Выбор вида чрескостного остеофиксатора в условиях внешней фиксации при лечении нестабильных переломов лодыжек и их последствий

Abstract

The incidence of distal tibia-fibula fractures is as high as 100–200 cases to 200,000 of the population a year with ankle fractures being the most frequent. The methods of surgical management for these fractures are numerous but transosseous osteosynthesis by G.A. Ilizarov is the most adequate to human physiology. Its modifications (including the use of various kinds of transosseous elements) result in the decrease of the rate of complications typical for this method. This research investigates the stresses emerging in the bone fixed with transosseous fixators and the selection of the preferred positions for their insertions in the management of ankle fractures and their consequences. The study of the contact surface of rods and various kinds of nails with the bone revealed that the contact surface widened and therefore the stress in the osseous tissue decreases depending on the size of the threaded screw portion as well as the number of threads inserted into the bone. The points of insertion should correspond to the widest part of the bone (metaphyseal areas) as it provides a larger contact area of the screw thread with the bone fragment decreasing the probability of its failure and the formation of gaps between bone and crew (aseptic necrosis) that reduce the fixation stiffness within the system of external fixation apparatus.