Department of Traumatology and Orthopedics of Belarusian State Institute for Advanced Medical Training was founded in October, 1953, as a part of USSR medical services rendered to patients with disorders and diseases of musculoskeletal system, training of highly qualified specialists and development of scientific researches in the field of traumatology and orthopedics.
Within 25 years, the department had been headed by V.O.Marks, Doctor of Medical Sciences, Honored Scientist of BSSR, who was invited from Kharkov Scientific and Research Institute for Traumatology and Orthopedics. V.O.Marks derived progressive and actual approaches and ideas of that time. So he started to implement progressive functional treatment of bone fractures and orthopedic diseases into practice in Belarus.
The issues of intra-articular injuries and diseases and hip congenital dislocation were of great attention at the department. V.O.Marks offered and implemented the method of diagnostics and treatment of congenital dislocation of the hip in newborns into the practice, developed clinical diagnostics of dislocated fractures of elbow joint, studied mechanical origin, clinics and diagnostics of vessel and nervous complications at fractures, he offered some diagnostic maneuvers, which came into the world and national medical science as "Marks symptom", "Marks bow". His monograph "Orthopedic patient work-up", published in 1956, was taken as the main educational guidance in all educational establishments of higher medical education of the former USSR. The monograph "Healing of bone closed fracture" (1962) played a very important role. The book "Orthopedic diagnostics" (1978) contributed greatly into science, which is considered to be the best one among national guidances on orthopedics and traumatology.
Under the supervision of V.O. Marks, more than 1000 traumatologists, many clinical residents had been trained.
Since 1978, professor A.V.Rutsky, Doctor of Medical Sciences, academician of the National Academy of Sciences of the Republic of Belarus, laureate of state prize, Honored Scientist of the Republic of Belarus, headed the department. Under his supervision a range of scientific interests was greatly expanded, scientific researches had being studied as before.
Works written by A.V.Rutsky are of great importance for medical science and healthcare practice. They cover the issues of operative treatment of musculoskeletal system injuries of different localizations. In his works, A.V.Rutsky offered the following: methods of three-flange nailing at subcapital fractures, treatment of comminuted fractures of spoke bone distal direction, bone autoplasty at medial fractures of femoral neck. His researches on peculiarities of severe and complicated fractures contributed greatly to the medical science. They helped to improve the results of treatment of elbow area fractures in children. In 1975, Doctoral thesis on this issue was defended.
Having a longstanding clinical experience and excellent skills in rendering medical care while treating fractures, in 1970, A.V.Rutsky published a monograph - "Prolonged tractions in traumatology and orthopedics", and the monograph "Injuries of magistral blood vessels" (1985), which has been actual until the present time. A.V.Rutsky is a co-author of the following books: "Teratology of Man" (1979,1991), "Pediatric Neurology" (1990), "Neuro-orthopedic and orthopedic-neurological syndromes in children and teenagers" (1998), "Encyclopedia for pediatric neurologists" (1993).
In 1987, A.V.Rutsky together with A.N.Mikhailov published "X-ray Diagnostic Atlas" in 2 volumes, which filled an essential gap in national medicine literature. It gained general recognition and huge public attention.
Under the supervision of A.V.Rutsky, an original hip joint endoprothesis had been worked out and had been created, which got the Certificate of European Standards. Mass production of it had been set.
Researches of tissual blood flow and metabolic processes open new perspectives in diagnostics and treatment of injuries and bone and joint diseases. Such researches helped to work out the criteria of evaluation of mineral metabolism conditions in bones of false joints or ununited fracture, indications for osteoplastic biostimulating operations. V.A.Grib, V.I.Medvedev, I.I.Harkovich, O.P.Kezlya, Abdula Ali Asbahi, V.A. Yarmolovich defended Candidate's theses on these issues.
Other actual fields of traumatology and orthopedics have been being developed. The following Candidate's theses have been protected: "Comparative evaluation of primary autoplasty and suture of finger flexor chorda in "critical area" (1987) by A.A.Lerner; "Injuries of knee joint meniscus (arthroscopic diagnostics and risk factors of pathology changes)" (1999) by A.P.Maslov; "New technologies in the treatment of traumatic defects of soft tissues with the usage of drug dosage forms on the basis of hydrogel" (2008) by A.N.Benko. The following Doctoral theses have been protected: "Organizational and tactical aspects of microsurgery replantation of joints and their segments" (1997) by V.N.Podgaisky, "Diabetic foot (pathogenesis, clinics and treatment)" (199 9) by N.N.Tchur.
In the 80th-90th-s, based on the research findings, totally 18 Doctoral and Candidate's theses had been protected, 420 scientific works had been published, including 12 monographs, 10 invention patents had been received.
Both treatment and pedagogical activities have been an important part of the department's work.
The first clinical base was Surgery Division at Minsk Railway Hospital. In 1954, at Minsk Regional Clinical Hospital there were 4 patient's rooms (30 beds) belonged to the department, in 1955 the department had an autonomous Traumatology Division on the same base.
From 1958 to 1961, A.V.Rutsky was head and a teacher at the department, Y.F.Fraifeld worked as an Associate Professor, I.P.Pesliak worked as an assistant. Hereafter, the Division was expanded to 60 beds, and since 1971, the department had moved to the Republican Clinical Hospital, to Orthopedic and Traumatology Division of adults and children, situated in Lesnoy village. In 2 years, the Third Division for recovering trauma patients (60 beds) was opened, which in 1985 was converted into the Division of Complicated Trauma. Today treatment and academic activities have been carrying out on the bases of these divisions.
In the 60-70 -ties the pedagogical staff of the department was represented by the following teachers: professor V.O.Marks, associate professors I.P.Pesliak, A.V.Rutsky, V.G.Beletsky, assistants R.R.Makarevich, V.A.Grib, I.I.Harkovich.
The first training course was run in 1954, which was completed by 9 physicians. In the following years, the department run 3- and 4-months training courses in traumatology and orthopedics, other advanced training courses for traumatologists and general surgeons, which covered the issues of diagnostics and treatment of orthopedic and traumatology diseases.
In the late 90s, the department was represented by the following staff: professor, Candidate of Medical Sciences, A.V.Rutsky, Associate Professors V.A.Grib, I.I.Harkovich, O.P.Kezlya, R.V.Makarevich, assistants A.P.Maslov, V.A.Yarmolovich. Since 2004 A.N.Benko, an assistant, Candidate of Medical Sciences, has been working at the department. L.A.Bondar, an excellent professional of plaster technique, had been working at the department for more than 40 years. Since March, 2004, the Department has been headed by O.P.Kezlya, an Associate Professor, Doctor of Medical Sciences.
In 2013, the department had its 60th Anniversary.
Clinical work
Main fields of the clinical work are the following ones:
Endoprosthesis of large joints (hip, knee, ankle, shoulder, elbow). Endoprosthesis is carried out with the help of domestically produced constructions ("ALTIMED") and the foreign-made ones (W.LINK, STRYKER, De Puy). The following methods are widely applied at the clinic: method of minimally invasive endoprosthesis of hip joint with femoral neck-sparing, implantation of endoprostheses with short femoral component (proximal fixation) with bearings ceramics-ceramics, and also ceramics-cross-link polyethylen. Staff of the department has implemented and has been applying minimally invasive surgical access to the hip joint for endoprosthesis. Most advanced knee joint endoprostheses with mobile polyethylene liner are widely being applied. Knee joint endoprostheses, partially or totally stabilized (linked or rotational), are applied while treating severe knee joint deformations.
Reconstructive surgery of large joints
Correcting pelvis osteotomies and osteotomies of cephalic end of hip in patients with dysplastic coxarthrosis, avascular necrosis of head of femur are widely carried out.
Minimally invasive correcting osteotomies of shin bone cephalic end in patients with knee joint deforming arthrosis have been implemented into clinical practice.
These operations are considered to be organ-preserving ones, which help to stop arthrosis progression and avoid joint endoprosthesis.
Arthroscopy of large bones joints (coxofemoral, knee, ankle, shoulder, elbow).
Correction of inborn and acquired deformations of bones and joints (elongation of limbs, limb redressment) with the application of external fixation devices.
Osteosynthesis of bone limb fractures. Either "traditional" (open) external fixation with the help of a plate or minimally invasive skeletal fixation (external, internal and out-local) is applied in clinical practice. The last one helps to maximally retain blood supply of fractured fragments, refuse from external immobilization, start an early rehabilitation, get an excellent cosmetic result. While applying minimally invasive methods, site of fracture can't be opened, incision is made far from the fracture area, its closed reduction and fixation are done by modern extramedullary or intrabone hardware, which are injected from small discission far from the fracture.
Operative and conservative treatment of pelvis injuries
Treatment of patients with multitrauma and polytrauma
Treatment of complications after musculoskeletal system traumas (nonunions, false joints, acute and chronic infection)
Organ-retaining operations in patients with bone cancer
Organ-retaining operations at benign tumors and tumour-like bone diseases
Operative and conservative treatment of traumas in children and teenagers
Operative and conservative treatment of bone diseases and joint diseases in children and teenagers
Scientific and research work
Based on the research findings, totally, in the 80-90s, 18 Doctoral and Candidate's theses were protected, 420 scientific works were published, including 12 monographs, 10 invention patents were received.
Clinical and pedagogical works are of great importance at the Department.
Teaching and guiding work
Since the time of the department's existence many physicians have undergone training there: more than 5000 physicians, about 120 clinical residents, who work as head of divisions, traumatologists. The department prepares specialists in the field of traumatology and orthopedics from foreign countries - Iran, Morocco, Syria, the Republic of Yemen, Lebanon etc.
Clinical base of the department is Minsk Regional Clinical Hospital. The clinics of traumatology and orthopedics of BelMAPE is situated on the basis of three departments: 1 and 2 orthopedic and traumatology divisions of complicated trauma for 160 beds. The clinic is equipped with modern devices.
The department has a special classroom for practical classes on new technologies of endoprothesis and osteosynthesis. Master-classes are run on artificial bones.
Topics of advanced training courses are closely connected with dynamically developing needs of practical healthcare.
Main advanced training courses
- Traumatology and Orthopedics/for traumatologists, surgeons with the work experience up to 3 years
- Compressive-distraction osteosynthesis in traumatology and orthopedics/ for traumatologists with work experience from 3 to 10 years
- Treatment of infra-articular and juxta-articular fractures/ for traumatologists
- Osteosynthesis in traumatology and orthopedics/for traumatologists
- Endoprosthesis of large joints/for traumatologists
- Diseases and injuries in children/ for traumatologists
The department carries out training for the following specialists: traumatologists working in-patient clinics and out-patient clinics, surgeons, oncologist-orthopedists, neurosurgeons, teachers of medical Universities etc.
Main forms of classes: practical classes, lectures, seminars. The department has a special classroom for osteosynthesis, endoprosthesis, arthroscopy, where learners master new methods of operative treatment of musculoskeletal system pathology. The learners study from rounds, clinical discussions, consultations. A special attention is paid to minimally invasive methods of osteosynthesis during the classes in the operating room.
Staff of the department carries out follows-up of patients, consultations in outpatient clinic, planned and emergency call-outs to district centers of Minsk region.
Teaching staff of the department carries out consultations at Professor's State Medical Advisory Centre of BelMAPE.
International cooperation
Within the last 5 years the department prepared 26 clinical residents and 53 doctors from Georgia, Libya, Lebanon, Palestine, India, Iran, Yemen.
Two specialists from the staff are existing members of SICOT (World Organization of Traumatologists and Orthopedists). Annually, staff of the department participates in SICOT congresses and EFORT congresses (European Association of Traumatologists and Orthopedists) as lecturers.
Within the last 5 years specialists of the department have undergone training on the basis of orthopedic clinics in Frankfurt on the Main (Germany), Clinic named after V.Degi (Poznan, Poland), Clinic of Paracelsus (Salzburg, Austria).
The department collaborates with specialists from Poznan Medical University, Military Medical Academy (Saint-Petesburg), Scientific and Research Institute named after Vreden (Saint-Petersburg), Russian Central Institute of Traumatology and Orthopedics (Moscow).
In the frameworks of international project LinkAdemy specialists of the department (associate professor A.N. Benko) were invited as surgeon-instructors to show master-classes and present the surgeon's show case on the primary, revisory and unicondylar endoprothesis of knee joint at university clinics of Bucharest (Romania ), Sofia (Bulgaria), Budapest (Hungary).
