Взаємозв'язок електричного опору та морфологічних змін стегнової кістки щурів після моделювання відкритого перелома (експериментальне дослідження)

Background. Due to the development of industry, increasing number of vehicles on the roads rate of traumatic injuries among adult population causing disability and mortality is still high in all countries of the world. Among all fractures of long bones open diaphyseal fractures ranges from 28% to 53%. Objective. To study the relationship of electrical resistance and morphological features of the femur of white male rats after modeling the open fracture. Methods. Studies were conducted on white male rats aged about 3 months. Digital multimeter UT70B was used to measure the electrical resistance of bones in experimental animals after 1 and 3 hours of experimental modeling of opened bone fracture. Histological and electron microscopic studies were performed to evaluate bone structure. Results. 1 hour after modeling an open bone fracture it was detected the presence of empty lacunae or gaps filled with detritus. 3 hours after the experiment cellular density in the first studied area was reduced 4.1 times, in the second area - 3.2 times comparing with the control. Conclusion. These histological examination and study of the electrical resistance of bone fragments after re-fracture (with or without coagulation fragments) indicate similar changes in direction of the bone. Electrical resistance after testing in the clinical setting can be used for testing the bone fragments after an open fracture to assess viability. We have developed a technique for evaluation the electrical resistance making it possible to predict the viability of bone tissue with opened diaphyseal fractures of extremities on early stages.Проведено гистологическое, электронно-микроскопическое исследование и изучено электрическое сопротивление отломков бедренной кости на белых крысах после моделирования открытого перелома различной степени тяжести. Обнаружены гистологические, структурно-функциональные изменения в трех исследованных точках дистального и проксимального отдела фрагментов кости. Установлена корреляционная взаимосвязь электрогенеза костной ткани и состоянием остеоцитов с использованием прибора мультиметра цифрового UT70B. Метод сопротивления может быть использован для оценки жизнеспособности костной ткани в клинических условиях при открытых диафизарных переломах костей конечностей на раннем госпитальном этапе.Проведено гістологічне, електронно-мікроскопічне дослідження та вивчений електричний опір відламків стегнової кістки на білих щурах після моделювання відкритого перелому різної тяжкості. Виявлені гістологічні, ультраструктурні зміни в трьох досліджених точках дистального і проксимального відділу уламків кістки. Встановлено кореляційний взаємозв'язок електрогенеза кісткової тканини і станом остеоцитів, з використанням приладу мультиметра цифрового UT70B. Метод електричного опору може бути використаний для оцінки життєздатності кісткової тканини в клінічних умовах при відкритих діафізарних переломах кісток кінцівок при госпіталізації постраждалих

Theoretical and practical problems of optimization the long bone fractures osteosynthesis in patients with varying degrees of trauma severity.

Background. Today the treatment of polytrauma pathologies is complicated by two major problems. Firstly, there is still no universally accepted injury and severity scale for patients with polytrauma, that makes it impossible to develop an objective prognosis and treatment outcomes for victims. Secondary, the universal surgical treatment in patients with long bone fractures in the polytrauma remains indeterminate, the best ways to be agreed stabilization of fractures, depending on the severity of the general condition of patients, location and character of the musculoskeletal system damage. Objective. Justification ways to improve the results of osteosynthesis in patients with multiple and associated fractures of long bones by optimizing treatment strategy based on scoring and severity of injuries. Methods. It was worked out case histories of 226 patients (160 men and 66 women) with combined trauma to determine the optimal scales. To support the optimal volume of osteosynthesis tactics for patients with multiple and associated long bones fractures based on scoring and severity of the injuries, it was analyzed the treatment results of 104 this category patients (75 men and 29 women). All patients were divided into main (43 persons) and the control group (61 persons) on the basis of one-step (main group) or two-step (control group) surgical treatment. Results. Mathematical and statistical analysis of the four most widespread rating and severity scales of the damage in polytrauma, gave the opportunity to determine two the most effective ones in terms of constructive and prognostic validity, informative and ease of use. In order to determine the advantages and disadvantages of one-step and two-step treatment schemes of multiple and associated long bone fractures in patients with injury severity by ISS 25-40 points and severity by VPH-SP 21-32 points, the treatment results were compared by author system of health and social criteria. Conclusion. It is proved that the optimal treatment strategy for victims with multiple and combined fractures of long bones is one-step, including all types of ex-fix osteosynthesis with reposition of bone fragments and closed intramedullary blocked nailing osteosynthesis