Romanenko K. Ununited diaphyseal fractures of long bones (risk factors, diagnostics, treatment)

The object are disorders of reparative osteogenesis after diaphyseal fractures of long bones; 6 patients with the different disorders of reparative osteogenesis. 59 white rats of Wistar line with modeling of different condition for reparative osteogenesis the aim to work out and substantiate differential approach to the treatment of patients with various types of ununited fractures on the base of results of radiological, morphological and biochemical investigation of the zones of disregeneration among the patients; the methods are clinical, roentgenological, densitometrical, morphological, biochemical, experimental and statistical; the newness are new knowledge about risk factors of the disregeneration development after diaphyseal fractures of long bones, that include diseases influencing negatively on the structure-functional condition of bone tissue before trauma; factors of trauma itself and factors, that appear during the treatment; it was proved that the forming of mature regenerate in the conditions of stable osteosynthesis is characterised by great raising of macromolecule biosynthesis (glycoproteins, proteoglycans and noncollagen proteins) with the peak before mineralization stage and following normalization; thus unstable osteosynthesis or St. aureus infecting in the condition of stable osteosynthesis lead to he forming of nonosteogenic tissues and prolonging of osteoreparation; results - the pathogenetically based complex differential approach to the treatment of patients, targeting on the full repair of the biomechanical integrity of bone tissue and both segment and limb function, was worked out; the results of investigation were introduced in practice of the department of orthopaedics and traumatology in the hospital