Object: ankle joint, malleolar fracture, tibiofibular syndesmosis injury. Goal: to improve the treatment outcomes for patients with malleolar fractures by improving diagnostics, developing biomechanical substantiation of methods and devices for differentiated stable and functional osteosynthesis. Methods: clinical, radiological, biomechanical, and statistical. The reasons of negative osteosynthesis outcomes for some times of malleolar fractures upon use of AO technology were determined for the first time based on biomechanical research in comparative assessment of rigidity malleolar fractures’ fixation with different types of on-bone osteosynthesis plates, use of new osteosynthesis variants for lateral malleolar fractures playing the main role in ensuring the ankle joint stability was scientifically substantiated. It was experimentally determined that the rigidity and reliability of osteosynthesis in type A and B malleolar fractures is 1.5 to two times higher when using the device designed by the author. New plates for differentiated on-bone stable and functional osteosynthesis of lateral malleolar fractures were developed for the first time based on biomechanical research (patents of Ukraine No. 49223, No. 49224) and the methods and instruments for osteosynthesis were improved. A device for diagnosing tibiofibular syndesmosis injury and a method of ankle joint instability assessment allowing for non-invasive control of both anatomic and functional state of tibiofibular syndesmosis on different stages of patient treatment were developed for the first time (patents of Ukraine No. 53844, No. 53845). Based on the conducted experimental biomechanical research and the devices and methods of malleolar osteosynthesis and tibiofibular syndesmosis diagnosing a differentiated approach to osteosynthesis of different types of malleolar fractures was offered for the first time. Devices and methods of differentiated stable and functional osteosynthesis in case of malleolar fractures, simple in use, allowing for selective approach to stabilization of different types of malleolar fractures, providing for early function and load-bearing capacity of the joint that underwent surgery, preventing instability thereof and facilitating improvement of anatomic and functional treatment outcomes were developed and biomechanically substantiated. The developed diagnostic device and method of ankle joint instability assessment allow for non-invasive diagnosing of tibiofibular syndesmosis injury and assessing its anatomic and functional state, choosing the appropriate method of function recovery and preventing after-surgery instability of the ankle joint. The research results were implemented to clinical practice of State Institution “Institute of Traumatology and Orthopedics of the Academy of Medical Sciences of Ukraine”, Clinical Institution “Regional Clinical Hospital named after M.I. Mechnikov”, Dnipropetrovsk city, Clinical institution “Zaporizhzhya Regional Clinical Hospital”, MHCI “Regional Clinical Hospital – Centre of Emergency Medicine”, Kharkiv city, State Institution “Sixth Municipal Clinical Hospital”, Dnipropetrovsk city, CI “Pavlograd Municipal Hospital No. 4”, CI “Sevastopol Municipal Hospital No. 9”, SI “Departmental Hospital of Kherson Station”, CI “Sinelnikovo Central District Hospital” and to the academic process of specialized departments of Dnipropetrovsk State Medical Academy of the Ministry of Health of Ukraine and Lugansk State Medical University of the Ministry of Health of Ukraine. Traumatology and orthopedics.
