Pobel A. The clinical and experimental research of treatment ofintraarticular fractures at effecting of the harmful metal-lurgical factors (exsperimental-clinical investigation)

The object of investigation - the process of regeneration of bone and articular cartilage; the process of rehabilitation of function of injured of joint at the conditions of intoxication by lead and dangerous chemical substances of metallurgical production. The purpose - to work out the system of the treatment of intraarticular fracture victims exposed to effect dangerous factors of metallurgical production. Methods of investigation - experimental, histological, clinical, X-ray, statistical ones. The system of the treatment of the patients with intraarticular injures which were by effect dangerous chemical substances of metallurgical production (of SiO2; SО2; CO2; NO2, phenol and lead exceeded) was developed on the base creating new apparatus for osteosynthesis, methods of surgical treatment and grounds the way of drugs therapy. It had been obtained new knowledge the chemical substances of the air of open-hearth process effected on bone and articular cartilage of the rats which were into metallurgicalshop in the course of a 1,5 month. Destructive and degenerative changes in the bone and cartilage tissue were found. The regeneration processes at intraarticular injure were delayed. It had been demonstrated that osteo- and chondroprotective drugs were effective on stage forming of tissue specific structure of callus formation on the experimental rats. It had been summarized the results of treatment of 254 patients with intraarticular fractures of hip joint, knee joint and shin foot joints. Patients were the inhabitants of Zaporozhye worked for a long time at metallurgical production or lived at regions of city, where the concentration of chemical dangerous substances place exceeded the standard in 1,8-5 times. Devices for external fixation and a modular design of the devices (patents of Ukraine № 38701 А, № 30750) were used for fixation of intraarticular fractures of proximal pаrt of a femur. The methods of functional osteosynthesis with osteo- and chondroprotective drugs increase the effectiveness of the treatment of patients and ensure for a long time good results from 77%, 88% and 80% of the pathients with intraarticular fractures of hip joint, knee joint and shin foot joints accordingly. The described recommendations were used in practical application Ukrainian Academy of Medical Science Sytenko Instityte of Spine and Joint Pathology, in the educational process on department traumatology, orthopaedic and combustiology of medical academy in practice work of clinical hospitals № 5 and № 9 Zaporozhue city, medical units № 6, "Zaporozhstal" and "Dneprospezstal".