Zhigun A. Consequences of acetabulum fractures: prediction, diagnostics, treatment (clinico-experimental research)

Object: Fractures of acetabulum and its consequences. Purpose: restoration of hip joint function at patients with the consequences of acetabulum fractures due to proving, development and clinical introduction of new methods, its diagnostic, surgical treatment and tendency prediction. Methods: clinical, roentgenological, magnetic-resonance and computer tomography, biomechanical, biochemical, histological, statistical. In the first time the model of traumatic damage of hip joint was developed. It allowed us to reproduce the early stages of destructively-dystrophic process in the experiment. In the first time on experimental models at laboratory animals (rats) the features of mechanogenesis of hip joint destructively-dystrophic process was studied. We concluded that the degree of destructively-dystrophic process in a joint depends on the force of action of mechanical factor, on its orientation and permanence of action. The presence of posttraumatic discongruence of one of articular surfaces of hip joint can result to dystrophic changes with its realization to arthrosis. In the first time at comparison of experimental and clinical supervisions we have established biological regularities of dystrophic and destructive changes in bone and cartilaginous tissues of animals and people. New conceptual model of mechanogenesis of destructively-dystrophic process in hip joint was created. It allowed us to learn principal reasons of its development and to define its role in the system "hip ? pelvis ? spine". In the first time the complex of biochemical indexes of estimation of bone and cartilaginous tissues was established at patients with the consequences of acetabulum fractures. It allowed us to define the motion and the stage of destructively-dystrophic process in hip joint. In the first time we have concluded that the dosed influence of low temperature factor on the bone tissue can lead to the death of osteocytes, it promotes to the forming of congruent articular surfaces. We have established chondro-reparative activity of embryonic tissues during their transplantation in the osteohondral defect of joint. In the first time new approach to the hip joint was introduced, it provides the best review of the operating field, diminishes the time of surgical interference and allows to use the correction of proximal hip fragment in three planes. The principles of optimal strategy and the tactic of treatment were developed. They allow substantially to promote the quality of medicare to the patients with the consequences of acetabulum fractures. The complex approach to the treatment of consequences of acetabulum fractures connects surgical and pharmacological facilities and decreases the terms of treatment, and improves results. Research results are intronduced in clinical practice: State institution "Sytenko Institute of spine and joints pathology, Academy of medical sciences of Ukraine", regional clinical hospital of Volyn, municipal organization " city clinical hospital № 1 of Sumy", municipal organization of health protection "Regional clinical hospital, urgent center of medicare and medicine of catastrophes", regional clinical hospital of Lugansk. Traumatology and orthopaedia.