Metal osteosynthesis of open fractures of the long tubular bones]

An analysis of treatment of 123 patients with open fractures of long tubular bones has shown that automobile crash is the most frequent cause of the trauma (67.5%). The prehospital aid was given only to 9.7% of the patients. The primary surgical treatment of the wounds was carried out by traditional rules, the local application of antibiotics for prophylactics of purulent complications did not justify itself. Better results of treatment of open fractures were obtained after metallo-osteosynthesis of open fractures of the femur bone. The highest percentage of complications were observed after epiosseous osteosynthesis of the leg bones.     

Stable metal osteosynthesis in fractures of long tubular bones and cranio-cerebral trauma]

On the basis of an experience of application of modern methods of trans-osseous (123), intraosseous (67) and osseous (3) metallo-osteosynthesis and their combinations (30) in 159 victims (aged 4.5-86 years) with associated craniocerebral injury is drawn a conclusion on the expediency of application of different methods of metallo-osteosynthesis of long bones depending on a number of indications. In this case the severity of the craniocerebral injury and the victim state, the character and association of the bone fractures, the period of the traumatic disease are taken into consideration. The most efficient is the early application of stable metallo-osteosynthesis. Combination of the stable connection of fractured fragments with the principle of minimum intervention damaging is of special significance. For this reason in the period of early compensation (2 initial post-traumatic days) the trans-osseous osteosynthesis is preferable. Metallo-osteosynthesis is expedient according to the rigorous indication in the period of stable compensation (9-21 post-traumatic days), preferably at the closed fractures of femur and forearm. The results of treatment have been evaluated with 123 (77.36%) operated patients. The positive outcomes have been noted with 95% of patients that is indicative of the efficiency of the applied methods.     

Functional intraosseous osteosynthesis of diaphyseal fractures of long bones

The analysis of the treatment of diaphyseal fractures of tre long bones with functional intraosseous osteosynthesis (FIO) of 593 patients (675 bones) during three years is presented. The techniques of osteosynthesis have been worked out by the author and are performed without using an electro-optical transducer and drilling out of the medullary canal. At the postoperative period no immobilization with a plaster cast is necessary. The function of the operated extremity is restored before the fraction is consolidated. The disability terms are shorter than usual. There have been no non-unions, false joints or contractures. There was one case of osteomyelitis (0.1%). The definition of FIO is given, the conditions for its performance and the requirements for the intraosseous fixator are presented as well as the facts of making use of FIO in the treatment of non-unions and false joints of the long bones are listed.     

Combined osteosynthesis in diaphyseal fractures of the long tubular bones

An operative method of union and fixation of long tubular bones consisting in combination of the compressive-destruction and intramedullary osteosynthesis is described. The method is minimally traumatic and gives high degree of stabilization of fragment ends. Early functional load on the extremity facilitates the union of fractures.