a biopsy of the musculus vastus lateralis was performed, and venous blood samples were taken during the experiment.Results: The intake of leucine against the background of training led not only to a pronounced increase in the level of IGF1 protein in blood by 1.5 times (which corresponds to the literature data), but also to a trend towards an increase in the expression of IGF1Ea mRNA by 1.8 times in the skeletal muscle, and a decrease in the level of markers of muscle membranes damage – creatine phosphokinase (CPK) activity and myoglobin. In addition, changes in the IGF1-dependent collagen genes expression strongly correlated with changes in IGF1Ea expression, but not with IGF1 protein in blood (pooled group, n = 12). Thus, the intake of leucine as a part of the essential amino acids can reduce damage to skeletal muscles caused by excessive physical activity, lack of physical activity, or direct trauma.Conclusion: A 10-week BCAAs intake by individuals with documented chronic muscle membrane damage caused an increase of basal levels of IGF1 in blood and a trend towards increased IGF1Ea mRNA expression in skeletal muscle, and also caused a modest reduction in damage of skeletal muscle membrane.

The aim of the research is to analyse the recommendations of the World Health Organization (WHO) on the involvement of primary health care in the implementation of rehabilitation in case of musculoskeletal disorders and describe the situation in this area in Ukraine. Materials and methods. Methods of system and structural-logical analyses, bibliosemantic method were used during the research. The materials included published documents and information sources of the WHO, regulations of Ukraine on the implementation of medical rehabilitation, publication of scientific research. Results: WHO points out that rehabilitation integrated into primary medical care is one of the categories of rehabilitation care. It has a number of obstacles and requires more active action by the state leadership. The people with musculoskeletal disorders are also identified as key group of consumers of rehabilitation at the level of primary medical care. In Ukraine in recent years, the development of rehabilitation is constantly being improved by regulations. They create the possibility of providing rehabilitation services at all levels of medical care, identify the consumers and scope of rehabilitation services, regulate the use of telerehabilitation. However, the possibility of receiving rehabilitation services for persons with musculoskeletal disorders at the level of primary medical care in Ukraine is still limited by certain regulations and levels of staffing and technical support of the health care system. Conclusions. Securement of rehabilitation services to people with musculoskeletal disorders in the provision of primary health care requires the development of new approaches to its organization, taking into account the recommendations of the WHO.

The article deals with local injection therapy (LIT) in arthrological practice, the purpose of which is the introduction of a drug into the joint cavity or periarticularly, removal of excess synovial fluid from the joint cavity with subsequent analysis of its composition for differential diagnosis and decision-making on treatment tactics. The most commonly used in LIT are glucocorticoids, hyaluronic acid (GlK), autologous platelet-rich plasma. The method of introducing GLA into the joint cavity is considered by experts as a promising method for the treatment of osteoarthritis, the most common chronic joint disease. GlK-based preparations differ in concentration, molecular weight and production method. The article presents the results of studies using high- or low-molecular drugs GlK in the treatment of patients with osteoarthritis of the knee, hip and small joints. Attention is drawn to the fact that LIT with GlK preparations is used in the treatment of other diseases of the musculoskeletal system. Data are presented, including those of Russian authors, on the effectiveness of GlK in OA of the shoulder joints, in the syndrome of compression of the shoulder rotators. Thus, the restoration of range of motion and a significant reduction in pain in the shoulder area was achieved against the background of the use of 3 to 5 injections of the GlK preparation produced in the Russian Federation by bacterial fermentation. The unique production technology of the GlK preparation makes it possible to reduce the risk of bacterial endotoxins, completely purify the solution from hyaluronidase, increase homogeneity, and preserve the molecular weight. On the basis of the obtained evidence of efficacy and safety, HLA preparations are included by various medical associations and professional communities in Russian and international clinical guidelines for the treatment of OA.

В статье рассматривается вопрос формирования знаний и умений по профилактике травматизма студентов на учебных занятиях для дисциплин по видам спорта силовой направленности, преподаваемых на факультете физической культуры и спорта Томского государственного педагогического университета. Представлен разработанный вариант обучения студентов факультета физической культуры и спорта методике профилактики травматизма, основанной на упражнениях статического и статодинамического характера работы мыщц. Данная методика опирается на научно-методические принципы и подходы к процессу обучения профилактике травм опорно-двигательного аппарата при занятиях гиревым спортом. Разработанная методика обучения студентов профилактике травматизма опорно-двигательного аппарата включает в себя следующие компоненты: теоретические темы, темы практических занятий по профилактике травматизма, средства воздействия на мышечные группы, дозы воздействия, интенсивность работы и интервалы отдыха между подходами. Представлены результаты воздействия разработанной методики до и после эксперимента. Экспериментально доказана эффективность разработанной методики обучения студентов, направленной на формирование знаний и умений по профилактике травм опорно-двигательного аппарата при занятиях гиревым спортом.

The aim of the work to determine the dynamic characteristics of overall physical condition indicators in 11–13-year-old female weightlifters after injuries of the musculoskeletal system at the training stage of physical therapy. Materials and methods. The experimental population comprised 45 female weightlifters (aged 11–13 years, qualification ‒ I, II, III junior categories) from SСYSSOR “Spartak” of the Zaporizhzhia regional council, CYSS “Kolos” of Kamiansko-Dniprovskyi district of Zaporizhzhia region, Berdiansk CYSS of Zaporizhzhia Region City Council, and students of Kharkiv Regional Higher School of Physical Culture and Sports majoring in weightlifting. Patients after musculoskeletal injuries were divided into two groups: main (MG, n = 22) and control (CG, n = 23). Patients of the control group underwent standard treatment (generally prescribed in medical establishments). For main group patients in the training period, the program of physical therapy has been developed and implemented, with the current control of overall physical condition indicators. Research methods. Analysis of literature and sources of information presented on the Internet; clinical observations; pedagogical testing; methods of mathematical statistics. Results. Analysis of overall physical condition indicators of athletes of 11–13-year-old weightlifters of the main and control groups during the recovery and training periods allows us to state that main group athletes have higher growth rates, and dynamic characteristics of their overall physical condition are linear with constant focus on improvement. According to the indicators of “running 30 m, s” test, the following growth indicators were recorded: main group athletes (-0.48), control group athletes (-0.29), the difference (-0.19). According to the indicators of “standing long jump, cm” test, the following growth indicators were recorded: main group athletes (+14), control group athletes (+5), difference (+9). According to the results of the test “flexion-extension of the arms in the supine position, n” the following indicators were obtained: main group athletes (+4.44), control group athletes (+2.86), difference (+1.58). Conclusions. Intensification of the training process and forcing the training of junior athletes in weightlifting are the leading factors that result in injuries of the musculoskeletal system, multisystem pathologies and the development of pathomorphic phenomena. Indicators of overall physical condition of weightlifters aged 11–13 allow us to state that main group athletes have a higher difference in growth, and the tendency of their overall physical condition has a linear focus on improvement. Indicators of overall physical condition of control group athletes are nonlinear, according to “running 30 m, s” and “standing long jump, cm” the test results.

Exercise is a major factor in the development of occupational pathology of the connective tissue and musculoskeletal system, including chronic lumbosacral radiculopathy (LSRP), which accounts for 20% of occupational diseases in Ukraine. Some problems remain insufficiently studied despite a significant number of scientific works devoted to the study of issues of etiology, pathogenesis, features of clinical manifestations, the use of diagnostic and prophylactic measures in LSRP. The criteria for diagnosing changes in the peripheral nervous system need to be clarified and systematized by in-depth study of the functional state of the nervous apparatus in patients with LSRP of professional genesis. The research was carried out in a group of 60 miners of the main professions (coal-cutter, mining worker of a clearing pit (MWCP), drifter) suffering from LSRP. The activity of the neuromuscular apparatus was assessed according to the indices of electroneuromyography (ENMG), namely: the amplitude of the M-response during stimulation at the distal point of the right and left m. Abductor Hallucis, n. Plantar Medial, S1, S2 (mV), as well as indicators of terminal and residual latencies (ms), the speed of the impulse along the indicated nerves (m/s). It was found that the average amplitude of the M-response during stimulation at the distal point m. Abductor Hallucis, n. Plantar Medial in the MWCF group was at 6.37 mV (with a reference value of 4-5.8 mV), the average pulse conduction velocity was 38.46 m/s (with a reference value of 40.00 -50.00 m/s), it was found that most often in the group of coal-cutters (64.2%), a pathological indicator of terminal latency was recorded, while in a group of drifter, it did not go beyond the normal range in one of the surveyed miners suffering from LSRP of occupational genesis. Thus, ENMG of the long nerves of the lower extremities is a useful tool of objectifying the diagnosis of LSRP of ocupational genesis, it allows to determine the degree of impairment of the functional activity of peripheral nerves, neuromuscular synapses and the contractility of the striated muscles. [ABSTRACT FROM AUTHOR]

The review presents an urgent problem of modern sports medicine — the development and inclusion of new nutritive and metabolic food products in the treatment of athletes with injuries and diseases of the musculoskeletal system. The analysis of the main etiological factors of the musculoskeletal disorders in athletes is presented. The study of the anatomical, histological and functional features of the bone-cartilaginous structures in athletes made it possible to establish the priority macro- and micronutrients, which should be the basis in modern specialized and functional food products. Brief composition characteristics of the new canned food “Enmit-beef” and dry protein concentrate “Ostov” (for the drink preparation) are presented. The preliminary results of the use of these functional meat-based products indicate their effectiveness in rehabilitation and treatment of athletes with musculoskeletal disorders.

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Digital tomosynthesis is a radiological method having an intermediate position between x-ray and computed tomography (CT). Benefits with the imaging technology include improved image quality, post-processing (reconstructed to 1 mm thick slices), minimal tissue overlap in the projection image and a lower X-ray dose as compared to CT. Tomosynthesis is most commonly used in breast, chest (pulmonary tuberculosis), musculoskeletal and intraoral screening examinations. There is disagreement among professionals on feasibility and clinical effectiveness of tomosynthesis in the diagnosis of musculoskeletal injuries and diseases. Our goal was to summarize evidence relating to efficacy and feasibility of tomosynthesis in the diagnosis of musculoskeletal injuries and diseases. Russian and foreign literature was reviewed based on methodological principles of the PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions. The review included 34 articles in English and in Russian (referenced 16 to 49) describing an original study with focus on phantom, diagnostic, clinical studies. We considered articles which investigated use of tomosynthesis in the diagnosis of musculoskeletal injuries and diseases including rheumatoid arthritis affecting the hands and feet, specific and nonspecific spine lesions and injuries, nonspecific lesions and injuries to the joints; subtle fractures and dislocations. With the advantages of tomosynthesis in clinical practice, the imaging modality can be recommended for the diagnosis of the above conditions.

The movement dynamic characteristics are the main parameters for physical exercise dosing during the athlete recovery process. However, taking into account the geometric characteristics of movement is no less important, especially when restoring the joint range of motion. The hypothesis of the study was the assumption that the use of movements’ geometric characteristics allows to “design” the optimal physiological rehabilitation patterns for movement volume restoration. Objective: to develop general principles and to create a mathematical model of the optimal trajectory characteristics for the restored part of the athlete’s musculoskeletal system. Materials and methods: We used 3D Qualisys Motion Capture and Analysis System in our investigation. The study involved 32 complex coordination sports athletes (age 9-15) with hip and ankle joint injuries (bruises, sprains strains). All they required a joint movement volume restoration. Results: The study revealed that joint movement volume restoration following the individually selected pathways involving effective mathematical modeling (study group) takes shorter time to restore the athletes than traditional physiotherapy methods (control group). For typical injuries (bruises, sprains and strains) of the hip joint area, the rehabilitation took 18±5 days for controls and 12±3 days for experimental group subjects. Nearly the same pattern was observed in restoration the ankle joint (12±4 days of recovery for controls versus 8±3 days for the experimental group). Conclusions: Restoring the joint movement volume, the workloads should be evaluated with geometric rather than dynamic indicators; for planar movement, that should be the distal limb path curvature relative to the restored joint.

Objective: tto identify potential pedagogical causes for disorders in the functional state of the musculoskeletal system in young track and field athletes. Materials and methods: following activities were performed: analysis of 10 training programs used across Russia for young track and field athletes in terms of physiological, biomechanical and pedagogical content; study of results from questionnaire survey conducted among coaches of young track and field athletes; interpretation of the data obtained with the aim to identify key pedagogical risk factors resulting in physiological and biomechanical preconditions for chronic and acute injuries of musculoskeletal system in young track and field athletes. Results: analysis of 550 exercises recommended for general and special conditioning of young track and field athletes was instrumental in determining 6 sets of exercises subject to special attention or absolute forbidding in the said athletes. Exercises included in the sets amounted to about 10%. The findings of the survey conducted among 11 coaches revealed that the greatest challenges for them represented physiology and bioenergetics of youth sports as well as pedagogical concepts for minimizing chronic and acute injuries of the musculoskeletal system. Conclusions: there are risk factors that may be of great importance as deduced from the study in addition to those considered by earlier literature references. They include common weak aspects in the training programs, grave errors in deciding on conditioning and special exercises for these cohorts, lack of adequate competencies among coaches.

The review of literature presents the new direction in the treatment of sports injuries and diseases of the musculoskeletal system – using of autologous platelet-rich plasma/plasma enriched in soluble platelet factors (PRP/PORFT). PRP/PORFT reveals anti-inflammatory, analgesic, anticatabolic and regenerative effects after local injection to affected area. Technology of preparation and clinical application of PRP/PORFT were under consideration. There were described the results of clinical studies on PRP/PORFT application in sports medicine and damage of musculoskeletal system. It was shown the clinical efficacy of 2-3 injections of PRP/PORFT into the area of muscle, ligaments, joints injury. Most effective use of PRP/PORFT was shown for therapy of lateral epicondylitis and osteoarthritis. There were no yet evidences for its efficacy in therapy of patients with damaged Achilles tendon. The best clinical effects of PRP/PORFT use was demonstrated in patients with trauma and damage of musculoskeletal system at the initial stages of treatment, and also as a part of rehabilitation courses.

The purpose of the work is to investigate the effectiveness of the use of physical condition control of students of special medical groups for the development of physical therapy programs. Materials and methods. 40 students of 1st and 2nd year students of National University “Lviv Polytechnic” and Zaporizhzhya State Medical University participated in the experimental studies, which on the basis of the medical examinations were assigned to a special medical group for the presence of diseases of the musculoskeletal system (scoliosis I, II and III degrees). The following methods were used in the research process: analysis and generalization of scientific literature and Internet data; analysis of medical records of students; instrumental methods of morphometric and psychophysiological studies; pedagogical observations; pedagogical experiment of ascertaining orientation; methods of mathematical statistics. The results of the study show that the application of theoretical and methodological provisions and recommendations of corrective measures in the system of test control of physical conditions in students of a special medical group in the practical work, on the basis of integration of specially selected means of physical therapy, enables to activate compensatory mechanisms, mobilize reserve mechanisms ability of the body to increase the competence to perform motor actions, helps to accelerate the formation of knowledge, skills, and elimination of defects motive sphere, eliminating the difference in indicators of psychophysical development between students of the main, preparatory and special medical group. Conclusions. The control of morphofunctional and psychophysiological indicators is an effective mechanism of correction of the physical condition of students of a special medical group with functional disorders of the musculoskeletal system and a necessary prerequisite for the development of complex programs of rehabilitation based on the use of therapeutic exercises.

Purpose: to develop and prove the effectiveness of a comprehensive physical therapy program for children with systemic visual and musculoskeletal lesions based on the undifferentiated connective tissue dysplasia. Material and methods: the study involved 24 children of 6 years old. The study was conducted at the special educational complex. Research methods: medical histories review; clinical examination by the criteria of T. Milkovsky-Dimitrov and A. Karkashov; definition of the joint hypermobility degree by the Carter-Wilkinson criteria in the modification of Beiton; assessment of the back extensor muscles’ and abdominal press’ strength endurance (by A.M. Reisman and F.I. Bagrov tests); visometry. Results: During a preliminary study a tendency of an increase in the joint hypermobility degree in accordance with the myopia degree was established: children with mild myopia had mild form of joint hypermobility; children with moderate myopia had mild and moderate degrees of joint hypermobility; joint hypermobility at children with a high degree of myopia varied from mild to severe (generalized). A tendency of an increase in the number of children with impaired posture in accordance with an increase in the myopia degree was also established. A comprehensive physical therapy program was developed and implemented. It included modern technologies and recovery tools: therapeutic exercises for the eye muscles (solarization, palming); musculosceletal system training on the BOSU platform; balanced daily diet; self-massage of the circular eye muscles and eyelids; art therapy (fairy tale therapy); Su-Jok therapy. This methods made up the essence of the author’s program named «Sleepy Kittens». This program affected the visual analyzer and the musculoskeletal system positively. Conclusions: As a result of physical therapy measures in the main group, a number of children with high degree of myopia decreased; strength endurance of the back extensor muscles and abdominals increased; a number of children with joint hypermobility of moderate degree decreased; joint hypermobility of high degree was absent.

The goal is to perform a paleoradiologic MRI study of the tissues of the musculoskeletal system of the mummy of a woman from the Pazyryk culture from the Ak-Alakh-3 burial ground on the Ukok Plateau, in which previously had been found tumor metastases (from the right breast) and the consequences of a severe trauma - a dislocation of the right hip and damage to the right brachial joints. The method is a high-field MRI on the magnetic resonance scanner (Achieva Nova, Philips, 1.5 T). Results. The manifestations of osteomyelitis of the femurs bones were revealed in the tissues of the musculoskeletal apparatus of the mummy. The signs of damage to the anterior cruciate ligament of the right knee joint and lig. bifurcatum of the right foot were revealed, which indicates the effect of unfavorable factors of traumatic genesis. There were also signs of an inflammatory process, spondyloarthritis and osteoarthritis (probably autoimmune genesis): a pronounced narrowing of both sacroiliac joints, zones of inflammatory edema of bone tissue in the projection of the left sacroiliac joint, joints of the foot, involvement of the periarticular soft tissues-achillobursitis.

Because of the successful implementation of modern treatment technologies at any stage of therapy of children with oncohematological diseases, their overall and disease-free survival has increased significantly. According to recent observations, 80 % of children after the completion of a special antitumor treatment continue to have changes of different organs. Almost all patients are at risk for late complications from the musculoskeletal system but little attention is paid to this issue. Evaluation of long-term complications from the musculoskeletal system and mineral metabolism in patients, development of their complex rehabilitation and prevention is an actual problem of pediatric oncology and hematology. This review summarizes data on long-term complications from the musculoskeletal system after special therapy. The necessity of diagnostics approaches harmonization and correction of not only the most common complications, but also little studied conditions, such as reduction of bone mineralization, is shown. It is noted that multidisciplinary rehabilitation treatment of children in remission can not only correct the consequences of the underlying disease, concomitant pathology and the consequences of special therapy but also reduce the disability of children.

We outlined and described basic directions of national traumatology development at the period of 1950-1980 illustrated by the example of Saratov traumatological school, estimated the contribution of SarNIITO traumatologists into this development at the abovementioned period, depicted syna — one of the founders of acute trauma clinics.

The study of the spatial and temporal characteristics of the gait of children and adolescents is an important task. The purpose of this study was to determine the spatial and temporal characteristics of the gait of children and adolescents of different age categories who systematically engage in sports.Methods. On motion capture complex Vicon in the Center for Collective Use "Three-dimensional study of the biomechanics of motion" of the Astrakhan State University, 43 children were examined: 22 children in the control group and 21 children in the study group.Results. Quantitative indicators of the spatial and temporal characteristics of the gait of children engaged in sports dancing were obtained and a comparative analysis of this data with the control group was carried out. An increase of walking speed and cadence, a decrease in the time of single and double support in male athletes in the 7-12 year old group was revealed; increased of walking speed and cadence, a marked decrease in the time of single support, a decrease in the limp index in female athletes in the 7-12 year old group; an increase the cadence in female athletes in the group of 12-15 years.Conclusions. Doing sport every day helps with the spatio-temporal changes of the walk among children and teenagers. The imbalance of the motor function is examined among girls, that doing sports between the age of 7-12, so that’s why it needs a special attention from doctors, traumatologist and orthopedists.

Introduction A scientifically-based knowledge on the incidence, dynamics of detection and structure of congenital malformations of the musculoskeletal system (CMMS) has both practical and scientific significance. For many years, the Turner Institute has close scientific and practical ties with the state public health institution "Diagnostic Medical and Genetic Center" of St. Petersburg which carries out a regional monitoring of congenital disorders in St.Petersburg. Our objective was to present regional statistical data on the CMMS detection and structure in newborns and children of the first and second years of life, morbidity and disability in children aged 0-17 years in connection with congenital malformations of the musculoskeletal system, to study the proportion of CMMS patients in the orthopedic clinic and their need for surgical, including high-tech, treatment, and dispensary follow-ups in outpatient orthopaedic settings. Material and methods Regional statistics of St. Petersburg on prevalence, dynamics and structure of congenital malformations of the musculoskeletal system in children born in St. Petersburg in 2001–2015 were analyzed. The statistical data on the prevalence of congenital malformations of the musculoskeletal system in children aged 0–17 years in St. Petersburg were studied. Based on the studies conducted at the Turner Institute in 2014–2016, the proportion of patients treated for congenital malformations of the musculoskeletal system was revealed as well as their need for surgical treatment. Peculiarities of dispensary follow-ups of CMMS patients at orthopedic consultations of children's clinics of St. Petersburg were analyzed. Results and discussion The prevalence and structure of congenital malformations of the musculoskeletal system in 783,000 children born in St. Petersburg in the period of 2001–2015 are presented in accordance with blocks Q65–Q79 of ICD-10. Diagnostic results of congenital malformations of the musculoskeletal system in newborns (2.70 ‰) and in children of the same group until they reached three years of age (4.21 ‰) were studied in dynamics. Infacnts and children up to 17 years old with congenital malformations of the musculoskeletal system are under regular supervision of orthopedic surgeons. Disability due to congenital anomalies and malformations takes the third place among all the diseases detected in patients aged 0-17 years, established by pediatric medical and social expert boards of St. Petersburg. At the clinic of the Turner Institute, the proportion of patients with CMMS among all admitted patients was 38.6 %. Among them, 78 % of patients with CMMS received surgical treatment, of which 80 % of operations were performed using high technologies. Conclusions Statistics on congenital malformations of the musculoskeletal system in newborns and children under 3 years old and a high level of their disability shows the need in a specialized care for these children, including high-tech surgical treatment.

The treatment of patients with long bones fractures, despite the development and improvement of treatment methods and fixing devices in certain cases can lead to unwanted results such as a formation of posttraumatic deformity -- malunion. Objrctive. To provide modern approach regarding clinical significance and necessity of correction of secondary changes in moving segment that appeared as a result of formation of lower extremity malunion. Methods. The results of treatment of 196 patients were analyzed (89 men, 107 women; age from 19 to 76 years). All the patients had the malunion of the long bones of lower extremities and have been treated from 2004 to 2019 years. Analysis of special literature and own experience was performed to identify the effects of malunions. Results. It was shown that formed malunion lead to tangible shortening of injured extremity, joints overloading and muscle function violation. Malunions are compensated by the means of changing in movement arch and gait pattern. While it is noted that unphysiological load on joints, that predispose the development of degenerative changes, and muscle fatigue and pain are the results of muscle work to support inadequate position of the joints. Malunions on the level of femur and tibia became clinically significant on condition of severe restriction of extremity function, thus its restoration is the goal of treatment. Different cases of malunion development were considered: varus, valgus, antecurvatio, recurvatio, translation, torsion malalignment. Clinical examples are given. Conclusions. Clinical significance of different malunions depend upon their localization, presence and severity of secondary changes, status of injured extremity and physical condition of the patient, his or her individual demands. Secondary changes can play the role of compensation and spread on injured extremity, sacro-iliac joints, lumbar spine, contralateral extremity. The assessment of secondary changes of musculoskeletal system is mandatory for the patients with malunions during the planning of treatments measures. The indication for surgical correction should be defined with taking into consideration possible development of malunion complications in future. Key words. Posttraumatic deformity, malunion, malalignment, lower extremity, secondary changes, compensation. [ABSTRACT FROM AUTHOR]

Objective: to reveal the prognostic-diagnostic significance of polymorphism of vitamin D receptor (VDR) gene G63980A, reference SNP (rs) 1544410, and possible prognostication of the risk of disorders appearance in the structural-functional state of the bone tissue in a combined course of osteoarthritis (OA) and obesity in young people. Methods: the study group included 96 patients at the age of (35.5 ± 0.9) years with OA and obesity, the control group were 96 practically healthy people of the same age and gender, the comparison group consisted of 18 patients with OA and the normal body mass. Obesity was classified after calculation of the body mass (Ketle) index. The functional state of the locomotor system was assessed by the WOMAC scale. The mineral density of the bone tissue was measured with bone densitometer Explorer QDR W (Hologic). Gene polymorphism was investigated in the human genome by the method of polymerase chain reaction. Odds ratio (OR) of the disease development was calculated. Results: severe radiological stages of joints were revealed 2.4 times more frequently in OA combined with obesity than in isolated OA. Osteoporosis was diagnosed in 59.4% of patients from the study group versus 50% in the comparison one. In the study group, patients with polymorphic variants of VDR gene, who had the B allele, predominated. The following risk factors for the development of OA were revealed: bone fractures in patients and their family members in the past history, genotype variation in VDR gene, age of the onset of disease under 30 and the radiological stage of OA. Conclusions: clinical-instrumental manifestations of the disease worsen in young patients with OA against a background of obesity. The same patients form osteoporotic disorders as early as during five years of the combined course of the above nosologies. Prognostically unfavourable factors are as follows: the BB variant of VDR gene, fractures in patients and their family members' past history, manifestation of the disease under 30 years of age and the radiological stage of OA. [ABSTRACT FROM AUTHOR]

An important issue in the treatment of osteoarthritis is the development of new methods to eliminate pain and restore joint function. However, it is impossible without the understanding of the causes of the disease and the formation of pathological walking. Objective: on the base of physiological data of the body pattern formation and the pathogenesis of osteoarthritis, to work out a conceptual model of pathological postural pattern formation with a long course of the disease. Results: the physiology of the body patterns formation in statics and dynamics is considered. The conceptual model reflects the process of body formula formation from the birth under the influence of the environment. Own movement pattern is created under the influence of receptors (vision, hearing, tactile, vestibular, etc.). The first violations of support ability do not occur with the appearance of pain, but with the onset of loss of depreciation properties of the cartilage. Prolonged mismatch of the thigh muscle groups leads to the development of flexion-adducing contracture. The walking pattern is changing. The formed postural pattern begins to change under pathological changes in the body, leading to the switching of compensatory mechanisms, a change in the body formula and the creation of another picture of movement. Conclusions: the study of the conditions for the formation of the characteristic walking pattern, due to the congenital and corrected body patterns throughout life, makes it possible to foresee the pathological consequences of diseases of the musculoskeletal system, especially during their long course. Analysis of postural patterns changed as a result of the degenerative process allows us to predict the result of surgical treatment, including total joint replacement of the lower limbs, and to develop an individual complex of rehabilitation measures to restore normal movement in a patient. [ABSTRACT FROM AUTHOR]

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Purpose: the improvement of cooperation and the interaction of an attending physician and a specialist on physical rehabilitation at violations of activity of musculoskeletal system. Material & Methods: physical rehabilitation is considered as a difficult system with the hierarchically-ordered structure. The analysis of references and the system analysis are applied. Results: the modern approaches to coordination of centers of decision-making and the management in hierarchical systems are analyzed. The ways of the interlevel coordination in organizational systems are revealed. The need of coordination of activity of an attending physician and a specialist on physical rehabilitation is proved. The content and the direction of coordination signals for the system of physical rehabilitation at violations of activity of the musculoskeletal system are determined. Conclusions: the coordination of activity of an attending physician and a specialist on physical rehabilitation at violations of activity of the musculoskeletal system has to occur in certain ways: on purposes, on restrictions, in time, on input and output parameters.

More and more people use baby slings and wraps instead of wheelchairs. The child is in front of the person who wears them. The baby weight is distributed evenly and symmetrically. Carrying a baby in a sling is safe, doesn’t damage a locomotor system if the binding in a sling is good. Carrying a baby in a sling helps in treatment hip dysplasia and has a good outflow on the hip joints in infants.

The purpose of the study – the optimization of clinical diagnosis of chronic course of Ixodes tick-borne borreliosis based on indicators of immune and cytokine status of patients.Materials and Methods: clinical and immunological study of patients with chronic Ixodes tick-borne borreliosis in the Krasnoyarsk region. The observations were made on 205 patients for 1,5 years. The diagnosis was based on clinical and epidemiological data confirmed the identification of specific antibodies to borrelia by ELISA. The indices of cellular and humoral immune system, phagocytosis, cytokine (interleukin-1β, 4, 8 , tumor necrosis factor-α).Results: Show Part chronicity of infection after an noneritemic form of the disease (37,5%) and combined forms of Ixodes tick-borne borreliosis with tick-borne encephalitis (33,2%). Clinical manifestations were characterized by the involvement in the pathological process of the musculoskeletal system (42,9%) and combined lesions to the nervous system (38.5%). A rare variant of the chronic course of borreliosis was central nervous system as the onset of the disease (3,5%). Common infectious syndrome relapse accompanied by autonomic dysfunction with prevalence parasimpatotonus (59,0%) and simpatotonus (41,0%), and febrile reactions (71,2%) were more subfebrile with fever (51,2%).Conclusion: pathogenetic mechanisms of chronic course of Ixodes tick-borne borreliosis closely associated with inflammation and immune-mediated reactions of the organism , and are characterized by the presence of cellular immunodeficiency, insolvency phagocytosis, suppression of the synthesis of interleukin-4 and interleukin-8 intensive products.

The paper presents a brief review of the primary and recurrent disability of persons under the age of 18 in the Voronezh Region in comparison with data on the Central Federal District and the Russian Federation. The article draws attention to the urgency of the comprehensive approach to diagnostics and development of measures of multilevel prevention and medical and social rehabilitation of patients and disabled persons with this pathology. It highlights the great importance of rehabilitation and habilitation for the formation or recovery of their social and professional status.