Bilinskiy P. Low-contact multiplaned osteosynthesis of bones fractures and their sequelae (theoretical, experimental grounds and clinical implementation)

The object of this scientific research is a low-contact multiplaned osteosynthesis of fractures and pseudoarthritis of long bones. The process of knitting consolidation was under conditions of low-contact osteosynthesis. The object of this work is to develop a new trend in surgical treatment of fractures and pseudoarthritis of long bones on the basis of low-contact multiplaned osteosynthesis. The applied methods included clinical, roentgenologic, statistical, biomechanical and morpho-logic methods, simulation, development of extremities elements method and osteosynthesis construction. Low-contact multiplaned osteosynthesis conception is developed, the methodology of its realization is studied. Basic biomechanical parameters of fresh femur preparation were studied. The technique for low-contact osteosynthesis was developed. Eight constructions were patented in Ukraine. Their fixation potentialities were studied by means of definition of carrying capacity of the "fixative-bone" system. Theoretical and experimental data concerning the value of fractured fragments micromobility, strain of plates depending on the fixative construction and characteristics of a fracture line were obtained. It was found the difference in dynamics of medullar replacing infarcts of proximal and distal fractured fragments during total-contact, intramedullar and low-contact osteosynthesis. The dependence of reparative regeneration on fixation method was studied experimentally. The technique of fractures and pseudoarthritis of long bones treatment was developed by means of application of low-contact osteosynthesis methods. As a result of this technique application positive results of treatment were obtained in 90 patients. The specification of the fixatives sets for a low-contact osteosynthesis are registered in State standard of Ukraine. The obtained results are applied in clinical practice of 8 orthopedic and traumatologic departments in such cities of Ukraine as Kyiv, Kharkiv and Chernivtsi. Traumatology and Orthopedics