The characteristics of stiffness are studied and the fixation means allowable load at fractures of the distal epimetazh of the tibia is calculated. The processes of a fracture points mutual displacements development under the influence of long-term cyclic loads are studied. Metal osteosynthesis was performed using various types of medial and lateral plates with angular stability and blocked plates for fixing fractures in the distal epimetazh of the tibia. The tests are conducted under the influence of actual physiological loads of compression, bending and torsion, including cyclic loading modes.

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Цель: эмпирическим путем (в натурном экспериментальном исследовании) определить взаимосвязь между рентгенологической плотностью и модулем упругости костной ткани в области голеностопного сустава. Методы: определен модуль упругости 10 образцов корковой костной ткани большеберцовой кости и 42-спонгиозной костной ткани дистального отдела большеберцевой (ББК), малоберцевой (МБК), таранной костей. Исследование модуля упругости костной ткани проводили путем регистрации линейных перемещений при статических и квазистатических комп рессионных нагрузках. Рентгенологическую плотность в единицах Хаунсфилда (HU) оценивали с помощью компьютерной томографии (КТ). Результаты: установлено,

The aim: to conduct retrospective analysis of treatment outcomes in polytrauma patients with multiple long bone fractures of lower extremities. Materials and methods: retrospective study of treatment results in patients hospitalized to the polytrauma department of Kyiv City Clinical Hospital №17 from January 2013 to December 2016. Results: among patients with polytrauma and multiple long bone fractures of lower extremities, males dominated (67.9%) and the main cause of injury was a road accident (73.3%). The most common localizations of injuries were chest trauma (82.4%), traumatic brain injury (74.8%). The severity of injury was 29.2 ± 10.5 points according to the Injury Severity Score (ISS), degree of consciousness disorders was 9.1 ± 3.3 points in conformity with Glasgow Coma Scale (GCS). Patients developed complications, including nosocomial pneumonia (40.5%), acute respiratory distress syndrome (ARDS) (19.1%) and fat embolism syndrome (10.7%), as well as sepsis (28.2%) and multiple organ failure (MOF) (16.0%). Mortality rate was 24.4%. Conclusion: It was found that among patients with polytrauma and multiple long bone fractures of lower extremities males dominated on the basis of gender, the main cause of injury was a road accident. The most common localizations of injuries were chest trauma and traumatic brain injury. Among controversial issues of treatment and diagnostic process are low frequency of pelvic binder application, ultrasound according to focused assessment with sonography for trauma (FAST) protocol and whole body multispiral computed tomography (WBMCT), which should be performed in 100.0% of patients with high-energy trauma at the time of admission to the hospital. In addition, frequency of Early Total Care (ETC) tactics application was too low, and definitive osteosynthesis in some cases was performed unreasonably late, using conservative fixation methods, which is a cause of complications and treatment prolongation in patients with polytrauma. The most common complications were pulmonary: nosocomial pneumonia, ARDS and fat embolism syndrome. Mortality rate was 24.4%.

Summary. Relevance. Health-related quality of life (HRQoL) is an important indicator of the treatment. Quality of life consists of functional, physical, emotional, social and spiritual states [1], and therefore has become a leading criterion in many researches, along with physical and economic factors. In the course of its development, the concept of quality of life has been correctly indicated as a parameter of the result in the recommendations of many medical societies [2]. Objective: to assess the quality of life of patients with adolescent idiopathic scoliosis who were treated conservatively. Materials and Methods. The study included 54 patients who were treated at the clinic of the Department of Pediatric Surgery of the Bogomolets National Medical University in the period from 2015 to 2019. The mean age of the patients was 12.6 years (range 10 to 15 years), the mean Cobb angle was 24.8° (range 20° to 37°), and the mean torso angle was 7.2° (range 6° to 17°). All patients underwent conservative treatment with continuous use of the Cheneau corset [6]. Indicators of quality of life were studied using Brace Questionnaire (BrQ) [8] at the beginning and at the end of treatment. The minimum duration of conservative treatment was 2 years. Results. Patients with adolescent idiopathic scoliosis at the end of treatment had lower scores in all domains of BrQ. This difference was statistically significant for the mean overall BrQ score and for the domains of general health perception, physical functioning, emotional functioning, self esteem and aesthetics, bodily pain, and social functioning. Assessments in the domains of vitality and school activity were not significant. Conclusions. It was found that the quality of life immediately after the end of conservative treatment of adolescent idiopathic scoliosis in the Cheneau сorset is gradually improving. Due to limitations in the design of the study, this finding highlights the importance of measuring quality of life indicators to assess how patients with adolescent idiopathic scoliosis perceive the impact of their disease.