Ryabokon P. The locked nail osteosynthesis for articular fractures of the calcaneus

Thesis is devoted to improve the efficiency of treatment in patients with intra-articular fractures of the calcaneus through clinical and biomechanical studies of foot function violations and the development of a new method of locked nail osteosynthesis. On the basis of mathematical and computer models of the foot it has been revealed that in case of calcaneal height and length decreasing the vertical movement of calcaneal tuberosity and additioanal triceps surae muscle force and indicators of deformation and displacement of the Achilles tendon were increased. On the basis of osteometric and biomechanical studies there was developed an original design of the locked nail, which is due to intraosseous arrangement of the elements provides direct support to the posterior calcaneal articular facet, does not create the conditions for a conflict with the surrounding tissue, minimizes the surgical exposure trauma and reduce the risk of purulent necrotic complications. The optimal intracalcaneal locked nail localisation and its strength was proved biomechanically. The method of calcaneal locked nail ostheosynthesis was designed and put into practice. The indications for its use were determined. The study presented a comparative analysis of the effectiveness of calcaneal plate and locked nail ostheosynthesis in 77 patients (88 feet) with intraarticular calcaneal fractures. The clinical efficiency of the proposed method of locked nail ostheosinthesis was proven by postoperative complications rate reduction and improvement of the anatomical and functional outcomes.