Leonid N.Solomin, MD, PhD Orthopaedic SurgeonProfessor of Orthopaedic SurgeryLeading Researcher, Vreden Russian Research Institute of Traumatology and OrthopedicsProfessor of the General Surgery Chair, St. Petersburg State UniversityHonorable Professor of Russian Ilizarov Scientific Center “Restorative Traumatology and Orthopedics”Experience in the field of Limb Lengthening and Reconstruction Surgery - over 25 years.
The results of the developed method of analysis and planning hindfoot deformities correction in t... more The results of the developed method of analysis and planning hindfoot deformities correction in the sagittal plane is shown, which is easy to implement and it allows using this way regardless of the possible midfoot deformities or equinus of the ankle joint.
The results of the developed method of analysis and planning midfoot deformities correction in th... more The results of the developed method of analysis and planning midfoot deformities correction in the sagittal plane is shown, which is easy to implement and it allows using this way regardless of the possible hindfoot deformities or equinus of the ankle joint
Aim The study was aimed to assess the results of treatment for fracture-dislocations of the proxi... more Aim The study was aimed to assess the results of treatment for fracture-dislocations of the proximal humerus (PH) within different time frames for optimizing treatment tactics. Patients and Methods This retrospective cohort study evaluated clinical outcomes of 25 patients with fracture-dislocations of the PH (15 patients were analyzed for short- and medium-term results, and 10 – for long-term results). The follow-up period ranged from 1 to 9-years. All patients underwent: clinical examination, constant score assessment and shoulder X-ray examination. Clinical, radiological and statistical methods were used for analysis. Results Assessment of the degree of initial displacement of tubercles and its impact on the results of treatment showed that significantly better results were obtained in case of displacement no more than 10 mm (p=0.041). Patients with displacement no more than 10 mm had an average score of 68.0±16.1 points (Mean=69.5), while those with displacement of the tubercle(s...
Purpose. To create an improved atlas designed to insert transosseous elements through foot bones.... more Purpose. To create an improved atlas designed to insert transosseous elements through foot bones. Materials and Methods. The study performed in two stages using eight frozen (fixed) and ten non-fixed cadaveric preparations of leg-foot complex. The foot was divided in 14 transverse and 3 oblique levels. 12 positions were determined at each of the levels for each bone of the level. Both prohibited positions (the projection of significant blood vessels and nerves) and safe positions determined in the frozen preparations. The displacement amounts of soft tissues in the non-fixed preparations studied relative to foot bones for movements in the ankle, metacarpophalangeal, and interphalangeal joints. The positions with minimum displacement of soft tissues and with the absence of significant vessels and nerves were designated as “recommended positions” for insertion of wires and half-pins in transosseous osteosynthesis. Results. The data obtained during the experiment were processed graphic...
The three-fold, five-fold change of unified repositional hinges is necessary for correction of co... more The three-fold, five-fold change of unified repositional hinges is necessary for correction of complex multicomponental multiplanar deformities using the Ilizarov fixator. Transosseous devices the work of which is based on computer navigation (so-called hexapods) allow to move bone fragments in a single-stage manner along the “integral” trajectory. The length of each of connecting telescopic rods – struts – conforms to the initial position of bone fragments. The software calculates the change of each strut length to achieve the required bone fragment position. The made comparative analysis of the hexapods used nowadays (Taylor Spatial Frame, Ilizarov Hexapod System and Ortho-SUV Frame) has demonstrated the advantages of Ortho-SUV frame in the potentials of reposition, osteosynthesis rigidity, comfort of hardware and software use. Ortho-SUV Frame has been evaluated in treatment of 93 patients (109 cases of the frame appliance). Deformity correction (fracture reposition) was achieved ...
Aim: to find the optimal configuration of passive computer-assisted ORTO-SUV device for the corre... more Aim: to find the optimal configuration of passive computer-assisted ORTO-SUV device for the correction of complicated midfoot and hindfoot deformities. Material and methods: The study was carried out using plastic “shin-foot”complexes, on which different versions of Orto-SUV device layout: five versions for midfoot deformities and three versions for hindfoot deformities. A model providing maximum amplitude of the movement was considered optimal. Results: Optimal layout for midfoot provides dorsiflexion of 41,1±1,7°; plantar flexion - 32,1±1,4°; supination - 53,3±1,8°; pronation - 35±1,6°; abduction - 44,2±2,1°; adduction - 43,2±1,7°. Optimal layout for the correction of hindfoot deformities provides rotation in sagittal plane upwards - 96,5±2,4°;rotation in sagittal plane downwards - 36,2±1,4°;“varusation” (angulationmedially in the frontal plane) - 31±1,3°; “valgusation” (in the frontal plane outwards) - 44,5±1,9°; movement upwards and backwards, angle of 45° to the horizontal plan...
Introduction. Extracortical Clamp Device (ECD) is a tool that, unlike conventional wires and pins... more Introduction. Extracortical Clamp Device (ECD) is a tool that, unlike conventional wires and pins, does not perforate long bone cortex. Therefore, its use simplifies methods of combined and consequtive use of internal and external fixation, osteosynthesis in periprosthetic fractures and deformities. Purpose of the study - to compare the rate of complications and their structure depending on extracortical clamp device application and conventional transosseous elements in combined external fixation of femur. Materials and methods. We analyzed the complications arising in treatment of 66 patients with frames where ECD were used (group «ECD»). The results were compared with the results of treatment 29 patients, when utilizing combination of external and internal fixation, external fixation device included conventional transosseous elements only (group «W-P»). Results. In the group «ECD» inflammation of the soft tissues around fixing elements was identified in 14.8% of cases. In these pa...
Periprosthetic femoral fractures with a well fixed endoprosthesis (Vancouver types B1 & C) tradit... more Periprosthetic femoral fractures with a well fixed endoprosthesis (Vancouver types B1 & C) traditionally require fixation with cable or divergent screw plates or allograft struts. Union rates of 86% and complication rates of 29% have been reported 1,2. Circular external fixation has been used successfully, however the presence of an implant restricts pin position opions, and risks endoprosthetic infection 3,4. A novel percutaneously inserted Extracortical Clamp Device (ECD) was developed to allow stable capture of the endoprosthetic femoral fragment without disturbing the prosthesis or cortical envelope and to permit a minimally invasive external fixation solution to achieve union without fracture site or prosthetic bed violation.
European journal of orthopaedic surgery & traumatology : orthopédie traumatologie, 2015
Accepted management of diaphyseal fractures associated with significant tissue loss is rigid intr... more Accepted management of diaphyseal fractures associated with significant tissue loss is rigid intramedullary stabilisation with free or rotational musculocutaneous flap coverage. Circular external fixation is a powerful tool in the management of limb trauma and with recent advances has been developed to provide multiple techniques for which even massive tissue loss can be addressed without the need for free tissue transfer. Gradual and acute shortening, acute fracture deformation and gradual lengthening with restoration of deformity combined with distraction tissue histiogenesis can provide the surgeon with an array of options which can be precisely tailored to the particular personality of a severe open diaphyseal fracture.
Circular fixation according to the Ilizarov method is a well-recognised modality of treatment for... more Circular fixation according to the Ilizarov method is a well-recognised modality of treatment for trauma and deformity. One shortcoming of the traditional fixator is its limited ability to correct more than one plane of deformity simultaneously, leading to lengthy frame-time indices. Hexapod circular fixation utilising computer guidance is commonplace for complex multidimensional deformity but difficulties often arise with correction of femoral deformity due to bulkiness of the frame construct, particularly in proximal deformity and in patients of increased size. The Ortho-SUV frame is an innovative hexapod which permits unique customisation to individual patient anatomy to maximise tolerance and optimal range of deformity correction. We hypothesised that the optimal configuration and maximal degree of correction achievable by the Ortho-SUV frame can be biomechanically modelled and applied clinically. A study was constructed using Ortho-SUV and femoral limb models to measure deformi...
In the correction of complex multi-component and multi-planar deformities (Tables 16.1 and 16.3) ... more In the correction of complex multi-component and multi-planar deformities (Tables 16.1 and 16.3) using the Ilizarov frame, unified reduction nodes have to be replaced three to five times (Fig. 17.1) [368]. Every frame re-assembly involves a change in the reductional units and is a highly laborious process in which there is additional patient exposure to radiation. Sometimes, due to the peculiarities of frame assembly (external supports are not oriented at a right angle to the axes of the bone fragments, a bone is not at the center of a support, the support for some reason is not closed, etc.), correction of one component can lead to the secondary translation of other(s). These secondary translations will, in turn, require correction and therefore additional frame re-assembly.
Tienda online donde Comprar Basic Principles of External Skeletal Fixation using Ilizarov Device ... more Tienda online donde Comprar Basic Principles of External Skeletal Fixation using Ilizarov Device al precio 169,52 € de Solomin, Leonid, tienda de Libros de Medicina, Libros de Nefrologia - Nefrologia clinica
wThe aim of this study was to test a novel planning method for midfoot deformity correction, base... more wThe aim of this study was to test a novel planning method for midfoot deformity correction, based on reference lines and angles (RLA) of talus and first metatarsal of 64 normal radiographs from 55 patients. The anatomic lateral talometatarsal angle (aLTMA), resulting from the intersection of talus joint line (TJL), from the border of the articular surface of the talus to the posterior process of talus, and the anatomic axis of the first metatarsal, was 28.5° ± 4.5°. The intersection of those 2 lines divided the TJL in 2 segments (ac and ab) with the ratio k1 = 0.7 ± 0.3. The length of the first metatarsal line was measured from its intersection with the TJL and first metatarsal head, and it was 3.6 times longer that of the TJL (k2). To analyze foot deformity, we propose to draw the TJL line as follows. Use the k1 ratio to determine the point where the aLMTA intersects the TJL. From this point, an idealized anatomic first metatarsal line should be drawn, at 28.5° from the TJL. The distal end of that line is based on the k2 ratio (3.6 × TJL length). Next, the actual anatomic lateral talometatarsal line of the deformed foot is drawn. The intersection between these 2 lines identifies the apex and magnitude of the deformity. Deformity correction planning using the proposed method was demonstrated and confirmed in 2 cases. A reference method for analysis and planning of midfoot sagittal plane deformity correction independent of foot position relative to the ankle joint or the presence of concomitant hindfoot deformity appears promising for future investigation and use.
The results of the developed method of analysis and planning hindfoot deformities correction in t... more The results of the developed method of analysis and planning hindfoot deformities correction in the sagittal plane is shown, which is easy to implement and it allows using this way regardless of the possible midfoot deformities or equinus of the ankle joint.
The results of the developed method of analysis and planning midfoot deformities correction in th... more The results of the developed method of analysis and planning midfoot deformities correction in the sagittal plane is shown, which is easy to implement and it allows using this way regardless of the possible hindfoot deformities or equinus of the ankle joint
Aim The study was aimed to assess the results of treatment for fracture-dislocations of the proxi... more Aim The study was aimed to assess the results of treatment for fracture-dislocations of the proximal humerus (PH) within different time frames for optimizing treatment tactics. Patients and Methods This retrospective cohort study evaluated clinical outcomes of 25 patients with fracture-dislocations of the PH (15 patients were analyzed for short- and medium-term results, and 10 – for long-term results). The follow-up period ranged from 1 to 9-years. All patients underwent: clinical examination, constant score assessment and shoulder X-ray examination. Clinical, radiological and statistical methods were used for analysis. Results Assessment of the degree of initial displacement of tubercles and its impact on the results of treatment showed that significantly better results were obtained in case of displacement no more than 10 mm (p=0.041). Patients with displacement no more than 10 mm had an average score of 68.0±16.1 points (Mean=69.5), while those with displacement of the tubercle(s...
Purpose. To create an improved atlas designed to insert transosseous elements through foot bones.... more Purpose. To create an improved atlas designed to insert transosseous elements through foot bones. Materials and Methods. The study performed in two stages using eight frozen (fixed) and ten non-fixed cadaveric preparations of leg-foot complex. The foot was divided in 14 transverse and 3 oblique levels. 12 positions were determined at each of the levels for each bone of the level. Both prohibited positions (the projection of significant blood vessels and nerves) and safe positions determined in the frozen preparations. The displacement amounts of soft tissues in the non-fixed preparations studied relative to foot bones for movements in the ankle, metacarpophalangeal, and interphalangeal joints. The positions with minimum displacement of soft tissues and with the absence of significant vessels and nerves were designated as “recommended positions” for insertion of wires and half-pins in transosseous osteosynthesis. Results. The data obtained during the experiment were processed graphic...
The three-fold, five-fold change of unified repositional hinges is necessary for correction of co... more The three-fold, five-fold change of unified repositional hinges is necessary for correction of complex multicomponental multiplanar deformities using the Ilizarov fixator. Transosseous devices the work of which is based on computer navigation (so-called hexapods) allow to move bone fragments in a single-stage manner along the “integral” trajectory. The length of each of connecting telescopic rods – struts – conforms to the initial position of bone fragments. The software calculates the change of each strut length to achieve the required bone fragment position. The made comparative analysis of the hexapods used nowadays (Taylor Spatial Frame, Ilizarov Hexapod System and Ortho-SUV Frame) has demonstrated the advantages of Ortho-SUV frame in the potentials of reposition, osteosynthesis rigidity, comfort of hardware and software use. Ortho-SUV Frame has been evaluated in treatment of 93 patients (109 cases of the frame appliance). Deformity correction (fracture reposition) was achieved ...
Aim: to find the optimal configuration of passive computer-assisted ORTO-SUV device for the corre... more Aim: to find the optimal configuration of passive computer-assisted ORTO-SUV device for the correction of complicated midfoot and hindfoot deformities. Material and methods: The study was carried out using plastic “shin-foot”complexes, on which different versions of Orto-SUV device layout: five versions for midfoot deformities and three versions for hindfoot deformities. A model providing maximum amplitude of the movement was considered optimal. Results: Optimal layout for midfoot provides dorsiflexion of 41,1±1,7°; plantar flexion - 32,1±1,4°; supination - 53,3±1,8°; pronation - 35±1,6°; abduction - 44,2±2,1°; adduction - 43,2±1,7°. Optimal layout for the correction of hindfoot deformities provides rotation in sagittal plane upwards - 96,5±2,4°;rotation in sagittal plane downwards - 36,2±1,4°;“varusation” (angulationmedially in the frontal plane) - 31±1,3°; “valgusation” (in the frontal plane outwards) - 44,5±1,9°; movement upwards and backwards, angle of 45° to the horizontal plan...
Introduction. Extracortical Clamp Device (ECD) is a tool that, unlike conventional wires and pins... more Introduction. Extracortical Clamp Device (ECD) is a tool that, unlike conventional wires and pins, does not perforate long bone cortex. Therefore, its use simplifies methods of combined and consequtive use of internal and external fixation, osteosynthesis in periprosthetic fractures and deformities. Purpose of the study - to compare the rate of complications and their structure depending on extracortical clamp device application and conventional transosseous elements in combined external fixation of femur. Materials and methods. We analyzed the complications arising in treatment of 66 patients with frames where ECD were used (group «ECD»). The results were compared with the results of treatment 29 patients, when utilizing combination of external and internal fixation, external fixation device included conventional transosseous elements only (group «W-P»). Results. In the group «ECD» inflammation of the soft tissues around fixing elements was identified in 14.8% of cases. In these pa...
Periprosthetic femoral fractures with a well fixed endoprosthesis (Vancouver types B1 & C) tradit... more Periprosthetic femoral fractures with a well fixed endoprosthesis (Vancouver types B1 & C) traditionally require fixation with cable or divergent screw plates or allograft struts. Union rates of 86% and complication rates of 29% have been reported 1,2. Circular external fixation has been used successfully, however the presence of an implant restricts pin position opions, and risks endoprosthetic infection 3,4. A novel percutaneously inserted Extracortical Clamp Device (ECD) was developed to allow stable capture of the endoprosthetic femoral fragment without disturbing the prosthesis or cortical envelope and to permit a minimally invasive external fixation solution to achieve union without fracture site or prosthetic bed violation.
European journal of orthopaedic surgery & traumatology : orthopédie traumatologie, 2015
Accepted management of diaphyseal fractures associated with significant tissue loss is rigid intr... more Accepted management of diaphyseal fractures associated with significant tissue loss is rigid intramedullary stabilisation with free or rotational musculocutaneous flap coverage. Circular external fixation is a powerful tool in the management of limb trauma and with recent advances has been developed to provide multiple techniques for which even massive tissue loss can be addressed without the need for free tissue transfer. Gradual and acute shortening, acute fracture deformation and gradual lengthening with restoration of deformity combined with distraction tissue histiogenesis can provide the surgeon with an array of options which can be precisely tailored to the particular personality of a severe open diaphyseal fracture.
Circular fixation according to the Ilizarov method is a well-recognised modality of treatment for... more Circular fixation according to the Ilizarov method is a well-recognised modality of treatment for trauma and deformity. One shortcoming of the traditional fixator is its limited ability to correct more than one plane of deformity simultaneously, leading to lengthy frame-time indices. Hexapod circular fixation utilising computer guidance is commonplace for complex multidimensional deformity but difficulties often arise with correction of femoral deformity due to bulkiness of the frame construct, particularly in proximal deformity and in patients of increased size. The Ortho-SUV frame is an innovative hexapod which permits unique customisation to individual patient anatomy to maximise tolerance and optimal range of deformity correction. We hypothesised that the optimal configuration and maximal degree of correction achievable by the Ortho-SUV frame can be biomechanically modelled and applied clinically. A study was constructed using Ortho-SUV and femoral limb models to measure deformi...
In the correction of complex multi-component and multi-planar deformities (Tables 16.1 and 16.3) ... more In the correction of complex multi-component and multi-planar deformities (Tables 16.1 and 16.3) using the Ilizarov frame, unified reduction nodes have to be replaced three to five times (Fig. 17.1) [368]. Every frame re-assembly involves a change in the reductional units and is a highly laborious process in which there is additional patient exposure to radiation. Sometimes, due to the peculiarities of frame assembly (external supports are not oriented at a right angle to the axes of the bone fragments, a bone is not at the center of a support, the support for some reason is not closed, etc.), correction of one component can lead to the secondary translation of other(s). These secondary translations will, in turn, require correction and therefore additional frame re-assembly.
Tienda online donde Comprar Basic Principles of External Skeletal Fixation using Ilizarov Device ... more Tienda online donde Comprar Basic Principles of External Skeletal Fixation using Ilizarov Device al precio 169,52 € de Solomin, Leonid, tienda de Libros de Medicina, Libros de Nefrologia - Nefrologia clinica
wThe aim of this study was to test a novel planning method for midfoot deformity correction, base... more wThe aim of this study was to test a novel planning method for midfoot deformity correction, based on reference lines and angles (RLA) of talus and first metatarsal of 64 normal radiographs from 55 patients. The anatomic lateral talometatarsal angle (aLTMA), resulting from the intersection of talus joint line (TJL), from the border of the articular surface of the talus to the posterior process of talus, and the anatomic axis of the first metatarsal, was 28.5° ± 4.5°. The intersection of those 2 lines divided the TJL in 2 segments (ac and ab) with the ratio k1 = 0.7 ± 0.3. The length of the first metatarsal line was measured from its intersection with the TJL and first metatarsal head, and it was 3.6 times longer that of the TJL (k2). To analyze foot deformity, we propose to draw the TJL line as follows. Use the k1 ratio to determine the point where the aLMTA intersects the TJL. From this point, an idealized anatomic first metatarsal line should be drawn, at 28.5° from the TJL. The distal end of that line is based on the k2 ratio (3.6 × TJL length). Next, the actual anatomic lateral talometatarsal line of the deformed foot is drawn. The intersection between these 2 lines identifies the apex and magnitude of the deformity. Deformity correction planning using the proposed method was demonstrated and confirmed in 2 cases. A reference method for analysis and planning of midfoot sagittal plane deformity correction independent of foot position relative to the ankle joint or the presence of concomitant hindfoot deformity appears promising for future investigation and use.
The results of the developed method of analysis and planning hindfoot deformities correction in ... more The results of the developed method of analysis and planning hindfoot deformities correction in the sagittal plane is shown, which is easy to implement and it allows using this way regardless of the possible midfoot deformities or equinus of the ankle joint.
The results of the developed method of analysis and planning midfoot deformities correction in t... more The results of the developed method of analysis and planning midfoot deformities correction in the sagittal plane is shown, which is easy to implement and it allows using this way regardless of the possible hindfoot deformities or equinus of the ankle joint
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Papers by Leonid Solomin
- Anatomic axes
- Mechanical axes
- Joint lines
- Anatomic angles
- Mechanical angles
Each of them defines for frontal and sagittal planes.
- Anatomic axes
- Mechanical axes
- Joint lines
- Anatomic angles
- Mechanical angles
Each of them defines for frontal and sagittal planes.