Abstract
Introduction: Intramedullary nailing is synthesis and consolidation of fracture fragments with the main goalto gain strength and permanent placement of the implants. Two techniques of intramedullary osteosynthesis are used: with dynamic or with static intramedullary nail. Dynamization include conversion of static nail by removing screws from the longest fragment. The aim of this study is to determine whether there is a difference in the speed and quality of healing of the type A and B fractures of the femur and tibia treated by static or dynamic intramedullary nails and to compare the results.Methods: The study was conducted on a total of 129 patients with closed fractures of the diaphysis of the femur and tibia type A and type B. Patients were divided into two groups, based on the applied operating method, static or dynamic intramedullary osteosynthesis.Results: The average number of weeks of healing femoral and tibial fractures was slightly in advantage of static intramedullary osteosynthesis, it was 17.08 weeks (SD=3.382). The average number of weeks of healing in 23 patients with fractures of the femur, treated by dynamic intramedullary osteosynthesis was 17.83 (SD=2.978).Conclusion: We can conclude that static intramedullary nailing osteosynthesis unable movements between fragments which directly stimulates bone formation and formation of minimal callus. Static intramedullary ostesinthesys resolve the problem of stabilizing the fracture, limb shortening and rotation of fragments.
Highlights
Intramedullary nailing is synthesis and consolidation of fracture fragments with the main goal to gain strength and permanent placement of the implants
Patients were divided into two groups, based on the applied operating method, static or dynamic intramedullary osteosynthesis: 1. Patients with fracture of the femur or tibia treated with static method of intramedullary nailing, where the static intramedullary nail fastened cross screws (3 or 4 screws) on both ends, and by that controls the axial and rotation instability and bending (24 patients with femoral fractures and 58 patients with tibial fractures) 2
According to the results of clinical and radiological study conducted by three independent examiners, the average number of healing of fractures of the femur and tibia expressed in the weeks go slightly in advantage of static intramedullary osteosynthesis and it was 17.08 weeks with a standard deviation of 3.382
Summary
Intramedullary nailing is synthesis and consolidation of fracture fragments with the main goal to gain strength and permanent placement of the implants. The aim of this study is to determine whether there is a difference in the speed and quality of healing of the type A and B fractures of the femur and tibia treated by static or dynamic intramedullary nails and to compare the results. The average number of weeks of healing in 23 patients with fractures of the femur, treated by dynamic intramedullary osteosynthesis was 17.83 (SD=2.978). Indication for osteosynthesis with intramedullary nail are fractures of the middle part of the long bones, most of the transverse and short oblique fractures, mostly of femur and tibia. This kind of stabilization has three main advantages : 1. Stability and early function of extremities are achieved by axial (biomechanically optimal) use of implants, in favorable circumstances; the patient will be mobilized almost immediately after surgery
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