Grymailo M. Clinical and biomechanical rationale of locking intramedullary nailing for fractures of the distal femur.

Object: distal femur different types fractures. Aim: increase of efficiency of treatment of patients with the distal femur fractures by the biomechanical ground of application of intramedullary locked nailing and perfection of this methodology. Methods: clinical, roentgenologic, mathematical design, statistical. First on results undertaken biomechanics studies new knowledge are got about the tensely-deformed state of model of thigh-bone on conditions of fixing of distal femur breaks by means of the different fixing, that defined expediency of the use of retrograde intramedullary locked nailing even in case of intra-articular breaks of types 3.3 В.1, В.2, С.1, С.2 and С.3 (AO). From biomechanics positions and taking into account the type of break the chart of treatment of patients is worked out with the breaks of distal femur. The new method of retrograde intramedullary locked nailing is worked out, that allows considerably to bring down the risk of origin of postoperative osteoarthrosis of knee-joint (patent of Ukraine on an useful model № 79062). On the basis of the obtained biomechanics, clinical and roentgenologic data the complex going is worked out and reasonable near treatment of patients with the breaks of distal department of thigh-bone, sent to complete renewal of anatomic structures and function of the damaged lower limb in as possible early terms, upgrading of life of patients on all period of rehabilitation. Application of chart of treatment of breaks of distal department of the thigh-bone improved methodology of introduction of bar at retrograde intramedullary locked nailing allowed substantially to improve the results of treatment and improve quality life of patients. The worked out methodology is simple in implementation, widely accessible not only for the specialized traumatology clinics but also for surgery in-patient departments. The inculcated method of treatment of contractures of knee-joint with the use of post-isometric relaxation of muscles allowed to improve the results of treatment of postoperative knee contracture. The basic results of research are inculcated in clinical practice of the Kharkiv "Regional clinical hospital - center of urgent medicare and medicine of disasters", the "Kharkiv municipal clinical hospital of ambulance and first medical aid named after prof. A.І. Meshaninov", Central city hospital of Lubotin, Kharkiv municipal multi-field hospital № 18, in the educational process of department of traumatology and orthopaedy, department of anesthesiology, traumatology and extreme medicare of the Kharkiv national medical university of ministry of health. Traumatology and orthopedics.