40 YEARS EXPERIENCE OF INTERLOCKING INTRAMEDULLARY METALLIC-POLYMERIC OSTEOSYNTHESIS IN TREATMENT OF 1200 PATIENTS WITH SHAFT FRACTURES

The article comprises the main principles of interlocking intramedullary metallic-polymeric nailing (IIMPN) and the experience of its implementation in 1200 cases of shaft fractures during the period of 40 years. Three generations of metallic-polymeric nails and techniques for closed, semi-closed and open IIMPN were designed. The nails can successfully be interlocked with proximal and distal bone fragments without an intraoperative X-ray control. Therefore, the operation can be made in any hospital capable of surgical treatment of fractures. Unlike interlocking metallic nailing, the dynamic variant of IIMPN makes the additional operation of dynamization unnecessary. CMPN-3 and CMPN-2 nails have options of intraoperative axial and lateromedial compression between fragments, which is impossible in interlocking metallic nailing. The carving conjunction between screws and polymer, which flexibility is close to that of the bone, excludes critical concentration of tensions and considerable dynamic loadings, and therefore prevents fractures of the interlocking screws. Good follow-up results were obtained in 94.2% patients.The article comprises the main principles of interlocking intramedullary metallic-polymeric nailing (IIMPN) and the experience of its implementation in 1200 cases of shaft fractures during the period of 40 years. Three generations of metallic-polymeric nails and techniques for closed, semi-closed and open IIMPN were designed. The nails can successfully be interlocked with proximal and distal bone fragments without an intraoperative X-ray control. Therefore, the operation can be made in any hospital capable of surgical treatment of fractures. Unlike interlocking metallic nailing, the dynamic variant of IIMPN makes the additional operation of dynamization unnecessary. CMPN-3 and CMPN-2 nails have options of intraoperative axial and lateromedial compression between fragments, which is impossible in interlocking metallic nailing. The carving conjunction between screws and polymer, which flexibility is close to that of the bone, excludes critical concentration of tensions and considerable dynamic loadings, and therefore prevents fractures of the interlocking screws. Good follow-up results were obtained in 94.2% patients

Consequences in the Treatment of Long Bones Fractures with the Application of Minimally Invasive Methods of Intramedular Metallopolymer Blocking Osteosynthesis

Improving the effectiveness of treatment in patients with the consequences of diaphyseal fractures of the tibia (improperly fused, unfused fractures, pseudoarthrosis, bone defects) is one of the urgent problems of traumatology, which has not only medical but also important social significance. The aim of the study is to publish clinical experience in the use of closed and semi-open blocking intramedullary metal-polymer osteosynthesis (BIMPO) in the treatment of 125 patients with consequences of diaphyseal long bones fractures. An analysis of the use of closed and semi-open blocking intramedullary metal-polymer osteosynthesis (BIMPO) in 125 patients with fracture consequences (non-fused fractures, pseudoarthrosis), who were operated with the use of 3 and 8 BIMPOF. Long-term results were observed in 103 (88.89%) patients. The consolidation of the fracture in the optimal time was noted in 98 (94.64%) patients. Within 44-90 days from the operation, resistance and limb function were restored. No case of osteomyelitis was observed. This result is rated as good.The use of new generation of intramedullary metal-polymer clamps for the treatment of bone fractures and their consequences has provided a significant reduction in surgical trauma, which optimizes the process of anatomical and functional restoration of the limb

Selenium in Biological Fluids in the Bodies of Patients with Associated Trauma

Modern literature widely covers the role of selenium and necessity of its intake in case of different diseases, but the studies concerning the dynamics of concentration of this element in patients with injuries of the muscular- skeletal system (MSS) and cranial-cerebral injuries (CCI) are isolated. At the same time, investigation of selenium metabolism in case of injuries of the MSS and CCI and development of the correction schemes are generally known to enable to improve the results of treatment considerably and decrease the consequences of injuries.Objective: to investigate the concentration of selenium in biological fluids in patients with associate trauma.Materials and methods: 42 patients, treated at the Traumatological Department for adults and Neurosurgical Department of the Emergency Rescue Hospital in Chernivtsi, were examined. All the patients were distributed into 3 groups: І group – patients with severe CCI and injuries of the MSS requiring vital activity support; ІІ group – with moderate CCI and injuries of the MSS; ІІІ (control group) – with injuries of MSS only.Results: The data obtained are indicative of decreased selenium concentration in all the biological media of the body (plasma, erythrocytes, urine) during the whole post-traumatic period, both in patients with severe CCI and injuries of the MSS and those with a moderate degree. Conclusions: 1. Pronounced disorders of selenium metabolism are evidenced to occur in patients with severe CCI and MSS injuries, which are manifested by its decreased concentration in all the examined biological media of the body during the whole acute period of injury. 2. The lack of considerable differences in selenium concentration in patients with severe CCI and MSS injuries and with moderate injuries is indicative of non- specificity of the disorders found, since they are a typical pathologic process peculiar for traumatic injury of any genesis and localization. 3. The state of selenium metabolism does not possess correlations with other clinical and biochemical laboratory indices. 4. Selenium deficiency requires administration of pharmacological correction, for example, with Selenase which is essential both in acute and post-traumatic periods