Petrуk T. Diagnostics and treatment of acetabular fractures

Object: Fractures of the acetabulum. Objective: To improve the results of treatment of the acetabular fractures, using the optimization of surgical tactics and the improvement of osteosynthesis technique. Methods: The clinical, biochemical, radiological studies, x-ray computer tomography, mathematical methods, informative and patent statistics. Algorithms of the acetabular fractures treatment were developed on the basis of consequent usage of radiography, X-ray computer tomography and 3D reconstruction. The sensitivity, specificity, predictability, efficiency and preciseness of radiographic and CT diagnosis of major types of acetabular fractures were determined. The necessity of precise anatomical reposition, with no more than 1 mm displacement for each of the three radiographic projections was proved. It was offered to use a new integrated diagnostic indicator of collagen metabolism (healing factor that allows to predict complications during the treatment ).The author developed and put into practice the device for the acetabulum posterior wall osteosynthesis (Patent of Ukraine № 47537). The developed algorithms of the basic acetabular fractures types helped to increase the preciseness in diagnostics of such injuries, and that allows now to choose the optimal strategy of treatmen. Clinical usage of the proposed method (of predicting the course of the healing process by identifying key biochemical parameters of blood serum) allowed to prevent complications in the outcome. Radiography in three projections while diagnostics, realization of the precise anatomical reposition (that includes degree of congruence of joint surfaces with no more than 1 mm displacement in each area ) and improvement of the postoperative rehabilitation allowed to improve the results of acetabular fractures treatment. These results help in treatment of the patients with acetabular fractures and they are being practiced widely at many medical establishments, such as Communal establishment of Kyiv Regional Council "Kyiv Regional Clinical Hospita", Kyiv City Clinical Hospital № 1, Clinical Hospital "Feofaniya", Communal institution "Regional Hospital" - Emergency center of medical care and medicine of catastrophe", Cherkasy Regional Council, Kyiv City Clinical Hospital Ambulance and medicine of catastrophe".