ISSN 1028-4427 (Print)

ISSN 2542-131X (Online)

Scientific and practical peer-reviewed medical journal

Founded in 1995 in Kurgan in memory of academician G.A. Ilizarov

Journal founder: National Ilizarov Medical Research Centre for Orthopaedics and Traumatology, Kurgan, Russian Federation

Recommended by the Supreme Attestation Board of Russia: included in the list of leading peer-reviewed scientific journals that publish main scientific results of the theses for scientific degrees of doctor and candidate of medical sciences

The journal is issued quarterly in Russian and English and is distributed in the Russian Federation, CIS countries and other foreign countries.

“Genij Ortopedii” is free for all authors that submit manuscripts.


Letter from the Editor

Russia's «Trama and Orthopaedic Map»

Since 2020, four national medical research centers for traumatology and orthopaedics have been functioning in the Russian Federation. A network of major research specialized institutions with three of them located in Moscow and St.Petersburg cannot embrace the diversity of successful activities of trauma and orthopaedic teams across the boundless land of Russia. Roles and functions of national centres are not supposed to destabilize the service due to priorities in decision-making and attracting new patients from other regions. Essentially, our objectives can be described as tracing a Russia's „trauma and orthopaedic map“ to enable identification of specific interactions displaying the distribution and density of specialists and institutions, and primarily, identification of wilderness areas to focus a particular attention on.

The cold hard facts on traumatic events, prevalence of musculoskeletal disorders, the availability of healthcare recourses and hospital beds per capita fail to reflect current problems at their core including difficulties in nosological entities. In some areas, a pediatric orthopaedic network can ensure perfect provision of care with the apparent absence of trauma care for patients beyond working ages, and vice versa. Hyperdiagnosis is not infrequent for some specific conditions that cannot be properly addressed with local services. Formal characterization of the inconsistensies, the detection of the causes and the consequences are of paramount importance for national medical research centers. Regional non-staff orthopaedic and trauma surgeons-in-chief are aware of the subtle aspects and limitations associated with regional factors and can apply appropriate 'marks' on the map. Pain points can be identified with the help of expertise from national medical research centers that focus on the monitoring of specialized medical assistance.

Unfortunately, there is no generic solution system made available for health care administation. Project-based management most commonly used in public administration can be an option. Each project/program should embrace a group of musculoskeletal diseases/conditions in persons of a certain age, for instance:

– Federal injury prevention and treatment program for individuals beyond working ages;

– Federal program for prevention and treatment of degenerative joint diseases;

– Federal program for prevention and treatment of spine diseases;

– Federal program for in-patient substitution care for isolated injuries to the bone and joints;

– etc.

Every federal project should include generic solution system based on health service delivery area, population density and regional factors. Standards of specialized medical assistance established by the Ministry of Health of the Russian Federation through guidelines and orders on provision of hospital facilities and health service staff are available for specialists of medical institutions but difficult to be maintained without financial and organizational support from regional health authorities. Federal clinical recommendations offer no solution to the problems and provide no base for a comprehensive approach. The scenario necessitates involvement of integrated federal programs that can be employed as a matrix to improve medical care in the regions and decline 'wilderness areas' with greater number of 'roads' and 'oasises' on the 'orthopaedic map'. Integrated federal programs can become the organizational and economic backbone for diagnosis, treatment and prophylaxis of musculoskeletal disorders and ultimately, improve quality of life of population.

A.V. Gubin, MD

Chief Editor of Genij Ortopedii