Background. Treatment of tibial nonunions is not a fully resolved problem. The use of ring fixators (RF) for this pathology is competitive in modern conditions. However, there are also disadvantages. Improvement of RF treatment technology is a promising direction for improving the results of treatment of this severe pathology. Purpose of work was to improve the results of the treatment of nonunions of the shin bones based on improving the technique of using RF taking into account the problematic issues of their use; to determine their effectiveness. Materials and methods. According to the proposed method, 42 patients with tibial nonunions were treated. Spoke-rod devices were used with the improvements we proposed — sharpening, modes of conducting and arrangement of spokes in a ring at angles in different planes. In the ring, which was used to bring the osteotomized segment down du-ring distraction osteosynthesis, the outward pins were inserted to prevent it from tipping over. Semi-closed osteotomy (minimally traumatic and safe) was performed with fan-shaped with a chisel from a cross section up to 2 cm, with the formation of a comminuted fracture. External fusion Softcast/Scotchcast allowed avoi-ding deformation of the regenerate and creating optimal conditions for the fusion of fragments. Results. The following results were obtained for the treatment of patients with nonunions of the lower leg bones using RF with our proposed modes of use according to the Modified Functional Evaluation System by Karlstrom-Olerud. Good results were obtained in 20 patients — 55.6 %. In 4 patients (11.1 %), the results were assessed as good with elements of mode-rate dysfunction. They were 22.000 ± 1.323 points. Satisfactory results were obtained in 7 patients (19.4 %), estimated at 28.0 ± 0.125 points. Bad, unsatisfactory results were observed in 1 case (2.8 %); excellent functional status — in 4 (11.1 %). Conclusions. Bearing in mind the severity of the lesion, we find this result encouraging. Given the insufficient number of observations, it is necessary to recommend the use of the proposed improvements in the use of RF for the treatment of tibial nonunions after fractures and further study of their effectiveness.
Background. Bilocal extra-focal osteosynthesis with ring fixators (RF) of tibial nonunion is a method used by some authors. But there are no systematized guidelines for its implementation. This work is devoted to solving this issue. The purpose was to improve the results of the treatment of nonunions of the shin using RF constructions for bilocal osteosynthesis in complex treatment. Materials and methods. Generalized data of treatment of 17 patients with septic nonunions of the shin bones, in the treatment of which the technology of bilocal osteosynthesis with RF was used. According to the Non-Union Scoring System, all cases required complex specialized medical care with a possible positive result (scores from 51 to 75). Bilocal osteosynthesis was part of a complex surgical procedure. The important parts were as follows. The so-called blood-saving tactic was used. We used a squeezing and hemostatic tourniquet, tranexamic acid, and a topically hemostatic sponge. The rings were mounted on solid rods. Semi-closed osteotomy of the anterior and lateral walls was performed from a small incision in a fan-shaped chisel; the posterior wall of the bone was intersected by the levator with a comminuted fracture. Before comparing the reduced fragment with the fragment, they were processed. Conservative therapy was aimed at preventing infection, improving vascular activity, and normalizing metabolic processes. Conclusions. The obtained result of bilocal osteosynthesis of nonunions of the tibia should be considered encouraging and requires further application and study.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.