Fractures of the distal metaepiphysis of the radial bone (DME RB) are one of the
topical and lifelong problems in orthopedics and traumatology. About 40-50% of all
damage to the upper extremity bones accounts for DME RB fractures. Strafun S.S.,
Tymoshenko S.V. note that approximately 20-25% of these patients have unstable,
intra-articular fractures with significant displacement. On this basis, each specific
surgical intervention for intra-articular fracture of type C3, starting from the planning
stage, should be considered as reconstructive-restorative intervention, which means a
combination of complete reconstruction of the shape of the articular surfaces and
creating conditions for unloading and maximizing unloading taking into account the
real situation, early recovery of the volume of movements in the joints. In the structure of the considered damages, fractures account for up to 47.3%, and type C fractures in 41% of patient. In this case, 23.1% of patients experienced flexion (flexion) / extension (wrist extension) within (20 ° - 40 ° / 0 ° / 30 ° - 60 °). In 1.5% of patients there was pain of varying degrees. The aim of the study was to improve the results of treatment of fractures of the distal metaepiphysis of the radial bone by optimizing and developing a clear algorithm for surgical treatment of type C3 fracture, depending on the anatomical orientation of the damage, the development and implementation of a pathogenetically sound system of rehabilitation treatment and rehabilitation. The basis of the scientific work is the analysis of the results of surgical treatment of 117 patients with unstable fractures of DME RB type C. Technical errors include: inadequately selected operating access, inadequate repositioning, especially fragments that form the articular surface, ignoring the restoration of displacements of the dorsal-ulnar structures (DW and DUC fragments) incorrect choice of the retainer, which causes the use of external immobilization, lack of intrapagent rehabilitation and prevention of complications. Based on the individual approach in the treatment of patients with intraarticular fractures of the distal metaepiphysis of the radial bone, which is based on clear indications for the choice of fixation method, depending on the type of fracture, preoperative planning, implementation of the developed algorithm for osteosynthesis, postoperative surgery, osteosynthesis complications in the wrist joint, with fractures of type C1, an excellent result was obtained in - 50.0%, good - 38.9%, satisfactory 11.1%; C2 - 51.8%, 33.9%, 14.3%; at C3 excellent result was obtained in 46,8% of patients, good - in 32,3%, satisfactory - in 16,1%; unsatisfactory - in 4,8%. Poor treatment results are explained by inadequate preoperative preparation, incorrect choice of fixation method and poor reposition of fragments.
