Chernyak I. Surgical treatment of diaphyseal fractures of the femur in children

The work is based on the analysis of surgical treatment of 82 patients with diaphyseal fractures of the femur. The main study group included 66 patients who were treated with minimally invasive methods of surgical treatment: Ender rods (n=23), external fixation rod apparatus (EFA, n=28), angular stable plates (ASP, n=7) and blocked intramedullary rods (n=8). Surgical treatment in the control group (16 persons) was performed using ordinary plates.Finite element method was used for biomechanical analysis of internal tension arising in the area of the fracture under load with using osteosynthesis methods of the main and control groups. After using intramedullary fixed retainers, ASP and EFA observed a uniform distribution of internal tension, after using ordinary osteosynthesis plate observed a skewed distribution. Prognosis of the relative risk (RR) of possible complications of surgical treatment was done. RR was significantly reduced after use of the treatment methods of main group. Oberg scale was used for evaluation of remote functional outcomes (6 and 12 months later). Algorithm of surgical treatment of femur diaphyseal fractures in children was develop, depending on the fracture nature, integrity of the skin, child's age and concomitant traumatic injuries.