ВІДДАЛЕНІ РЕЗУЛЬТАТИ ЛІКУВАННЯ ХВОРИХ, ОСТЕОСИНТЕЗ ЯКИМ ПРОВОДИВСЯ МЕТАЛЕВИМИ ТА ПОЛІМЕРНИМИ ФІКСАТОРАМ Резюме. Проведені дослідження, з застосуванням клінічних та рентгенологічних обстежень доводять, що патологічних змін кісткової тканини в ділянках синтезованих консолідованих метаепіфізарних пе-реломів в оперативному лікуванні яких застосовувалися фіксатори, виготовлені з полімерних ма-теріалів полігліколіду та поліаміду П-12, не виявлено на протязі всього терміну спостережень від 10 до 44 років після оперативного втручання. Обидва полімерні матеріали виявлять високу біосумісність, що дозволяє безпечно застосовувати фіксатори виготовлені з даних матеріалів для остеосинтезу метае-піфізарних переломів. Ключові слова: остеосинтез переломів, біодеградуючі імплантати, полігліколід, поліамід-12, дов-готривалі спостереження.Polymeric fixation devices for surgical treatment of closed limb fractures can be a good alternative to metal fracture fixation devices [1]. Currently the implants made of stainless steel (316L, 1X18N9Т), titanium, and titanium alloys have become widespread in the surgery, but there's a disadvantage of their application requiring the second surgical procedure, aimed to remove them afterwards [2, 3]. As for the polymeric devices, some of them are biodegradable, while others are bioinert due to the absence of corrosion, and therefore do not require the removal [4]. Just a few research reports exist, that are devoted to studying the consequences of the use of polymeric fixation devices with follow-up periods spanning from 1 to 5 years only, while further results for most of the polymeric materials normally remain untraced and therefore unknown [5, 6].Objectives: to determine changes of bone tissue in healed fracture areas after internal fixation with the use of polymeric or metal fixation devices in far outcome through applying clinical and radiological examination.Design and Methods. Results. The results of fracture treatment, using polymeric devices, were compared with the results of surgeries, where the devices made of stainless steel were employed. Changes of the tissues in the place of the fixation were examined using clinical and radiological methods and evaluated with the help of our own estimation score system. The system in question has included 8 clinical and 3 radiological criteria to form a three grade scale. Good results in 20-30 years after polymeric osteosynthesis with polyglycolide were achieved in 92.6 %, while in 7.4% of cases the results turned out satisfactory. In group of patients, operated with the use of polyamide-12 fixation devices, good results were achieved in 77.4 % of cases, while good results in patients after internal fracture fixation with metal fixation devices totalled 71.4%.Discussion. There was a complete restoration of bone structure in the place of polyglycolide implantation without any pathological formations or other changes. Polyamid-12 polymeric devices were covered with capsule of bone tissue similar to cortical layer. The diameter of polyamide-12 screws was...

Tibial fractures are very common injuries that require surgical management. For many cases, when the fracture involves the joint further complications occur, such as joint stiffness, osteoarthritis, aseptic necrosis of articular surfaces, ankylosis, infection complications, etc. To prevent joint stiffness open reduction and internal fracture fixation is used. That allows better positioning of fracture fragments forming joint surface and improve outcome. The article analyses results of surgical treatment of intraarticular fractures as well as biomechanical factors that are affecting the joint within the healing process and in later outcome period. Various treatment procedures are suggested to prevent development of osteoarthritis or to decrease its severity. The following options are used on all stages of treatment starting since the moment of injury, primary surgical procedures, rehabilitation period, and further non-surgical treatment in the internal medicine department. Important roles are assigned for use of chondroprotective drugs, intraarticular injections of Hyaluronic acid, physiotherapy and physical activity.