Dubovik S. Surgical treatment of patients with fractures in the distal third of the humeral shaft

Clinical studies were conducted in the period from 2019 to 2022 in three departments of traumatology and orthopedics of the Communal Non-Commercial Enterprise "City Clinical Hospital No. 11" of the Odessa City Council. Within the scope of the study, 127 patients (85 men, 42 women) with fractures of the cervical spine aged from 19 to 69 years (average age was 34.9 ± 17.5 years) were examined. The criteria for inclusion in the clinical study were patients with DTHD fractures, which according to the international classification of AO / ASIF belong to segment 12 (type A-C), the criterion for exclusion from the study was segment 13. For further retro-prospective comparative analysis, patients were divided into two clinical groups taking into account the type of surgical intervention: the first (comparison) consisted of 92 (72.44 %) patients who underwent open reposition and internal fixation (ORIF) with a plate; the second (study) included 35 patients (27.56 %), in the treatment of which transosseous osteosynthesis (TOS), developed by us, with a rod-type device, was used. The improved technology of minimally invasive osteosynthesis of extra-articular fractures of the distal part of the humerus expands the indications for surgical treatment of patients of various age groups, ensuring stable fixation of fragments for the entire period of fusion. The developed tactics of minimally invasive treatment, taking into account the presence of any accompanying pathology, which is a contraindication to bone osteosynthesis, allows to optimize an individual approach to the treatment of victims with fractures of the humerus in the lower third, to avoid complications, to reduce the proportion of unsatisfactory results, to shorten the periods of incapacity for work and disability in patients of the given category.