Levchenko O. Clinical and biomechanical substantiation of minimally invasive metalosteosynthesis in the treatment of the calcaneus closed fractures

The dissertation deals with the urgentissue of modern traumatology - minimally invasive surgical treatment of patients with closed fractures of the calcaneus. Use of computer simulation in this work enabled refinement of biophysical mechanism of the effect of so-called ligamentotaksis - the basis of closed reposition of the calcaneus fragments and to define the optimal configuration of the fixing screws for the main types of fractures. Minimal invasiveness by reposition and metalosteosynthesis was substantiated in this part of the study. Theoretical developments allowed to create a new minimally invasive method of surgical treatment of patients with closed fractures of the calcaneus (Ukraine patent № 41804). The method should be used for extra-articular fractures and fractures of type II. The use of the method is rational regardless of the type of fracture in the cases where the cutaneous covering of the damaged soles is significantly compromised or general condition of the injured is severe. Open reduction and traditional metalosteosynthesis are recommended in fractures of type III and type IV (classification of R. Sanders et al.). Аnalysis of the long-term results of surgical treatment of patients with calcaneus fractures showed that excellent and good functional results in the 1st (developed method) and 2nd (open reposition and traditional metalosteosynthesis) clinical groups made up, respectively, 92.3 % and 82.4 %. Thus, if the 1st clinical group did not demonstrate poor clinical outcomes, in the 2nd group they occurred in two cases, which made up 5.9%.