Object: fracture of the distal humerus, elbow fracture-luxation. Purpose: to prove theoretically and experimentally the technology of functional treatment of complex elbow injuries focused on the prevention of adverse effects of damage. Methods: information analysis, clinical methods of patients' examination, radiological and radiometric, computed tomography, ultrasonography, mathematical modeling using the finite elements method, biomechanical, morphological, biochemical and statistics methods. The concept of complex elbow injuries treatment has been developed on the basis of the functionality with the assessment of the stability loss of damaged elbow joint and the degree of displacement of the bone fragments; the system for quantifying the degree of stability loss, expressed in points, that allows to attribute damage to one of the four forms (stable, relatively stable, unstable, highly unstable) has been designed. On the mathematical model has been examined the distribution of the stresses intensity which arise in the distal humerus while modeling of osteosynthesis of its "low" fracture by two plates with locked screws and by the developed method. The rationality of the proposed method of osteosynthesis has been confirmed, and the new knowledge of the distribution of the stresses intensity in the distal humerus has become the basis of individual rehabilitation programs to improve joint function. In an experiment on a rat model of the elbow stable fracture-luxation, has been studied the effect of free osteochondral fragment on the morphological changes of tissues of mobile and immobilized joint, and it has been found that the most significant tissue destructive changes are observed in the presence of a bone fragment in an immobilized joint, the least expressed ones are observed when bone fragments are removed and the joint is mobile. In an experiment on a rat model of elbow unstable fracture-luxation at different variants of anti-inflammatory therapy (separately and combined - diclofenac sodium, indometacin ointment, a solution containing dimethylsulfoxide) has been found that in cases where a solution containing dimethylsulfoxide was applied, the earlier and more significant reduction inflammation markers in serum and less pronounced morphological manifestations of inflammation in joint tissues as compared with other treatment options has been observed. The technology of treating of the most complex elbow injuries- the fractures of the distal humerus and elbow fracture-luxation which takes into account the character of the displacement of fragments and the condition of joint stability has been improved, that allows to define clearly the treatment policy, to prevent the necessity of changing a method of treatment, involves the use of modern devices, including the developed methods and devices (fixation method of "low" distal humerus fractures (Ukrainian Patent № 33041A), the device for elbow injuries treatment (Ukrainian Patent № 57425A), the device for osteosynthesis of comminuted fractures of the radial head (Ukrainian Patent № 10371UA), the anti-inflammatory solution containing dimethylsulfoxide (14.0% dimethylsulfoxide, 0.13% hydrocortisone acetate, 0.025% dimedrol, 0.2% novocaine) for local application in early posttraumatic period, that reduces recovery time and improves the results of complex elbow injuries treatment. The developed device for osteosynthesis entered the National Register of medical technology and medical products of Ukraine (Certificate № 10466/2011), and was allowed for use in medical practice. The results of studies are introduced into clinical practice of SI "Sytenko Institute of Spine and Joint Pathology of Ukraine NAMS", Sumy Municipal Clinical Hospital № 1, Mykolaiv Municipal Emergency Hospital, Kharkiv Municipal Multisectoral Hospital № 18, Kharkiv Municipal Clinical Multisectoral Hospital № 25, Odessa Regional Clinical Hospital, Research Institute of Traumatology and Orthopedics of Donetsk National Medical University of Maxim Gorky" and were used in the learning process of specialized departments of Kharkiv Medical Academy of Post-graduate Education, Uzhhorod National University, Lugansk State Medical University. Traumatology and orthopedics.
