Vorontsov P. Surgical treatment of the fractures of neck of femoris

Object of the research: patients with unstable femoral neck fractures. Purpose: elaboration, scientific and clinical foundation of a new method of unstable femoral neck fractures surgery. Research modalities: complex clinical examination (anamnesis acquisition, patient's general and local status evaluation): X-ray method for fracture type determination, bone fragments condition, treatment efficiency, regeneration dynamics; biomechanical analysis for substantiation of femoral neck reconstruction in case of unstable subcapital and basal fractures; statistical method for ascertainment of reliability of the obtained results. Scientific novelty. An effective untraumatic organoretentive technology of surgical treatment of unstable subcapital and basal intra-articular femoral neck fractures has been developed and scientifically grounded. We have proved that for prevention of cutting forces along the line of unstable femoral neck fracture leading to instability of fixation, to disjoining of fractures, to destruction of holders and for activation of reparative process : а) in case of unstable subcapital intra-articular femoral neck fractures it is necessary to remove the bone wedge from a distal fragment of a neck stump with the wedge base directed upwards (the purpose is to arrange the fracture line transversely to the femoral neck axis).b) in case of unstable basal intra-articular femoral neck fractures it is necessary to remove the bone wedge from a proximal fragment of a neck stump with the wedge base directed upwards (the purpose is to arrange the femoral neck axis transversely to the fracture line, that results in increase of the neck-shaft angle).Clinical, X-ray and biomechanical researches have proved a high efficiency of this technology that essentially improves fracture union and further postoperative reconstruction of anatomic and functional parameters of the operated joint. This technology assures an early postoperative rehabilitation of the patients and effectively reduce hypostatic and neurotrophic complications. Scientific statements of the present thesis have been applied into clinical practice of such medical institutions as Institute of spinal column and articulation pathology of the Academy of Medical Sciences of Ukraine named after professor M. I. Sitenko, 17th Kharkiv Municipal Clinical Hospital, 25th Kharkiv Municipal Clinical Multitype Hospital, Kharkiv Emergency Hospital, Zaporizhya Emergency Hospital, Zaporizhya Regional Clinical Hospital, Ternopil Regional Municipal Clinical Hospital, Ternopil Emergency Municipal Clinical Hospital. Scientific statements of the present thesis are being used in educational process at the Chair of traumatology and orthopedy of Ternopil State Medical University. Traumatology and orthopedics.