Experience in surgical treatment of 519 patients with bone fractures of different localization been treated during 2000 - 2009 was analyzed. In 335 patients low-invasive percutaneous osteosynthesis with application of original and known low-invasive technologies was performed. In 184 patients with similar fractures osteosynthesis by standard conventional techniques was performed during the period from 2000 to 2004. Comparative analysis of early and long-term treatment outcomes showed the advantage of low-invasive osteosynthesis techniques at treatment of fractures with different localization. Main principles and peculiarities of low-invasive osteosynthesis were determined.

Original technique of percutaneous osteosynthesis was applied for the treatment of 24 patients with acetabular columns fractures. The achieved results were compared to the results of osteosynthesis performed using open direct reposition of bone fragments (39 patients). The efficacy of low-invasive surgery in acetabular column fractures with regard to provision of fragments consolidation, prevention of femoral head aseptic necrosis development and achievement of early medical and social rehabilitation of patients was showed. Maintenance of fragments blood supply, use of minimal surgical approach and closed reposition are considered to be the progressive direction of internal osteosynthesis development.

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Introduction Patella fractures account for one percent of all fractures. Arthritis, non-union and other complications which affect the function of the lower limb may develop in the long term. The aim was to develop the most optimal osteosynthesis techniques for patella fractures. Methods We analyzed long-term treatment results of 78 patients with patella fractures treated from 2017 to 2018 using the KOOS (The Knee Injury and Osteoarthritis Outcome Score) scale, clinical examinations and knee joint X-rays. Based on the methods of surgical treatment for patella fractures, we divided the patients into 5 groups: Weber tension band wiring for two-fragment fractures; cross-like osteosynthesis and other methods of patella osteosynthesis using K-wires and wire loops for multifragmental fractures of the patella; combined osteosynthesis (tension band wiring with an additional screw or cerclage around patella); partial patellectomy and the inferior pole osteosynthesis. Results A comparative analysis of patients' groups after surgical treatment of patella fractures using the KOOS scale showed the best results after Weber tension band wiring for transversal fractures (72 %). The results of patients with multifragmental fractures of the patella using K-wires and wire loops were positive in 64 %; after the restoration of the inferior pole in 68 %, after partial patellectomy in 57 %. Conclusion For transversal fractures of the patella, tension band wiring is the method of choice. With multifragmental patella fractures, good results are achieved by cross-like osteosynthesis and other methods using K-wires and wire bands. The use of patellectomy followed by wire loop locking should be avoided for all types of patella fractures. In fractures of the inferior pole of the patella, it is preferable to fix it to the main patella fragment.