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Introduction: Impression fractures of the proximal end of the tibia occupy the main place in the appearance of defor-mation of the articular surfaces. The goal is to improve the results of treatment of impression fractures of the proximal end of the shin bones, based on clarifying the volume of impression defects and filling the residual cavities. Materials and methods: The study analyzed the data of 32 patients with impression fractures of the proximal end of the tibia. The volume of the formed cavities was determined according to the program for the MSCT study (per cubic centimeter measurements). V = length *thickness *width *0.52 = cubic cm, the method by which radiation diagnostics doctors work and display the volume of the cavity in cubic centimeters. V cavity volume \u003d cavity length *cavity thickness *cavity width *0.52 \u003d cc / cm (0.52 is the accepted average value, standard). Results: The results were also studied according to the accepted methodology compiled by the crite-ria for evaluating the results, and they turned out to be the following in terms of the totality of the treatment performed: in 25 patients it was from 62 to 76 points, i.e. good, in 7 patients they were satis-factory, i.e. averaged 58 points, there were no unsatisfactory result. Discussion: The combined use of PRP-therapy, bone grafting or bone impregnated with platelet mass proved to be compatible in osteosynthesis of bone fragments using the Ilizarov apparatus. Conclusion: The use of modern visualization diagnostic tools determines the volume and calculations for filling bone defects.

To see the clinical result of Modified Judet’s Quadricepsplasty (MJQP) with patella traction at BARI-ILIZAROV ORTHOPAEDIC CENTRE for the treatment of knee extension contracture. Materials and methods: We received 16 patients with knee extension contracture treated by MJQP with patella traction from January 2015 to January 2021, at our BARI-ILIZAROV ORTHOPAEDIC CENTRE. The age at revision surgery was 25-58 years. The time between fracture treatment to MJQP was 4 to 20 months and our follow up was 10-30 months. We assessed pre-operative and post-operative range of motion (ROM). Results: Knee range of motion pre-operatively was 5-50 (35± 10)° and 35-85 (55±10)° after MJQP and in average of 0-35(18+10) °. We applied patella traction for 12-14 (10±3)° When we removed the patella traction the knee range of motion at that time was 95-110 (93±4)° and increase of 10-70 compared with the range of motion after release of all arthrofibrosis in the joint. Our follow up time was 12-35 (19±5) months. Knee range of motion at first follow up was 85-135 (105±13)°, an increase of 45-105 (70±15) ° compared with pre-operatively and of 10-45 (12±12)° compared with the range of motion after patella traction removed. Knee function was excellent in 12 cases (70%), good in 3 (27%) and fair in one (3%). Conclusion: MJQP with patella traction lengthens the contracted Quadriceps femoris gives excellent result with proper post-operative care and CPM therapy.

The calcium-sensing receptor (CaSR) is a G protein-coupled receptor that plays a key role in calcium homeostasis, by sensing free calcium levels in blood and regulating parathyroid hormone secretion in response. The CaSR is highly expressed in parathyroid gland and kidney where its role is well characterised, but also in other tissues where its function remains to be determined. The CaSR can be activated by a variety of endogenous ligands, as well as by synthetic modulators such as Cinacalcet, used in the clinic to treat secondary hyperparathyroidism in patients with chronic kidney disease. The CaSR couples to multiple G proteins, in a tissue-specific manner, activating several signalling pathways and thus regulating diverse intracellular events. The multifaceted nature of this receptor makes it a valuable therapeutic target for calciotropic and non-calciotropic diseases. It is therefore essential to understand the complexity behind the pharmacology, trafficking, and signalling characteristics of this receptor. This review provides an overview of the latest knowledge about the CaSR and discusses future hot topics in this field.

Diabetic foot ulcers (DFU) are chronic skin ulcers associated with deep tissue destruction around the foot and ankle region with varying degrees of lower extremity vasculopathy and neuropathy. Diabetic foot ulcer is associated with a high rate of morbidity, disability, mortality and psycho-social cost.

BackgroundDuring liver injury, liver sinusoidal endothelial cells (LSECs) dysfunction and capillarization promote liver fibrosis. We have previously reported that the LSEC vascular cell adhesion molecule 1 (VCAM1) plays a key role in liver inflammation in nonalcoholic steatohepatitis (NASH) and we now aim to uncover its role in LSEC capillarization and liver fibrosis.MethodsWild-type C57BL/6J mice were fed either chow or high fat, fructose and cholesterol diet to induce NASH and treated with either anti-VCAM1 neutralizing antibody or control isotype antibody. Inducible endothelial cell-specific Vcam1 deleted mice (Vcam1Δend) and control mice (Vcam1fl/fl) were fed choline-deficient high-fat diet (CD-HFD) to induce NASH or injected with carbon tetrachloride to induce liver fibrosis. LSECs isolated from Vcam1fl/fl or Vcam1Δend and hepatic stellate cells (HSCs) isolated from wild-type mice were cocultured in a 3-D system or a μ-Slide 2 well co-culture system.ResultsImmunostaining for Lyve1 (marker of differentiated LSECs) was reduced in Vcam1fl/fl mice and restored in Vcam1Δend mice in both NASH and liver fibrosis models. Co-immunostaining showed increased α-smooth muscle actin in the livers of Vcam1fl/fl mice in areas lacking Lyve1. Furthermore, scanning electron microscopy showed reduced LSEC fenestrae in the Vcam1fl/fl mice but not Vcam1Δend mice in both injury models, suggesting that VCAM1 promotes LSEC capillarization during liver injury. HSCs profibrogenic markers were reduced when cocultured with LSECs from CD-HFD fed Vcam1Δend mice compared to Vcam1fl/fl mice. Furthermore, recombinant VCAM1 activated the Yes-associated protein 1 pathway and induced a fibrogenic phenotype in HSCs in vitro, supporting the profibrogenic role of LSEC VCAM1.ConclusionVCAM1 is not just a scaffold for leukocyte adhesion during liver injury, but also a modulator of LSEC capillarization and liver fibrosis.

Post-traumatic femoral valgus and upper tibia valgus and procurvatum deformity with 10cm LLD were corrected with Ilizarov Technique. The lower femur deformity correction and deformity correction of upper tibia and lengthening were carried out simultaneously. This case demonstrates an approach to large complex post-traumatic deformity in the left knee region with puckering of the skin and bad scar.

ibrous dysplasia is a pathological condition, where normal medullary bone is replaced by fibrous tissue and small, woven specules of bone. Fibrous dysplasia can occur in epiphysis, metaphysis or diaphysis. Occationally, biopsy is necessary to establish the diagnosis. We present a review of operative treatment using the Ilizarov technique.