Method Of Osteosynthesis Research Articles

Comparison of standard miniplates and locked miniplates in post-traumatic fracture stabilization.

Bicortical screws (lag and positional) or miniplates with monocortical screws are generally used for the rigid fixa-tion of the sagittal split ramus osteotomy (SSRO) in maxillofacial surgery. However, in this osteosynthesis method, the plate must be perfectly adapted to the bone to prevent misalignment of the bone segment and occlusal changes. In addition, it is necessary to prevent the position of the condyle in the mandibular fossa from changing after fixation. In recent years, locked miniplate systems have been used to overcome these complications. The aim of this study is to compare the commonly used 2.0 mm standard miniplate/screw systems and 2.0 mm locking miniplate/screw systems in fresh sheep jaws with Obwegeser-Dal Pont (OD) and Hunsuck-Epker (HE) modifications, by evaluating standard parameters. Our study consists of two main groups and two subgroups. 40 sheep hemimandibulae were randomly divided into two main groups. Each group was randomly divided into two subgroups. There are ten hemimandibulae (n=10) in each subgroup. Linear force test was applied using 4-hole standard miniplate and 4-hole locking miniplate systems on sheep jaws with 5 mm advancement by applying OD and HE techniques, which are two frequently preferred modifications in SSRO. For statistical analysis SPSS® 16.0 (Sta-tistical Package for the Social Sciences, SPSS Inc. Chicago, Illinois, USA) package program was used. It was statistically compared with the 95% confidence interval using the Pearson coefficient, and p<0.05 was interpreted as significant. The values of the loading forces applied to the samples in the groups were subjected to analysis of variance (ANOVA) to confirm the normality of the sample. Multiple comparisons were made between groups using the Tukey test. The mean loadings in the groups were analyzed by one-way ANOVA. In general, as the strength of the force increases, the displacement values increase in all groups, but although it was observed that the locked miniplate/screw system was more stable than the standard miniplate/screw system, no statistically significant difference was found.

An integrated approach for early recovery of function in patients after fractures of the humerus in its proximal section

Creation of a complex highly effective system for the treatment of PH fractures, which includes a minimally invasive method of surgical treatment using the method of cephalomedullary osteosynthesis with direct locking pins and a highly specialized program of rehabilitation measures using a biofeedback (BFB) device, which will reduce the duration of treatment and improve the results of functional recovery injured limb. The results of treatment of 214 patients with fractures of the proximal humerus were analyzed. Of these, in 122 (57%) patients (the main group) osteosynthesis was used with a direct cephalomedullary fixator with the possibility of blocking the screws in the nail in different planes. The comparison group included 92 (43.0%) patients treated using other surgical techniques. Rehabilitation measures were started in the early postoperative period (from the 2nd day) in both groups and included a complex of physiotherapeutic treatment, physical exercises in different modes, in addition in the main group of the study, training was performed using a device with biofeedback. It is shown that the used treatment approach allows to increase the frequency of achieving good and excellent (52.4% in the main group and 27.2% in the comparison group) results and reduce the frequency of unsatisfactory results of treatment (9.8% in the main group and 21.7% in the comparison group) on the Constant score. The data obtained prove the high efficiency of the developed complex method for the treatment of proximal humerus fractures and restoration of the function of the upper limb.

Postoperative outcomes in patients with closed patellar fractures

To improve postoperative outcomes in patients with closed patellar fractures using a new method of surgical treatment. The authors proposed a new method of patellar osteosynthesis. Technique of osteosynthesis is described, and surgical scheme is presented. Treatment outcomes were analyzed in 68 patients with closed patellar fractures. The control group consisted of 34 patients who underwent Weber osteosynthesis. The authors assessed clinical and radiological data. Moreover, clinical example of a patient with traumatic closed patellar fracture and illustrations of surgical treatment are presented. Clinical data indicate the advantage of treatment in the main group.

Травматические и ятрогенные повреждения лучевого нерва при переломах диафиза плечевой кости

Damages to the radial nerve in diaphyseal fractures of the humerus, both primary and iatrogenic, are frequent and severe complications, accompanied by a long-term persistence of neurological deficit. The lecture discusses the issues of diagnosis, tactics of surgical treatment, pathogenetic treatment of the radial nerve traumatic neuropathy, and indications for revision. The main method of instrumental diagnosis of peripheral nerve injuries is ultrasound, which has a high diagnostic value in relation to the pathology under study. When choosing the method of osteosynthesis of a complicated fracture of the humerus, preference should be given to a closed pin osteosynthesis as a safer and less traumatic method. Revision of the radial nerve is indicated when a rupture is detected, with an unfavorable interposition with bone fragments and an implant.

Новые возможности накостного остеосинтеза при оскольчатых переломах проксимального отдела плечевой кости у пациентов с остеопорозом

The purpose — to conduct a comparative analysis of the results of surgical treatment of patients with bifocal and polyfocal fractures of the proximal humerus on the background of osteoporosis. Material and methods. In 2017–2020, 96 patients with fractures of the proximal humerus aged 55 to 88 years (average age 64 ± 2.3 years) were operated on in Vladivostok Clinical Hospital No. 2. The main group included 77 patients, the control group included 19 patients who underwent internal osteosynthesis according to the authors’ technique: interfragmental compression combined with fixation with a lockable plate. Results. The best results of the reposition were achieved in cases of earlier surgical intervention in both groups of patients. Complications (33.3%) were noted in the main group, including aseptic necrosis of the shoulder head and non-fusion of fractures. There were no similar complications in the control group. A significant difference in functional results in the studied groups of patients is explained by a number of reasons. Compression stable osteosynthesis allowed most patients to begin early active rehabilitation. Conclusion. Predictors of complications in the surgical treatment of patients with fractures of the proximal shoulder are the bone density, the choice of a fixator and the method of osteosynthesis.When evaluating the results of treatment in the main group of patients, a clear advantage of the developed method of osteosynthesis is shown in comparison with the standard use of a PHILOS-type lockable plate.

Оsteosynthesis for compound distal femur fractures with medial instability: сomparative analysis of conventional and innovative minimally invasive techniques

Compound fractures of distal femurfrequently lack me-dial stability, which can lead to failure of traditional plate fixation via lateral surgical approach. Aim of the study.To evaluate efficiency (mid-term functional results) of minimally invasive double plate osteosynthesis in cases of compound distal femoral fractures with medial insta-bility in comparison with conventional osteosynthesis technique. Materials and methods. 40 patients were included in three-site study. 20 patients with compound distal femoral fractures (1st group) underwent minimally invasive double plate osteosynthesis with prospective analysis of functional outcomes 6, 9, and 12 months af-ter surgery. Another 20 patients with similar fractures (2nd group) underwent conventional osteosynthesis with single lateral plate with retrospective evaluation of long-term functional outcomes of the treatment at 18 to 48 months after surgery. Clinical analysis of functional results in both groups was performed using KSS and Ly-sholm scales, anatomical results were evaluated by com-parison of valgus deformity degree of progression with control x-rays. Comparative analysis of the outcomes of surgical treatment in both clinical groups was performed using statistical tests for evaluating normal distribution and non-parametric tests for statistical hypothesis test-ing. Results. Statistically significant (p&lt;0.01) increase of KSS and Lysholm scales was registered in patients of the first group throughout the duration of the study. The number of good and excellent outcomes according to KSS scale in patients of the first group was 90%, and 85% in patients of the second group. The number of good and excellent outcomes according to Lysholm scale was 70% in both groups. The degree of valgus deformity pro-gression was significantly lower in 1st group of patients, including patients with 33-C3 type of fractures. Data cap-tured indicate effectiveness of suggested osteosynthesis method

Clinical variant of the method of osteosynthesis of the neck of the humerus against the background of osteoporosis

The article presents an observation of the successful treatment of a patient with a fracture of the surgical neck of the right humerus against the background of osteoporotic lesions of the bone skeleton. This patient was initially underwent osteosynthesis with a titanium T-plate and screws, however, 2 weeks later, the metal structure migrated and the cancellous substance of the humerus head was severely destroyed, which made it difficult to carry out repeated resynthesis. We have proposed and tested a new method of osteosynthesis of fractures of the surgical neck of the shoulder using a titanium plate and a cerclage loop. The presented clinical observation demonstrates the feasibility of performing osteosynthesis according to our proposed method in patients with severe osteoporosis, when other methods of osteosynthesis are ineffective, and endoprosthetics of the humerus head is unavailable due to the burdened somatic status of the patient and the inaccessibility of this operation in small hospitals in the country.

МЕТОДЫ ФИКСАЦИИ КОСТНЫХ ОТЛОМКОВ ПРИ ПЕРЕЛОМАХ НИЖНЕЙ ЧЕЛЮСТИ

Thing. A review of the literature devoted to the topical problem of maxillofacial surgery and surgical dentistry – methods of treating patients with mandibular fractures was carried out.&#x0D; The aim of the study is to review the materials of publications on the methods of treatment of patients with mandibular fractures.&#x0D; Methodology. The publications of domestic and foreign authors, considering methods of fixation of bone fragments in lower jaw fractures, have been studied.&#x0D; Results. Publications indicate that there are many treatments for mandibular fractures. Research results demonstrate the importance of bone stabilization for bone fusion. A common disadvantage of conservative and surgical methods of treatment is unstable fixation of bone fragments, which is the most common cause of delayed consolidation of a mandibular fracture. The presented studies show that bone osteosynthesis with metal plates is considered the most appropriate method for treating mandibular fractures.&#x0D; Conclusions. Splinting as a method of treating fractures of the lower jaw has a large number of disadvantages. A common disadvantage of methods for splinting the lower jaw is that these structures do not always provide anatomical reduction and stability for the entire period of consolidation or require mandatory intermaxillary fixation, the lower jaw is fixed in the central occlusion position, which is not a position of physiological rest, and leads to passive muscle tension. depriving them of active function.&#x0D; The main disadvantage of the methods of osteosynthesis using a suture and using wires is that it is difficult to achieve stable fixation of fragments using these techniques.&#x0D; Combined methods of fixation of bone fragments (use of a bone suture and dental splints) provide a stronger fixation of the fragments.&#x0D; In the past two decades, in the treatment of mandibular fractures, there has been an increase in the trend towards rigid or semi-rigid osteosynthesis using plates.&#x0D; The disadvantages of compression osteosynthesis is that significant compression can lead to ischemia and slow down the formation of callus.&#x0D; A common disadvantage of conservative and surgical methods of treatment is unstable fixation of bone fragments, which is the most common reason for their delayed consolidation.&#x0D; Bone osteosynthesis with metal plates is considered a more progressive method of treating mandibular fractures.

The use of the combined stable-elastic fixation for unstable injuries of the ankle joint in trans-syndesmotic fractures of the tibia

The problem of complications and the frequency of poor outcomes in the surgical treatment of ankle fractures with ti-biofibular syndesmosis (TFS) rupture (4.8–36.8 % of cases) remains significant. It was interesting from a scientific and practical point of view to conduct a clinical study to determine the effectiveness of the newly developed method of metal osteosynthesis for tibial fractures with TFS rupture, which would combine stability of tibial fixation and not limit the elastic qualities of TFS. The aim of the study: to determine the effectiveness of combined stable-elastic fixation for unstable injuries of the ankle joint in trans-syndesmotic fractures of the tibia. Materials and methods. On the basis of own clinical researches and data of literature sources, the method of the combined stable-elastic fixation for unstable injuries of the ankle joint in trans-syndesmotic fractures of the tibia is developed. The effectiveness of the proposed technique was evaluated 6 months after surgery on the Kitaoka scale. We have examined 12 patients with tibial fractures type 44 B1, B2 and B3 according to the AO classification, who underwent surgery using our methods. Results. The high efficiency of using the technique of combined stable-elastic fixation for unstable injuries of the ankle joint due to trans-syndesmotic fractures of the tibia has been determined. Good and excellent treatment results 6 months after surgery were observed in all 12 people (100 %), with excellent outcomes observed in 75 % of cases. There were no satisfactory and unsatisfactory treatment results. Conclusions. The study proves the high efficiency of the proposed method for combined stable-elastic fixation of ankle injuries in unstable trans-syndesmotic fractures of the tibia with TFS damage. There were 75 % excellent and 25 % good results within 6 months after surgery. A wider introduction of this technique into the practice of traumatologists of Ukraine is proposed.

Концептуальное моделирование репаративной регенерации при оперативном лечении диафизарных переломов

Проведено концептуальное моделирование репаративной регенерации при оперативном лечении диафизарных переломов. Использован системный анализ дооперационных, операционных и послеоперационных факторов влияния на репаративную регенерацию. Перед планированием оперативного вмешательства и выбором метода остеосинтеза и фиксатора должен проводиться системный анализ факторов влияния на репаративную регенерацию, в соответствии с характером перелома. После стабилизации невправленных фрагментов создаются условия для развития псевдоартроза. Достаточно часто процесс осложняется плохой васкуляризацией участков кости либо сдавливанием серкляжами. Анализ факторов влияния на репаративную регенерацию при оперативном лечении переломов имеет большое значение в предвидении их возможных расстройств и осложнений. Концептуальное моделирование репаративной регенерации расширяет понимание биологии процесса сращения отломков.

Application of Biological Glue in Orthopedics and Traumatology

The purpose of the study was to investigate the method of osteosynthesis using glues. Materials and methods. The simplest and most effective method in the treatment of traumatological patients is a plaster fixing bandage of different variations. This is a conservative type of treatment. Also, a very common method in the treatment of orthopedic and traumatological patients is the surgical method. Modern high-tech methods of osteosynthesis require a thorough preoperative examination of the patient, conducting a 3D tomographic examination for intra-articular fractures, clear planning of the course of surgical intervention, electro optical probing techniques during the operation, the availability of tool kits for installing retainers, the ability to choose a retainer intraoperative in the size range. An orthopedic-traumatologist and the entire operating team need appropriate training. All operational fixation methods must provide adequate stability to maintain axis length and rotation. Results and discussion. In the world practice, biological glues are used in such areas as abdominal surgery, neuro- and cardiac surgery, plastic and pediatric surgery, orthopedics and traumatology. Cyanocrylate glues have undergone extensive experimental clinical testing. Positive characteristics of cyanoacrylate glues are the ability to glue living tissues in a humid environment, polymerization rate, autosterility, bactericidal, absence of histotoxicity, hemostatic effect. Another glue in the review is sulfacrylate. It can be used in patients of any age, starting from newborns, regardless of the pathogenesis of the disease. Venaseal glue, used by many authors to treat fistulas of the gastrointestinal tract. Widely used fibrin glues, such as Evicel, are used to achieve hemostasis and sealing in surgery, for example, in vascular operations, kidney resection and neurosurgical interventions, in the surgical treatment of distal hypospadias in children. BioGlue glue is designed to seal surgical sutures, thereby preventing fluids (exudate, lymph, urine, gastric juice) and / or air from leaking through them. It is also used in liver surgery. At the moment, the use of bone cement is the most common auxiliary method for surgical interventions. But its side effects are very clear. Bone cement can cause the patient to die on the operating table or, in the postoperative period, in intensive care. This is due to an immediate or rapid allergic reaction. This situation is dangerous for humans. Biological glues are not so toxic and do not cause such allergic reactions Conclusion. The search for new materials and techniques for consolidating bone fragments is one of the most important problems of modern medical science, namely orthopedics and traumatology. Substances that are included in the biological glue must be bioinert, contain elements of strength (for holding fragments), looseness of the structure (for germination of capillaries between fragments), natural antibiotic (for antibiotic prevention), activators of hematopoiesis processes (for the fastest callus), organic and inorganic substances (for the building material of bone tissue). Therefore, the desire to improve treatment and improve its results, in particular in orthopedics and traumatology, is the key to the development of modern medicine

Functional state of the brain bioelectric activity in treatment of diaphyseal lesions of the radius using the transosseous osteosynthesis of the wire and rod arrangement

Radial fracture is the most common trauma to the musculoskeletal system and accounts for 50 % of traumatic injuries to the bones of the upper limb. Disability in patients with fractures of the forearm bones ranges from 6 to 8 months, so the choice of the most effective method of treatment is very relevant. Currently, an important point is the tendency of optimizing the transosseous method by eliminating the disadvantages and looking for new advantages of external fixation. Bone fracture and associated surgical intervention are always accompanied by varying degrees of changes in the links of the central nervous system, hemodynamics and metabolism. In order to study the bioelectrical activity of the brain in 47 patients with a fracture of the radial diaphysis treated in the Traumatology Department of the Irkutsk Scientific Centre of Surgery and Traumatology, in the pre- and postoperative period we compared EEG indicators of two variants of the layout of the external fixation apparatus (EF): wire and rod. Analysis of the rhythms of bioelectrical activity of the brain in both groups in the preoperative period revealed a normal zonal distribution with the dominance of the alpha rhythm on the EEG, which generally reflects a rather high degree of organization of neuroactivity and indicates the stability of cerebral homeostasis. At the same time, in the group of patients with a wire-mounted EF device in the postoperative period, EEG indices significantly differed from the values of the norm and ndicators in the group with a rod-shaped arrangement. A decrease in the amplitude of alpha and beta rhythms was noted, as well as a shift in the frequency of bioelectric activity towards slow waves, which is a sign characteristic of discirculatory encephalopathy. An EEG study using the method of transosseous osteosynthesis with EF devise of a rod assembly showed its greater efficiency compared to the use of an EF device of a wire assembly during treatment and rehabilitation. Thus, the study of the bioelectric activity of the brain is a reliable method for assessing its functional state after an injury, as well as the effectiveness of the treatment.

Остеосинтез у разі переломів шийки та вертлюгової зони стегнової кістки в дітей

Proximal femur fractures are uncommon injuries in children, accounting for less than 1 % of all fractures per year, but usually result in hospitalization and are at risk of complications. We have designed a device for bone fragments fixation in the case of proximal femur fractures and the method of its application in adults. The device consists of rods that are screwed into the cap of the head, the diaphyseal part and the module, which is located in the subtrochanter area. The rods can be connected to the module at any angle in the frontal plane. The device provides a certain stage of installation of the elements, which allows you to effectively place it with minimal bone destruction. Objective. Share your own experience in the treatment of femoral neck and proximal femur fractures in children. Material. The experience of treatment of 28 children with femoral neck fracture or proximal femur fractures for the period 2005–2020 is presented, 11 of them were treated conservatively with the skeletal traction. Osteosynthesis by the author’s device was performed in 17 patients: 15 closed reduction, 2 in case of intertrochanteric fracture, — open reduction. The method of osteosynthesis and postoperative management of patients is described in detail. Results. In children who were treated conservatively, the fracture consolidation was achieved within 5–7 months, in one of them — in the position of varus deformity. In contrast to conservative treatment, children began to walk with crutches after a few days after surgery, with partial weight-bearing on injured limb. The device was removed in 16 patients after 5–8 months, and complete fracture consolidation of the fragments in their anatomical position was noted. There were no pathological tissue reactions to the metal device. Conclusions. The proposed device and method of closed osteosynthesis with its usage in the case of proximal femur and femoral neck fractures in children can be recommended in the practice of pediatric traumatology.

Современные методики лечения пациентов с закрытым переломом надколенника

Abstract. Introduction Treatment of patients with acute fractures of the patella is the task of the trauma and orthopedic service and should provide restoration of the integrity of the bone tissue and the extensor apparatus of the knee joint for its early mobilization. There is an opinion that conservative treatment cannot meet requirements of patients’ quality of life, and therefore, most traumatologists are inclined to surgically treat patellar fractures. Purpose Based on the available literature data, to determine the most rational way to treat patients with patellar fractures Materials and methods Available studies published in the last 10 years were analyzed. The databases NCBI Pubmed, Healio Orthopedics, Medline were searched. Results Such osteosynthesis methods as patella suture, osteosynthesis with plates, special internal devices, external fixation devices, Kirschner wires and wire cerclage, various screws were covered. The question of clinical application of patellectomy was touched upon; the contribution of the Department of Traumatology, Orthopedics and Urgent Surgery of the Krasnov Samara State Medical University to the development of operative techniques of osteosynthesis of the patella, the basic concepts of scientific research, and also the most optimal ways of treating patients with patellar fractures were described. Conclusion The conservative method of treating patients with patellar fractures is most relevant if there are contraindications to surgery. It inevitably leads to persistent arthrogenic contracture. The best functional results of treatment have been achieved with surgical treatment due to the possibility of early mobilization of the knee joint. According to the data of available studies, plates and screws as well as osteosynthesis with Kirschner wires and wiring cerclage show maximum stability. There is evidence of a direct correlation between the risk of developing infectious complications and pain in the postoperative period and the number of elements of subcutaneous metal implants. Thus, the most optimal way to treat closed fractures of the patella is osteosynthesis with the use of wires and wire cerclage according to the tension band principle.

Реабілітаційні заходи у хворих на ранніх стадіях коксартрозу після проведення артроскопії кульшового суглоба

Актуальність. Розробка програм реабілітації для хворих після оперативних втручань з використанням сучасних методів остеосинтезу — один із найважливіших напрямків розвитку сучасного відновного лікування хворих ортопедо-травматологічного профілю. Мета дослідження: розробити реабілітаційні заходи в комплексному лікуванні хворих на ранніх стадіях коксартрозу після проведення артроскопії кульшового суглоба. Матеріали та методи. Проведено аналіз лікування 95 хворих із остеоартрозом кульшового суглоба I–II ст., яким виконане артроскопічне оперативне втручання на базі травматологічного відділення Вінницької обласної лікарні ім. М.І. Пирогова та ДУ «Інститут травматології та ортопедії НАМН України» у період 2007–2016 рр. Результати. На основі комплексного обстеження хворих на ранніх стадіях коксартрозу після проведення артроскопії кульшового суглоба розроблені засоби реабілітації в комплексному лікуванні цієї категорії хворих. Запропоновані засоби відповідали терміну післяопераційного періоду, особливостям оперативного втручання під час виконання артроскопії кульшового суглоба та індивідуальним особливостям пацієнтів та дали можливість у 100 % хворих провести ефективне відновне лікування. Висновки. Впровадження запропонованих авторами засобів реабілітації дозволить проводити повноцінне диференційоване лікування та покращить ефективність надання медичної допомоги цій категорії хворих.

"Transosseous Osteosynthesis" — a Promising Station for an Objective Structured Clinical Examination of Traumatologists and Orthopedists

The training of transosseous osteosynthesis for traumatologists-orthopedists is actual. Purpose of the research: development of OSKE stations in teaching the method of transosseous osteosynthesis. Material and methods. In the course of the simulation the technique of passing the spokes through the synthetic bone, the installation of the apparatus and the biomechanics of control are practiced. Results. The developed OSKE stations allowed us to objectively assess the level of training within a specified time frame. Conclusion: OSKE is an effective tool for the control of knowledge, including the methods of transosseous osteosynthesis. The inclusion of transosseous osteosynthesis station in the accreditation of orthopedic traumatologists is an urgent task.

Mechanical Comparison of Four Different Types of Osteosynthesis in a 11-mm Advancement Le Fort I Osteotomy.

This study aimed to evaluate 4 methods of osteosynthesis in the maxilla after a linear advance of 11 mm. Le Fort I osteotomies were performed on 24 resin models and different osteosynthesis were applied in the anterior region. Group I received Lindorf plates; group II, modified Lindorf plates; group III, inverted "T" plates; and group IV, "L" plates. All groups received "L" plates in the posterior region. Analysis were performed through universal mechanical testing machine with an axial linear load until 5-mm displacement. The data obtained about the force and the amount of deformation were computed, thus the energy required for displacement and stiffness was calculated. Statistical analysis was performed using 2-way analysis (Shapiro-Wilk, followed by Holm-Sidak) (P < 0.05). Groups I and II showed greater resistance to displacement (P < 0.05) than the other groups. The largest amount of maximum force exerted for the 5-mm displacement was in group II (91.73 N), followed by group I (87.46 N), presenting the best values in comparison with the other groups (P < 0.001). Group III had less stiffness (P < 0.001) than the other groups. The use of preclinical methodologies to verify the mechanical stability of fixation models allows a prediction in the choice of greater resistance systems. The fixation type with greater resistance to deformation was achieved with modified Linford plates followed by Linford plates in the anterior region and plate "L" bilaterally in the posterior region.

Management of intertrochanteric femoral fractures at Level 1 trauma center in Leningrad Region

Relevance. An in-house Protocol for proximal femoral fracture management was developed at Vsevolozhsk Clinical Interdistrict Hospital of Leningrad Region.Intention To demonstrate possible practical application of preliminary federal clinical guidelines at Level 1 trauma center in Leningrad Region including comparative analysis of its efficacy when treating intertrochanteric femoral fractures.Methodology. Post-surgery outcomes were retrospectively assessed in 86 patients of Vsevolozhsk Clinical Interdistrict Hospital (Group 1, per Protocol) and 28 patients of Tosno Clinical Interdistrict Hospital (Group 2, w/o Protocol) with intertrochanteric femoral fractures (31A by Arbeitsgemeinschaft für Osteosynthesefragen classification and S72.1 by ICD-10).Results and Discussion. There were no significant differences in patients’ age, methods of anesthesia and osteosynthesis between the groups. Group 1 demonstrated statistically significant decrease in preoperative bed-days, time to sitting up in bed after surgery, ambulation with walkers and duration of hospitalization. Group 1 patients needed less assistance from other health-care professionals, less intensive therapy and blood transfusions.Conclusion. Adoption of in-house protocols, optimization of supply and staffing as well as involvement of multidisciplinary teams will improve management of proximal femoral fractures.

Метод Илизарова при лечении детей с околосуставными переломами

Introduction Periarticular injuries in children include types I and II fractures according to the Salter-Harris classification and metaphyseal fractures. In most cases, conservative treatment is an effective method, but in some cases, surgical treatment, including external fixation, is the method of choice. Purpose Discussion of the principles of using the Ilizarov apparatus in the treatment of children with periarticular fractures of various locations, its advantages and disadvantages. Materials and methods We present the principles and features of the Ilizarov surgical techniques for treatment of children with periarticular fractures of the distal humerus, femur, radius and tibia. Discussion The methods of osteosynthesis for pediatric periarticular fractures imply transphyseal introduction of fixators that have a potential threat of iatrogenic damage to the growth plate in contrast to external fixation which performance implies that transosseous elements do not injure the growth zone, providing stable fixation of bone fragments in combination with early functional recovery of the damaged segment which is a key advantage over other methods. Conclusion The use of the Ilizarov apparatus enables to achieve the desired result in the treatment of pediatric periarticular fractures and has a number of advantages over other methods of surgical treatment.

Functional Outcome of Open Reduction Internal Fixation (ORIF) versus Minimally Invasive Plate Osteosynthesis (MIPO) in Distal Third Tibia Fractures

Introduction: Distal Tibia fractures are considered as a surgeon's nightmare as it is difficult to treat due to less muscle cover, precarious blood supply and its proximity to ankle joint. Here we compare two surgical procedures Open Reduction Internal Fixation (ORIF) and Minimally Invasive Plate Osteosynthesis (MIPO) methods. Aims and Objectives: Study was done to compare results between surgical approaches ORIF vs. MIPO in treatment of lower third tibia fractures. Methodology: The study included 64 patients out of which 32 were treated by ORIF and remaining 32 by MIPO. Outcome was evaluated on the basis of length of incision, duration of surgery, blood loss, duration of stay, mobilization with partial and full weight bearing, AOFAS grading. Results: Length of incision, blood loss, mobilization at full weight bearing was significantly higher in ORIF group as compared to MIPO and was statistically significant. Results and Conclusion: MIPO offers biological advantages over conventional plating techniques in terms of low surgical trauma, preservation of the blood supply, lesser evacuation of osteogenic fracture hematoma and stable construct.