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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">vmireaviz</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник медицинского института «РЕАВИЗ». Реабилитация, Врач и Здоровье</journal-title><trans-title-group xml:lang="en"><trans-title>Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2226-762X</issn><issn pub-type="epub">2782-1579</issn><publisher><publisher-name>РЕАВИЗ</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.20340/vmi-rvz.2025.6.CLIN.9</article-id><article-id custom-type="elpub" pub-id-type="custom">vmireaviz-1496</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКАЯ МЕДИЦИНА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL MEDICINE</subject></subj-group></article-categories><title-group><article-title>Наш опыт хирургического лечения болезни Фрайберга — Кёлера с применением аллографта из коллагеновой мембраны</article-title><trans-title-group xml:lang="en"><trans-title>Our experience with surgical treatment of Freiberg – Köhler disease using a collagen membrane allograft</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9948-2596</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шахул Хамид</surname><given-names>А. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Shahul Hameed</surname><given-names>A. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шахул Хамид Абдул Баситх. Врач травматолог ортопед, Ставропольский краевой клинический многопрофильный центр г. Ставрополя; соискатель кафедры травматологии и ортопедии</p><p>ул. Миклухо-Маклая, д. 6, г. Москва, 117198</p></bio><bio xml:lang="en"><p>Abdul B. Shahul Hameed. Traumatologist and orthopedist, Stavropol Regional Clinical Multidisciplinary Center; postgraduate student in the Department of Traumatology and Orthopedics</p><p>Miklukho-Maklaya st., 6, Moscow, 117198</p></bio><email xlink:type="simple">dr.basitkh@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1308-2899</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мальчевский</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Mal'chevskiy</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мальчевский Владимир Алексеевич. Д-р мед. наук, профессор РАН, профессор кафедры мобилизационной подготовки здравоохранения и медицины катастроф</p><p>ул. Одесская, д. 54, г. Тюмень, 625023</p></bio><bio xml:lang="en"><p>Vladimir A. Mal'chevskiy. Dr. Sci. (Med.), Professor of the Russian Academy of Sciences, Professor of the Department of Mobilization Preparation of Healthcare and Disaster Medicine</p><p>Odesskaya St., 54, Tyumen, 625023</p></bio><email xlink:type="simple">malchevski@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5656-1005</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Карпович</surname><given-names>Н. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Karpovich</surname><given-names>N. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Карпович Николай Иванович. Канд. мед. наук, доцент кафедры травматологии и ортопедии</p><p>ул. Миклухо-Маклая, д. 6, г. Москва, 117198</p></bio><bio xml:lang="en"><p>Nikolay I. Karpovich. Cand. Sci. (Med.), Associate Professor, Department of Traumatology and Orthopedics</p><p>Miklukho-Maklaya st., 6, Moscow, 117198</p></bio><email xlink:type="simple">karpovich_ni@pfur.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3092-9753</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Призов</surname><given-names>А. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Prizov</surname><given-names>A. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Призов Алексей Петрович. Д-р мед. наук, gрофессор кафедры травматологии и ортопедии</p><p>ул. Миклухо-Маклая, д. 6, г. Москва, 117198</p></bio><bio xml:lang="en"><p>Aleksey P. Prizov. Dr. Sci. (Med.), Professor, Department of Traumatology and Orthopedics</p><p>Miklukho-Maklaya st., 6, Moscow, 117198</p></bio><email xlink:type="simple">aprizov@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-5957-1548</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Агафонов</surname><given-names>Д. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Agafonov</surname><given-names>D. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Агафонов Даниил Германович. Врач травматолог-ортопед, младший научный сотрудник</p><p>Лиговский пр., д. 2-4, г. Санкт-Петербург, 191036</p></bio><bio xml:lang="en"><p>Daniil G. Agafonov. Traumatologist-orthopedist, Junior Researcher</p><p>Ligovsky Prospekt, 2-4, St. Petersburg, 191036</p></bio><email xlink:type="simple">ortho_spot@bk.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3477-172X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Апресян</surname><given-names>В. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Apresyan</surname><given-names>V. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Апресян Владислав Сергеевич. Аспирант кафедры травматологии и ортопедии</p><p>ул. Миклухо-Маклая, д. 6, г. Москва, 117198</p></bio><bio xml:lang="en"><p>Vladislav S. Apresyan, Postgraduate Student, Department of Traumatology and Orthopedics</p><p>Miklukho-Maklaya st., 6, Moscow, 117198</p></bio><email xlink:type="simple">apresyanvlad@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0677-2960</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Григорян</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Grigoryan</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Григорян Арцрун Андраникович. Аспирант кафедры травматологии и ортопедии</p><p>ул. Миклухо-Маклая, д. 6, г. Москва, 117198</p></bio><bio xml:lang="en"><p>Artsrun A. Grigoryan, Postgraduate Student, Department of Traumatology and Orthopedics</p><p>Miklukho-Maklaya st., 6, Moscow, 117198</p></bio><email xlink:type="simple">Artsrun3204@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Российский университет дружбы народов имени Патриса Лумумбы</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Patrice Lumumba Peoples' Friendship University of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Тюменский Государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Tyumen State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Санкт-Петербургский научно-исследовательский институт фтизиопульмонологии</institution><country>Россия</country></aff><aff xml:lang="en"><institution>St. Petersburg Research Institute of Phthisiopulmonology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>10</day><month>03</month><year>2026</year></pub-date><volume>15</volume><issue>6</issue><fpage>90</fpage><lpage>96</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Шахул Хамид А.Б., Мальчевский В.А., Карпович Н.И., Призов А.П., Агафонов Д.Г., Апресян В.С., Григорян А.А., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Шахул Хамид А.Б., Мальчевский В.А., Карпович Н.И., Призов А.П., Агафонов Д.Г., Апресян В.С., Григорян А.А.</copyright-holder><copyright-holder xml:lang="en">Shahul Hameed A.B., Mal'chevskiy V.A., Karpovich N.I., Prizov A.P., Agafonov D.G., Apresyan V.S., Grigoryan A.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://vestnik.reaviz.ru/jour/article/view/1496">https://vestnik.reaviz.ru/jour/article/view/1496</self-uri><abstract><sec><title>Введение</title><p>Введение. Болезнь Фрайберга – Кёлера представляет собой редкую форму остеохондропатии головки второй плюсневой кости, характеризующуюся аваскулярным некрозом, разрушением суставной поверхности и развитием вторичного артроза. Заболевание преимущественно поражает женщин в подростковом и молодом взрослом возрасте, сопровождаясь выраженным болевым синдромом, ограничением подвижности и деформацией стопы. Однако даже при ранней диагностике консервативное лечение часто оказывается недостаточным для предотвращения прогрессирования патологического процесса, что приводит к необходимости хирургического вмешательства.</p></sec><sec><title>Цель работы</title><p> Цель работы: оценить эффективность применения коллагеновой мембраны Chondro-Scaffold при хирургическом лечении болезни Фрайберга – Кёлера.</p></sec><sec><title>Объект и методы</title><p>Объект и методы. На основании ретроспективного анализа клинических данных 28 пациентов проведена оценка эффективности методики, включающей укороченную остеотомию и имплантацию коллагеновой мембраны Chondro-Scaffold с использованием функциональных (AOFAS и VAS) и рентгенологических показателей. Послеоперационное наблюдение проводилось через 3, 6 и 12 месяцев.</p></sec><sec><title>Результаты</title><p>Результаты. Использование коллагеновой мембраны Chondro–Scaffold приводит к значительному улучшению функциональных параметров стопы, что подтверждается увеличением балла по шкале AOFAS с 46,2 до 89,5 и уменьшением болевого синдрома с 7,6 до 1,5 по шкале VAS.</p></sec><sec><title>Заключение</title><p>Заключение. Применение коллагеновой мембраны Chondro-Scaffold является перспективным направлением в хирургическом лечении болезни Фрайберга – Кёлера, позволяющим улучшить клиникофункциональные показатели и повысить качество жизни пациентов. Для оценки долгосрочной эффективности необходимы дальнейшие исследования.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. Freiberg–Köhler disease is a rare form of osteochondropathy of the second metatarsal head characterized by avascular necrosis, destruction of the articular surface, and secondary osteoarthritis. The disease predominantly affects adolescent and young adult females and is accompanied by severe pain, limited mobility, and foot deformity. Even with early diagnosis, conservative treatment is often insufficient to prevent disease progression, making surgical intervention necessary.</p></sec><sec><title>Aim</title><p>Aim: To evaluate the effectiveness of the collagen membrane Chondro-Scaffold in the surgical treatment of Freiberg–Köhler disease.</p></sec><sec><title>Object and methods</title><p>Object and methods. A retrospective analysis of clinical data from 28 patients was performed to assess the effectiveness of a technique combining shortening osteotomy and implantation of the Chondro-Scaffold collagen membrane using functional (AOFAS and VAS) and radiographic parameters. Postoperative follow-up was carried out at 3, 6, and 12 months.</p></sec><sec><title>Results</title><p>Results. The use of the Chondro-Scaffold collagen membrane resulted in a significant improvement in foot function, as demonstrated by an increase in the AOFAS score from 46.2 to 89.5 and a decrease in pain intensity from 7.6 to 1.5 according to the VAS scale.</p></sec><sec><title>Conclusion</title><p>Conclusion. The use of the Chondro-Scaffold collagen membrane is a promising approach in the surgical treatment of Freiberg–Köhler disease, leading to improved clinical and functional outcomes and enhanced patient quality of life. Further studies are required to evaluate long-term effectiveness. </p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>болезнь Фрайберга – Кёлера [D010007 (Osteochondritis)]</kwd><kwd>аваскулярный некроз [D010020 (Osteonecrosis)]</kwd><kwd>коллагеновая мембрана [D024043 (Biocompatible Materials)]</kwd><kwd>регенерация хрящевой ткани [D012038 (Regeneration)]</kwd><kwd>хирургическое лечение [D013514 (Surgical Proce [Dures</kwd><kwd>Operative)]</kwd><kwd>остеохондропатия [D010007 (Osteochon[Dritis)]</kwd><kwd>плюсневая кость [D008682 (Metatarsal Bones)]</kwd><kwd>биоматериалы [D024043 (Biocompatible Materials)]</kwd><kwd>остеотомия [D010027]</kwd><kwd>регенеративная медицина [D044968]</kwd></kwd-group><kwd-group xml:lang="en"><kwd>freiberg disease [D010007 (Osteochondritis)]</kwd><kwd>avascular necrosis [D010020 (Osteonecrosis)]</kwd><kwd>collagen membrane [D024043 (Biocompatible Materials)]</kwd><kwd>cartilage regeneration [D012038 (Regeneration)]</kwd><kwd>surgical treatment [D013514 (Surgical Proce [Dures</kwd><kwd>Operative)]</kwd><kwd>osteochondropathy [D010007 (Osteochon[Dritis)]</kwd><kwd>metatarsal bone [D008682 (Metatarsal Bones)]</kwd><kwd>biomaterials [D024043 (Biocompatible Materials)]</kwd><kwd>osteotomy [D010027]</kwd><kwd>regenerative medicine [D044968]</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Авторы благодарят кафедру травматологии и ортопедии Российского университета дружбы народов имени Патриса Лумумбы за предоставленные инструменты.</funding-statement><funding-statement xml:lang="en">The authors thank the Department of Traumatology and Orthopedics at the Patrice Lumumba Peoples' Friendship University of Russia for providing the instruments.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Гуди С.М., Лучшев М.Д., Кузнецов В.В. и др. 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