Gavrilov I. The plastic of ligaments of skeletal-muscular system by autodermal transplants (experimental clinical research).

The object of research is the injury of ligaments of skeletal-muscular system and the process of transformation of autodermal transplants into tissue of ligament plastic by them of the ligaments of skeletal-muscular system. The aim is the working out, experimental-mathematics basis and clinical verification of conception of plastic restoration of ligaments of skeletal-muscular system by the autodermal transplants. The methods are analytical, biomechanical, morphological, clinical, X-ray and statistical ones. During the experiment the biochemical properties of ligaments of skeletal-muscular system and skin grafts were explored at the comparative aspect. The ways of correction of biochemical properties of skin grafts were determined. These ways provide an opportunity to reduce the tensile strength of skin grafts and in a such way approach them to the biochemical properties of ligaments. The morphological changes, which are in the preparations from autodermal transplants, were studied in the dynamics. Itwas proved that the gradual stretching of skin grafts, before their implantation on the place of injured ligament and adequate dynamic loading at the early after-operation period, had a positive influence on the process of the transformation of autodermal transplants into the tissue of ligament. The analysis of treatment of 75 patients was carried out. These patients were made the autodermal plastic of ligaments of different tracts of skeletal-muscular system, including 15 - autodermal plastic of ligaments of clavicular shoulder-blade joint during the treatment of patients with dislocations of acromial end of clavicle, 34 - autodermal suspension of shoulder for treatment of patients with unstability of shoulder joint, 14 - autodermal plastic of ligaments of knee joint, 6 - autodermal plastic of ligaments of anterior part of foot during the treatment of patients with the transverse-flat deformation of foot, and also 6 patients - autodermal plastic of ligaments of other tracts of skeletal-muscular system. It was established, that using of autodermal transplants for plastic reconstruction of ligaments of skeletal-muscular system allows to achieve the positive results of patients' treatment with this pathology even at those cases, when using the other plastic materials has a little effect or it is inadmissible at all (ostheoporhosis, cicatrice changes or inflammation process). The results have been introduced into clinical practice of orthopedic and traumatological departments in Luhansk, Kiev, Simferopol, Lvov, Donetsk, and Dnepropetrovsk city and into training process on the departments of traumatology and orthopedics of Luhansk, Donetsk and Crimea Medical Universities and also in KMAAE by P.L. Shoopik, Dnepropetrovsk State Medical Academy, and National Medical University by A.A. Bohomolets.