History, Modern State and Perspectives of Development of Plate Internal Fixation Methods

Belenkiy, I.G.; Sergeev, G.D.; Gudz, Yu. V.; Grigoryan, F.S.

doi:10.17513/spno.25248

Cited by 6 publications

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References 2 publications

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“…История развития накостного остеосинтеза, динамика модификации как самих пластин, так и методик их имплантации достаточно хорошо изучены, чего нельзя сказать об истории развития интрамедуллярного остеосинтеза [4]. Этому аспекту посвящены единичные публикации, а также отсутствует доступная и системная информация.…”

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Historical Parallels in the Development of the Intramedullary Osteosynthesis. State and Prospects

Belenkiy¹,

Хоминец²

2020

СПНО (MPSE)

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Цель работы-на основании данных литературы осветить исторические аспекты развития интрамедуллярного остеосинтеза, показать современное состояние и перспективные направления развития этой технологии. Изложены исторические предпосылки развития интрамедуллярного остеосинтеза в XIX в. и в начале XX в. Отмечено, что прогресс этой технологии был связан с открытием асептики, наркоза, рентгеновских лучей, а также с развитием металлургии. Описаны основные этапы совершенствования технологии интрамедуллярного остеосинтеза с указанием хирургов, внесших наибольший вклад в прогресс методики. Констатировано, что сегодня интрамедуллярный остеосинтез является реальной альтернативой накостному при лечении переломов длинных костей конечностей метаэпифизарной локализации. Обозначены перспективные тенденции развития интрамедуллярного остеосинтеза: попытки стабилизации гвоздя без блокирования, производство фиксаторов из композитных материалов. Обозначены различия в путях совершенствования технологий интрамедуллярного остеосинтеза у нас в стране и за рубежом, показаны причины отставания советской травматологической школы во второй половине XX в. Констатировано, что в настоящее время в России ликвидировано значительное отставание в развитии профессионального сообщества и в подходах к лечению пациентов с переломами костей конечностей. Российский рынок предлагает широчайший спектр изделий как отечественного, так и зарубежного производства. С развитием современных технологий сегодняшние изыскания ученых направлены на тонкие биомеханические исследования с целью совершенствования конструкций для интрамедуллярной фиксации. Ключевые слова: остеосинтез, интрамедуллярный остеосинтез, история остеосинтеза, травматология, эволюция остеосинтеза.

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Historical Parallels in the Development of the Intramedullary Osteosynthesis. State and Prospects

Belenkiy¹,

Хоминец²

2020

СПНО (MPSE)

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The effect of the surface structure of titanium alloy medical screws on their wear resistance

et al. 2019

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In this work, the effect of vacuum ion-plasma treatment on the wear resistance of the medical screws surface made of VT6 titanium alloy is studied as well as on the mechanical characteristics of the screws in contact with the plate for osteosynthesis. It is shown that the TiN titanium nitride deposition on the screw head increases the surface microhardness by 3 times and also provides lowering the torque during removal of the screw out of the plate.

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Flistory and prospects of development of methods of osteosynthesis and osteosynthesis of the humerus diaphysis

Khorak,

Kogan,

Lyakh

et al. 2023

vmirvz

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Relevance. About 800 thousand people die every year as a result of injuries and their consequences, in the Russian Federation the frequency of injuries is 12 %. Fractures of the humerus diaphysis account for 1-5 % of the total number of traumatic injuries of the skeleton, at the same time, there is no tendency to reduce injuries in modern society, therefore, the number of surgical interventions aimed at restoring the integrity of the bone does not decrease. Among the reasons for the unsatisfactory results of osteosynthesis, iatrogenic ones are distinguished: inconsistency from a biomechanical point of view, the choice of an unsuitable metal structure, insufficiently correct comparison of the ends of bone fragments and neglect of contraindications to the use of submerged structures with increased contamination of the wound with open fractures. Non-infectious complications of primary osteosynthesis include false joints, improperly fused fractures, untenable osteosynthesis, as well as fractures and migrations of implanted metal structures. The described complications are the basis for repeated (revision) surgery, or rheosteosynthesis. The purpose of this study is to analyze the historical aspects of the development of osteosynthesis and rheosteosynthesis methods, as well as to determine the prospects for their further development.Materials and methods. In the process of writing the article, the analysis of data from literary sources published in the period from 2016 to 2023 was carried out.Results. Speaking about the choice of osteosynthesis technique, it should be noted that no recommended and maximally described techniques will be able to fully cover the variety of situations that arise during osteosynthesis operations, therefore, first of all, a positive outcome depends on the experience of the surgeon and his ability to make situational decisions. Each of the methods used has both advantages and disadvantages, and which treatment tactics the surgeon would not prefer - there is always a risk of complications and, as a result, an unsatisfactory result. In such cases, patients undergo revision operations of osteosynthesis (rheosteosynthesis), minimizing or completely eliminating bone defects. The complexity of correcting the consequences of injuries of the humerus diaphysis is due to the variety of conditions leading to the development of various kinds of bone defects or false joints, as well as in a limited number of techniques that can fully repair the damage in a short time. Taking into account the rather long periods of consolidation of fragments, rehabilitation of patients with this type of pathology implies the use of devices capable of providing stable fixation and the possibility of early restoration of upper limb functions for fastening bone fragments. As a rule, revision surgical interventions include excision of scars from the interfragmental area or corticotomy, removal of deformation (if present), rimming of the medullary cavity and intramedullary osteosynthesis, to which, in rare cases, fixation with a short plate may additionally be applied. The range of revision surgical interventions may include rheosteosynthesis in combination with: segment elongation and corrective osteotomies, bone alio- and autoplasty, with bone elongation on a nail in an external fixation device.Conclusion. The development of modern technologies of osteosynthesis and osteosynthesis of the diaphyses of long tubular bones in general, and the humerus in particular, has passed a serious evolutionary path. In recent decades, methods and technologies of osteosynthesis have been actively developing and improving. With the development of knowledge in the field of the mechanism of bone fusion, implant designs and installation technologies are changing, new modifications of operative accesses are being developed. When choosing the method of fixation of bone fragments, minimally invasive osteosynthesis techniques are becoming increasingly popular. Currently, combinations of different rheosteosynthesis methods are being actively introduced, which significantly expands their capabilities, in comparison with their application separately.

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History, Modern State and Perspectives of Development of Plate Internal Fixation Methods

Cited by 6 publications

References 2 publications

Historical Parallels in the Development of the Intramedullary Osteosynthesis. State and Prospects

Historical Parallels in the Development of the Intramedullary Osteosynthesis. State and Prospects

The effect of the surface structure of titanium alloy medical screws on their wear resistance

Flistory and prospects of development of methods of osteosynthesis and osteosynthesis of the humerus diaphysis

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