Komarov M. Substitution defects of long bones on the artificial implants on the carbon base (experimentalinvestigation with clinical application)

Object: carbon carbon material, as a substitute of a bone tissue. The purpose: to improve possibilities of treatment of patients with defects and pathological fractures of long bones by working out and an experimental substantiation of techniques of replacement of bone defects artificial implants from carbon-carbon composite material (CCCM). Methods: clinical, radiological, mathematical modeling, conceptual modeling, morphological, electrochemical, statistical. The model of replacement of segmentary defects of long bones at patients with tumoral defeats of a skeleton is developed. The original technology of connection of the bone fragments, developed within the limits of the given model theoretically allows to provide substitution a segment of a long bone with the set parametres of rigidity of connection bone fragments. The design for replacement of segmentary defects represents combined carbon composite implant in a kind intramedullary rod of the same diameter, as diameter of the marrowy bone’s channel and «spacer» - a hollow tube with thickness of a wall of 4-8 mm which has internal diameter equal to diameter of a rod. In experiment on animals absence of harmful influence carbon composite material on a bone tissue in a zone of implantation and on internal organs is proved, than biological inertness of a material is confirmed. Experimentally electrochemical method proves biological inertness of a carbon material. It is proved, that together with titanic implants and implants with a sheeting the carbon composite material does not form in a physiological solution active Galvan pairs, capable to lead to late infection complications. For the first time the method mathematic modeling by a method of final elements calculates optimum parameters of connection implant with a bone. Are proved the form implant and features of connection implant with a bone. New ways of connection of bone fragments and substitution defects of a long bone which allow to provide reliable primary stability of a segment are developed andto keep it for as much as possible long term. Developed new implants and the technique of connection of bone fragments leads to reduction of the general terms of treatment and social rehabilitation of patients for the account refuse of immobilization, early movements in adjacent joints. At use of the developed techniques of an osteosynthesis and replacement of bone defects implant replacement do not demand. For replacement of segmentary defects of long bones samples implant are developed and made, techniques of their use are fulfilled at diaphyseal and metadiaphyseal segmentary defects of long bones, clinical approbation of the offered devices and techniques is spent is patented two offered ways of replacement of bone defects. The permission to clinical use implants from CCCM is received. Results of dissertational research in the form of techniques of replacement of segmentary bone defects are introduced in clinical practice of Official foundation «Institute of a pathology of a backbone and joints of a name of the professor of M.I.Sitenko АМН of Ukraine», Department of bone oncology of scientific research institute of traumatology and orthopedy of Donetsk national medical university of M.Gorkogo MPH Ukraine and in clinic of damages of the Military-medical clinical centre of northern region of Department of health of the Ministry of Defence of Ukraine.