CHAPTER 2. THE MATERIAL AND RESEARCH METHODS.

Clinicodiagnostic research of efficiency of vibratory stimulation of a circulation in vessels of the bottom extremities is spent on 20 healthy volunteers of both sexes (10 men and) women) at the age from 20 till 35 years.

Parametres of an arterial blood flow registered a method ultrazvuyokovoj dopplerografii by means of the apparatus «Sonotechnik GMBH» (Germany) before vibratory influence, is immediate after it and in 30 minutes after vibratory influence. The regimen constant izlucheyonija with frequency of 8 MHz was used. Estimated peak linear rate of a blood flow and average minute rate of a blood flow in a back tibial artery and a back artery of foot.

Indicators of a volume blood flow in vessels of anticnemions registered under the same scheme a method реовазоірафни on reoanalizatore with computer obrayobotkoj data «РЕАН-131», version 4.4 of manufacture NPKF «Physician MTD» (Russia). Estimated pulsovoe krovenapolnenie vessels, resistance arteyoriol, resistance of postcapillaries and venules, venous outflow and perifericheyoskoe vascular resistance.

Within the limits of clinical section of research by us it is spent sravnitelyonyj the analysis of results of treatment of 82 patients with fractures of calcaneuses at the age from 18лет to 61 years from among the patients hospitalised in travmayotologicheskie of unit of MUSES «the Hospital №12» cities of Volgograd (I group) and MUSES «Elabuzhsky TSRB» Ministries of Health RT (And group) from 1996 for 2002 inclusive. The overwhelming majority among them men - 72 patients (92,7 %) have made, women - 6 (7,3 %).

Selection of patients for research was spent by a continuous method. To 39 patients of I group the open reposition and nakostnyj an osteosynthesis is spent
Plates of joint-stock company and screws. To 43 patients of II group the closed reposition and chreskostnyj an osteosynthesis by the apparatus of external bracing on one of the ways developed by us is carried out: «the Way of treatment of splintered fractures pjayotochnoj bones» (the demand for the invention № 2003133047/20 (035390), a priority from November, 17th, 2003) and «the Way of treatment of splintered intraarticulate fractures of a calcaneus» (the demand for the invention № 2004131078/17 (033825), prioriteg from October, 25th, 2004).

Aftertreatment of all patients was spent on offered by us komyopleksnoj to the program with use developed techniques of vibratory stimulation regionarnogo circulations of the injured extremity poyosredstvom influences on kongrlateraliuju an extremity «the Device for a seismotherapy» and «the Way of therapy of contractures of joints of extremities» (the demand for the invention №2003135902/038638, a priority from 10.02.2003)

The remote results are studied at all patients on terms from 3 to 8 le As research methods used:

• Anamnestic data.

• Data of clinical survey.

• Anthopometrical data.

• Angulometrija.

• the Dynamometry of muscles of an anticnemion.

• Roentgenography.

• Rsovazografija.

• Ultrasonic dopplerografija.

• the Plantography.

• podometrija.

For an estimation of results of treatment modifitsirovanyonaja N.A.Ljuboshitsa's polyparametrical technique - E as a whole is used. R.Mattisa [61], with ucheyotom I.L.Shvartsberga's offers [111] and S.D.Tumjana's references [99]. 15 parametres were estimated:

1. Presence or absence of a painful syndrome (according to the anamnesis);

2. A fracture adnation (to clinical and radiological signs);

3. Angle Bellera (according to roentgenography);

4. podomstrija on M.O.Fridlandu;

5. Index SHtrittera (according to a plantography);

6. Volume of a flexion an ankle joint (by data angulomstrii);

7. Extension volume in an ankle joint (by data angulometrii);

8. Presence or absence of signs of an atrophy of muscles of an anticnemion (by data anyotropometrii);

9. Force of muscles of an anticnemion (according to a dynamometry);

10. Local vascular disturbances (to clinical signs);

11. A condition regionarnoj hemodynamics (according to ultrasonic doppleyorografii and reovazografii);

12. Presence or absence of a posttraumatic deforming arthrosis and its stage (to clinical and radiological signs);

13. Purulent complications;

14. Local neurologic disturbances;

15. Working capacity.

At an estimation of force of muscles of a hip and an anticnemion in connection with big variabelnoyostju absolute value the relative indicator - forces of muscles of the injured extremity in percentage of force of muscles healthy konechyonosti is used. Thus asymmetry to 10 % was considered as norm (as well as at healthy ljuyodej). The condition regionarnoj hemodynamics of the injured extremity was similarly estimated.

By each criterion the estimation from 2 to 4 points and rasschityyovalsja an average arithmetic point was exposed. At a mean score 3,5-4,0 result leyochenija was considered as the good; at 2,6-3,4 points - satisfactory;

Table 1.

The scheme of an estimation of results of treatment of patients with calcaneus fractures.

At 2,0-2,5 points - unsatisfactory. The scheme of an estimation of results

It is presented in table 1.

Statistical processing of the received data is executed on personalyonom computer Pentium-Ill with use of programs «Ехсе1-2003» and «Stat Soft Statistica 6.0».

Reliability of results of research was defined with use of criterion Stjudenta, errors of average arithmetic value were calculated on amplitude (scope of value) by S.E.Yermolaev's technique, and the estimation «vyyoskakivajushchih results» was spent by V.I.Romanovskogo's technique [11].