Главная Тезисы Лечение диафизарных переломов длинных костей STABLY-FUNCTIONAL OSTEOSYNTHESIS IN TREATMENT OF DIAPHYSIAL FRACTURES OF FEMUR

STABLY-FUNCTIONAL OSTEOSYNTHESIS IN TREATMENT OF DIAPHYSIAL FRACTURES OF FEMUR

 

In the orthopedics clinic of the Rivne regional hospital for period 2001-2005 years 159 patients have been treating with the fractures of femur, from which 113 (71.06%) with the diaphysial fractures. Men - 82 (72.6%), women - 31 (27.4%), habitants of village - 81(71.7%), citizens - 32(28.3%). The age of patients is from 17 to 77 years. The most diaphysial fractures were observed in capable of working age - 79 (69.9%). The closed fractures - 102 (90.2%), opened -11 (9.8%). The repeated fractures together with the break of the metal plate had happened in 7 (6.2%) patients. The fractures of 2-3 segments (femur-shank, thigh-shoulder, thigh-forearm) - in 6 (5.3%) patients. The method of operative treatment was determined on a clinical analysis. The transosseous osteosynthesis by wirepin apparatus was applied in 19 (16.8 %) cases, intramedullar in 9 (7.96 %), stably-functional in 85(75.24%). The simultaneous interference on two segments by two brigades it was carried out at 4 (3.5%) patients (stably-functional or intramedullar on one segment, on other transosseous osteosynthesis).

We use licensed metalware proposed by Ukrainian Association "Osteosynthesis". We watch after asepsis in an operating-room (regular bacterial control). The access to the fracture about out femur with careful attitude toward muscles, vessels, periosteum. We achieve anatomic adaptation of wreckages. The plates the direct wide, L-similar, screws of cortical, spongiosis were used. We trick into an active aspirator on 1-2 days. In a post operated period we appoint modern antibacterial, antiswell therapy, anticoagulative, analgesics, preparations for vessels, early function without rigid imobilization.

The osteomyelitis was not observed. There were the phenomena of corrosion of metal at the late delete of metalware. The consolidation came in optimum terms in 77 (68.14%), repeatedly operated 4 (3.54%), 3 (2.65%) patients had slow consolidation. The 19 operated patients in the second half of 2005 year continue treatment.

Boris Denysyuk, Victor Kasyanchuk, Volodimyr Zlativ.
The Rivne regional clinical hospital

 

 

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