Filonenko Y. The treatment of patients with olecranon fractures by interlocking technique.

Object: olecranon fractures. Aim: to improve the results of the treatment of patients with olecranon fractures by developing and introducing to the clinical practice of intramedullary blocking screw. Methods: clinical, laboratory and instrumental (radiography, computed tomography), questioning patients using specific Mayo and DASH questionnaires; analysis of the anamnesis and the results of clinical studies according to the developed map of the registration of clinical data of the patient; biomechanical research at the stand of modeled olecranon fractures with their subsequent stabilization according to the author's and Weber's methods; mathematical modeling with the creation of a finite element model; statistical. For the first time, as a result of the analysis of the stress-strain state of finite element models of the ulna with variants of osteosynthesis of the olecranon after its fractures, it was proved that when using the developed blocked screw, the level of maximum stresses in the olecranon and on the implant in the fracture zone is significantly lower in comparison with the application needle and wire cerclage according to the Weber method for all kinds of load (flexion, strain). It was found that the fixation of the olecranon performed by interlocking screw by loading from 20 to 90 N provides robust stability of fragments compared to the tension band wiring. Based on the results of experimental studies on physical models and mathematical modeling, the method of оsteosynthesis of the olecranon fracture using the blocked screw was proposed. Indications for the implementation of this technique were determined and the algorithm for treating fractures with this method was developed. The proposed technique for minimally invasive osteosynthesis of olecranon fractures and the system for its implementation (Patent No. 73928 UA) made it possible to load the limb in the early postoperative period, reduce the disability of patients and achieve excellent results in 97%. The developed indications for stabilization of the olecranon fracture using the interlocking screw technique provide a differentiated approach to the choice of a method for treating patients with olecranon fractures and its fixation after osteotomy. This helps to improve the results of treatment of this category of patients. Practical recommendations for the use of intramedullary blocked osteosynthesis to optimize the treatment of patients with olecranon fractures and its osteotomy were presented. Compliance with these recommendations can improve the quality of treatment and reduce the period of disability of the patient. The results of the dissertation work were introduced into the teaching and methodical process of the Department of Orthopedics and Traumatology of National Pirogov Memorial Medical University Ministry of Public health of Ukraine, Vinnitsa, practice of Traumatologic department of Pirogov Regional Clinical Hospital, Vinnitsa, Traumatologic department and a traumatic point of MKLSHMD of the city of Vinnitsa. Traumatology and Orthopaedics.