Baida M. Ring fixators of the wire-rod type and semi-rigid fixation systems as a variable osteosynthesis in the treatment of tibial nonunions

The dissertation presents an analysis and formulates a novel solution to the relevant scientific problem in clinical medicine, particularly in orthopedics and traumatology. The study aims to improve the quality of treatment for patients with tibial nonunions (TNU) following fractures by examining contributing factors, systematizing complications, determining their impact on fragment correction during treatment, defining the scope of reconstructive-restorative interventions based on prognostic scales, and applying variable osteosynthesis with circular fixators (CF). Advancements in modern traumatology (state-of-the-art surgical intervention technologies, defect reconstruction tools, and regeneration stimulation methods) do not fully address the issues of treating tibial bone consolidation disorders following fractures. The incidence of complications after fractures, according to various authors, ranges from 3% to 45%, depending on the localization and type of fracture. Tibial nonunion is one of the most common outcomes of diaphyseal fractures of long bones, primarily due to various factors. These include lower third tibial fracture regeneration disorders, especially under high-energy mechanical impact or intramedullary blood supply damage (a. nutricia). The results of treating tibial reparative osteogenesis disorders using various methods require further study and a search for simple and practical techniques for both conservative and surgical treatments. Most researchers note that predictors play a key role in forecasting treatment outcomes and determining its scope. In this study, the most well-known systems for evaluating nonunions of long tubular bones were utilized. As the number and combination of predictors increase, amputation may become necessary due to the minimal chances of restoring the limb as a functional organ. This also applies to the justification for using extrafocal osteosynthesis in the comprehensive treatment approach. Circulatory disorders, including venous insufficiency and impaired blood outflow, are common in the nonunion area and the affected segment. These result in disrupted microcirculation and metabolic processes. The catabolic direction of metabolic processes in traumatic injuries, combined with infections, correlates with the severity of the damage.