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Expansion of vein thrombosis and embolism remains a serious problem in traumatology and orthopedics up to the present day. Maintaining the balance between the efficiency of thromboprophylaxis and the danger of post operative hemorrhage can be achieved only when the prevention medication, its dose and the duration of use have been correctly chosen. An anticoagulant of the new generation (Pradaxa), per oral direct thrombin inhibitors dabigatran etexilate to the utmost complies with the above specified requirements that are why the authors decided in favor of its use in everyday clinical practice. A primary test for open use of dabigatran in 48 patients who underwent hip or knee arthroplasty has been carried out. Taking into account the highest risk of thromboembolic complications after large joints plasty, the method of mechanical prophylaxis DVT - electro neurostimulation of shin muscles has been introduced into clinical practice. According to the results of follow-up of the patients, who received different anticoagulants, the algorithm of an anticoagulant’s choice has been developed in various kinds of clinical situations with the possibility of changing injectable preparation to per oral forms. Convenience of per oral administration and predictability of dabigatran effect made it possible to provide consistency of hospital and out-patient stages of treatment, which also contributed to the reduction of thromboembolic complications, especially at an out-patient stage.

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Arthrodesis is one of the methods for treating advanced stages of the ankle joint deforming arthrosis. A distinctive feature of this operation is the variability of bone fragments fixation. There are various options for arthrodesis, but they are mainly divided into internal and external fixation. Moreover, the increasing popularity of arthroscopic arthrodesis technology and ankle arthroplasty developments have opened new possibilities for doctors but have also posed new challenges. Aim. To evaluate treatment options for ankle arthrosis of various etiologies and provide recommendations for clinical improvement. To give a prospective analysis of technology development. Clinical outcomes of arthroplasty, arthrodesis, and arthroscopy were not significantly different. Patients with endoprosthesis had significantly more frequent reoperations. Conclusion. In arthrodesis with the Ilizarov apparatus, there are more advantages due to variability and many modifications, and the scope of internal fixation expands. There is disagreement over the optimal choice of internal fixation for arthrodesis. The choice is determined by factors such as the patient’s condition and the doctor’s preferences. In uncomplicated ankle osteoarthritis, an antegrade intramedullary pin is preferred over a retrograde pin. Ankle joint arthroscopy has technical advantages, and its use in severe joint deformities has become a direction for future research. The results obtained can be applied in the motor rehabilitation of patients after arthrodesis. Arthroscopy and arthrodesis are the most promising for postoperative motor rehabilitation of patients compared to endoprosthetics.

The purpose of the work was to determine the factors responsible for the development of lower extremity deep vein thrombosis (DVT) after total hip arthroplasty in patients with aseptic femoral head necrosis and coxarthrosis. Complex clinical laboratory examination was performed in 56 patients aged 26 - 85 years (mean 59.11±2.42). At hospitalization stage 11 (19.64%) cases of DVT development were recorded. It was stated that more often thrombosis developed on the background of the lower limb veins pathology (varicose great saphenous vein, changes in deep veins after great saphenous vein thrombophlebitis). In group of patients with DVT statistically significantly more often the inflammatory reaction markers (leukocytosis and ESR), thrombocytosis as well as shortened APTT and increased fibrinogen levels. Besides, for DVT patients the more prolonged surgery, more marked blood loss and more often use of cement were typical. Such peculiarities may play a certain role in the development of thrombohemorragic complications after total hip arthroplasty and should be taken into consideration as a risk factor of venous thrombosis development at this type of surgical intervention.