Bakkar T. Diafizarnye breaks of bones of forearm and their treatment

Object: diaphyseal fractures of the forearm and the recovery process of upper limb function after surgery. Aim: to improve the outcomes in patients with forearm diaphyseal fractures by developing rod device and technology of controlled external fixation. Methods: clinical, radiographic, biomechanical (goniometry), experimental and theoretical (mathematical modeling using finite element method), statistics, comparative analysis of clinical material. First a comparative evaluation of the fixation stiffness of bones fragments of the forearm at transosseous and bone osteosynthesis was carried out with the help of experimental studies based on mathematical modeling (the finite element method). For the first time the original structural configuration of unilateral rod device for osteosynthesis of forearm fractures has been developed, allowing to manage the fragments in three planes (patent 87293 UA). For the first time a universal portable digital protractor-rotatometr was created (patent 96850 UA). The device allows us to define the range of motion, including rotary, in the adjacent segment for joints of damaged upper limb to assess the early and late results of surgical treatment. The application of the developed method of controlled external fixation allows us to increase the quality of reposition and fixation of the forearm fractures reduce by 4.17 times the amount of intra- and postoperative complications, reduce by 2.75 times the average length of stay in hospital, as well as recover of the upper limb function in the early postoperative period due to the possibility of a combination of the fracture consolidation and the rehabilitation of patients. The developed original device on the basis of the rods for separate external fixation of the forearm bones provides a stable fixation of fragments for the all union period, keeping the rotary arm function. This makes it possible to improve the immediate and long-term outcomes of these patients. The universality of the developed portable goniometer-rotatometr, the ease of use and accuracy of measurements of movements in the upper limb joints allow us to recommend it for use by physicians in clinics, laboratories of biomechanics and work MSEK. The results are introduced into the clinical practice of traumatological departments of the city clinical hospital № 1 and № 11, regional clinical hospital, regional medical center and hospital road (Odessa), a traumatological department of the city hospital № 4 (Mariupol), SI "Sytenko Institute of Spine and Joints Pathology of NAMS of Ukraine", and in the scientific and educational process of the Department of Traumatology and orthopedics of Odessa National Medical University of Ministry of Health of Ukraine. Traumatology and Ortopaedics.