Ефективність впровадження нових технологій в оперативному лікуванні черезвертлюгових переломів стегнової кістки хворих

A. V. Kalashikov; V. D. Malik; О.V. Kalashnikov

doi:10.14739/2409-2932.2016.2.70900

Authors

A. V. Kalashikov Institute of traumatology and orthopedics of NAMS of Ukraine,
V. D. Malik Poltava regional clinical hospital named. M. V. Sklifosovsky,
О.V. Kalashnikov Institute of traumatology and orthopedics of NAMS of Ukraine,

DOI:

https://doi.org/10.14739/2409-2932.2016.2.70900

Keywords:

Biomedical Technology, Femoral Fractures, Treatment Outcome

Abstract

Aim. Fractures of the proximal femur and their consequences every year cause enormous damage to the economy of any state. Despite the latest achievements of modern traumatology, quite high percentage (10 %) of unsatisfactory results of surgical treatment of cereberal fractures of the femur in patients remains present. Obtained postoperative complications usually lead to the re-operative intervention (total hip replacement). The authors developed a distal locking method of the intramedullary rod with cereberal fractures of the femur, depending on its type according to the classification of AO. This method applies for a patent of Ukraine for useful model. For fractures of type A1 according to the developed method of vertical stability provides intramedullary rod itself and needs no distal locking; only proximal blocking is done. For fractures of type A3 blocking is made with the help of one distal locking screw, which is introduced into the oval hole. Implementation of the proposed method allows to create micromotion in the system "bone - rod," contributs to optimization of reparative osteosynthesis and reduces the trauma of surgical intervention. The aim of the study was to determine the effectiveness of the implementation of new technologies in the surgical treatment of cereberal fractures of femur.

Materials and methods. A comprehensive clinical study of 100 patients with ceresville femoral neck fractures who underwent operative intervention – locked intramedullary nailing (LIN) have been done. All patients were divided into two groups, first (control) group consisted of 50 patients with ceresville fractures of the femur who underwent the LIN by conventional methods. The second (experimental) group consisted of 50 patients with ceresville fractures of the femur who underwent the LIN using the new technologies developed by the authors. The effectiveness of treatment in both groups of observation has been researched. The observation period was 1 year. There was statistically significant (p≤ 0.01) decrease in the number of early (2 times) and late (3 times) postoperative complications in patients group where the blocking intramedullary rod were performed biomechanically justified, according to the recommendations developed by the authors, in comparison with patients groups that used conventional methods of LIN.

Results. The use of new technologies allows to increase the efficiency in 10 % of surgical treatment of patients with ceresville fractures of the femur.

Conclusion. The implementation of proposed new technologies will allow to perform effective differentiated (depending on the type of fracture according to the AO classification), surgical treatment of patients, also to improve the efficiency of medical care to patients with ceresville fractures of the femur, which distinguishes the proposed method from the conventional methods of LIN.

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