The aim. To research some features of a combat injury of the jaw-facial region and possible options of surgical treatment using titanium implants. Materials and methods. We investigated clinical cases of the treatment of high-speed combat injuries of the maxillofacial area in the department of maxillofacial surgery with otolaryngological beds of Municipal Non-Commercial Enterprise “City Hospital of Emergency and Urgent Medical Care of the Zaporizhzhia City Council”. Results. Postoperative follow-up of the patients affected by high-velocity projectile showed positive treatment outcomes in all observations. The negative consequences of the trauma revealed in the postoperative period were persistent paralysis of facial muscles, lower jaw dysfunction with limited mouth opening, necrosis of the damaged tissues of the oral cavity, necrosis and suppuration of tissues around the wounds, formation of deforming scars and fistulas, sequestration. The most common functional disorders as a result of injury were paralysis of the facial muscles and mandibular dysfunction which were observed in 100 % of our cases. Sequestration of the bone fragments was observed in only one case, only one patient showed all the above mentioned negative pathological consequences of high-speed trauma. Conclusions. Our experience in the treatment of high-velocity gunshot wounds at the face leads to the conclusion that the results of the treatment and the choice of surgical tactics depend primarily on the severity of the wound and the degree of destruction of soft and bone tissues of the face. The great variety of the nature of injuries does not allow determining of a “golden standard” for final surgical treatment.

Summary. The efficiency of using the dynamic blocking intramedullary osteosynthesis (BIOS) technique for tibial fractures with the use of biodegradable implants based on the MS-10 magnesium alloy was determined. Objective: to approve the technique and to study the effectiveness of dynamic intramedullary osteosynthesis of diaphyseal fractures of the tibia using locking screws made of the biodegradable magnesium alloy MS-10. Materials and Methods. The study was carried out in the Department of Traumatology of the Municipal Non-Profit Enterprise “City Hospital of Emergency and Ambulance” of Zaporizhzhia City Council in Zaporizhzhia on 15 patients with diaphyseal fractures of the tibia, who underwent BIOS. Cannulated intramedullary titanium rods were used as a fixator. In the proximal section, a screw made of titanium alloy was introduced into a dynamic hole; a screw made of a biodegradable magnesium alloy MC-10 was inserted into a static hole. In the postoperative period, the patients underwent a course of complex rehabilitation measures. X-ray control was performed on day 1, at week 4, week 8, and week 16 after the surgery. Results. After the start of the dosed load on the injured limb, a fracture of the locking screw made of MC-10 alloy was radiographically recorded in all patients. The dynamic screw moves in the dynamic hole and the fracture is dynamized. The formation of callus in the fracture zone was unremarkable and took an average physiological time. The quality and structure of callus did not show any pathological features. Four months after the surgery, all patients were socially adapted and did not use additional support when moving. Conclusions. Based on the data obtained, it is possible to draw a conclusion about the possibility and advisability of using biodegradable implants made of magnesium alloy MS-10 in a dynamic BIOS of long bones of the human skeleton.

No abstract

No abstract

Summary. Modern medicine widely uses artificial materials to replace damaged tissues and organs. Biodegradable implants should be gradually replaced with living tissue and stay functioning within a specified period, don’t have any negative impact on surrounding tissues and a human body in general. Clinical studies of biochemical values specifying the intensity of inflammatory response to IM nailing with biodegradable implants are of clinical and scientific interest. Task of the study: to substantiate of the use of implants made of biodegradable magnesium alloy MS-10 in the dynamic IM nailing for diaphyseal fractures of the tibia. Materials and methods. The study involved 34 patients with diaphyseal tibial fractures, which resembled surgical treatment (IM nailing). Cannulated intramedullary titanium nails served as a blocking pin. The treatment included closed reposition followed with IM nailing of a tibia. To lock the nail, a screw made of magnesium alloy MS-10 was inserted in a static (round) hole in 16 patients. In 18 patients, a screw made of titanium was inserted into a static hole. The both groups passed blood sampling for studies, before and after the surgery, 2 and 4 weeks, 2 and 4 months after surgery. Biochemical blood tests were to determine the concentration of fibrinogen-monomer complexes in the blood plasma (β-naphthol test). Results. The study of the activity of AST and ALT found it lower (19 and 29%) in patients with biodegradable screws, compared to the group of patients with IM nailing locked with bioinert screws. The situation was similar with ESR, fibrinogen B and total bilirubin in the blood of patients in both groups. Conclusions. The study convincingly proves the expediency of the use of biodegradable material (magnesium alloy MS-10) to produce implants for the IM nailing for the patients with long bones’ fractures.