femur

New biological method of internal fixation of th

/STRU^NI RAD UDK 616.71-001.5-089.881:615.472 New concept in external fixation

A new concept in external skeletal fixation is presented. A 3D unilateral system developed by Mitkovic has widely been investigated biomechanically in AO institute in Davos (Switzerland). Consists of three components only providing extremely simple application and dynamic fixation of bones and different joints. This simple external fixator functions as an accurate reduction device at the same time, minimizing need for fluoroscopy. Clinically this system has been applied to mere then 13 thousand patients in 43 clinics. This paper presents the results of its application for treatment of open fractures, war wounds with fractures and for comminuted and intraarticular closed fractures in the series of 597 patients. Overall average time for union time was 3.2 months. Overall success of fracture healing was 96.8% including open and closed fractures. Our study suggests that the use of this 3D unilateral system is suitable for routine use. Key words: fracture, external fixation, Mitkovic external fixator, war wounds, nonunion rezim

Klinika za ortopediju i traumatologiju, Klini~ki centar Ni{ 2 Hirur{ka klinika, Klini~ki centar Ni{

Politrauma danas predstavlja te‘ak socio-ekonomski i medicinski problem. Za uspe{an ishod le~enja od presudnog je zna~aja odgovaraju}e hirur-{ko zbrinjavanje pojedinih povreda po prioritetu hitnosti. Blagovremeno i adekvatno zbrinjavanje preloma dijafize femura u sklopu politraume u zna~ajnoj meri smanjuje morbiditet i mortalitet i omogu}ava br‘i oporavak uz minimalni invaliditet. Prospektivnom klini~kom studijom analizirana je serija od 23 politraumatizovana pacijenta sa zatvorenim prelomima dijafize femura le~enih u Klini~kom centru u Ni{u u petogodi{njem periodu. Prvu grupu ~ini 9 ispitanika kod kojih je prelom re{en intramedularnom fiksacijom Kuntcherovim klinom dok drugu grupu ~ine 14 ispitanika kod kojih je prelom re{en unutra{njim fiksatorom po Mitkovi}u. Unutra{nji dijafizarni fiksator po Mitkovi}u predstavlja novo osteosintetsko sredstvo za definitivno le~enje preloma dijafize femura kod politraumatizovanih. Zahteva minimalno invazivnu hirur{ku tehniku bez grubih manipulacija uz minimalni gubitak krvi, pogodan je za zbrinjavanje te{kih kominutivnih preloma femura koji su ~esti u sklopu politraume i obezbeduju odli-~ne uslove za zarastanje. Klju~ne re~i: prelom dijafize femura, politrauma, unutra{nji fiksator Mitkovi} rezim