Potentialities of Surgical Treatment for Acetabular Fractures Using Low-Invasive Techniques

N.N. Priorov Journal of Traumatology and Orthopedics

Gavryushenko

Fomin

et al. 2021

BACKGROUND: Currently, several types of designs of support rings of M. Muller, Burch-Schneider, rings of the company Protek (Switzerland), implanted in the BB are widely used, which are used in the surgical treatment of long-standing fractures of the BB, as a rule, as a device that strengthens the walls of the BB. AIM: Study of the deformation properties of the repositional-fixing ring. MATERIALS AND METHODS: For carrying out mechanical tests, a ring with an external diameter of 52 mm was made by the method of sequential sintering using additive technologies by the company Konmet LLC, Moscow. Laboratory mechanical tests were carried out by the Testing Laboratory of Medical Devices and Materials of the N.N. Priorov National Medical Research Center of Traumatology and Orthopedics. RESULTS: As a result of static testing of the ring for compression, tension, torsion, and joint stretching and twisting of the edges of the ring connector, its deformation properties are studied. Load corresponding to the deformation of 2 mm, kN: compression 0.180; tension 0.061; torsion (torque corresponding to the angle of rotation of 5 degrees, Nm) 2.653; joint tension with twisting of the edges of the ring connector (load corresponding to the deformation of 10 mm, kN) 0.048. CONCLUSION: The results of the initial study of the deformation behavior of the ring structure show that it is necessary to refine the ring design and further study the deformation and strength characteristics of the ring.

Section: актуальностьunclassified

Repositional-fixation ring for surgical treatment of acetabular fractures (preliminary results of static tests)

N.N. Priorov Journal of Traumatology and Orthopedics

Gavryushenko

Fomin

et al. 2021

Universal reposition and fixation ring for surgical treatment of acetabulum fractures: preliminary results of laboratory static tests

N.N. Priorov Journal of Traumatology and Orthopedics

Gavryushenko

Fomin

et al. 2022

BACKGROUND: Several structures are widely used in the surgical treatment of long-standing fractures of the BB, such as support rings of M. Muller, BurchSchneider, rings of PROTEK (Switzerland) implanted in the BB. In traumatology practice, rings are used to strengthen fractured walls. However, these rings are not functionally designed for open reposition and fixation of columns and fractures, followed by TBS endoprosthetics with cement fixation of the components of the endoprosthesis. Recently, primary endoprosthetics of EP TBS became the trend for displaced fractures of the BB, which is considered the best option for surgical treatment of BB fractures. In the literature, no analogs of our ring were available, which provides CHP in the treatment of BB fractures. AIM: To study the deformation properties of a repositional fixation ring with an outer diameter of 52 mm with a stiffening rib. MATERIALS AND METHODS: A ring has been developed for the surgical treatment of acetabulum fractures (Patent for Invention No. 2692526 dated 26.06.2019 under Application No. 2018133671 dated 25.09.2018.; Bul. No. 18 dated 26.06.2019). For mechanical testing, a ring with an outer diameter of 52 mm with a stiffening rib was manufactured by sequential sintering using additive technologies by Konmet LLC (Moscow). Laboratory mechanical tests were conducted by the Testing Laboratory of Medical Devices and Materials of the FSBI NMIC TO named after N.N. Priorov (Moscow). RESULTS: A static testing of a ring with a stiffener for compression, stretching, torsion, joint stretching, and twisting of the edges of the ring connector was performed, and its deformation properties and reaction to external loads during static tests were examined. The load corresponded to the deformation of 2 mm, kN; compression, 0.209; tension, 0.082; torsion (angle of rotation of 5 degrees, Nm), 9.422; and joint stretching with twisting of the edges of the ring connector (load corresponding to the deformation of 10 mm, kN), 0.060. CONCLUSION: The results of the initial study of the deformation behaviors of the new ring design clearly show the elastic nature and deformation properties of the ring, which were attributed to the stiffening rib. The positive primary results of studying the deformation behaviors of the ring reinforced with a stiffening rib indicate the possibility for clinical trials and the direction of further refinement of the design..

Complications of Acute Acetabular Fractures Surgical Treatment: Systematic Review

Traumatology and Orthopedics of Russia

Zagorodniy

Загородний³

et al. 2021

Background.The combination of classical anterior and posterior approaches, as well as their modifications, is recognized as the most effective in acetabular fractures surgical treatment. The use of classical and modified approaches is accompanied by serious intra- and postoperative complications associated primarily with the duration of surgery, significant blood loss, tissue trauma, surgical site infection. The aim of review — to determine the main and most frequent complications associated with surgical approaches to the acetabulum. material and methods. Access to literature sources is carried out in the information systems and databases PubMed/Medline, Embase, Scopus, Сochran Library, eLibrary, Wiley Online Library. Keywords: acetabular fractures, surgical treatment, approach to the acetabulum, total hip replacement.Results. The most common intraoperative complications are incorrect fragments reduction, sciatic nerve injury, less often — intraarticular implant position, damage to the superior gluteal artery and other vessels, among the early postoperative complications - wound infection, both superficial and deep, less often — venous thrombosis. Late postoperative complications are mainly represented by the development of heterotopic ossification, post-traumatic coxarthrosis, less often revealed aseptic necrosis of the femoral head, residual protrusion and secondary femoral head lesion. Conclusion. The main approach to the acetabulum are the ileo-inguinal and the Kocher-Langenbeck approach, as well as their combination.Complications were more common using two approaches, especially in cases of simultaneous use. The main intraoperative complications are the sciatic nerve and the superior gluteal artery injury with posterior approaches, the femoral lateral cutaneous nerve with expanded ilio-femoral approach, and the obturator nerve with anterior approaches.