организация травматолого-ортопедической помощи т р а в м а т о л о г и я и о р т о п е д и я р о с с и и 2013-2 (68)

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Osteosynthesis with cannulated screws is one of low invasive osteosynthesis techniques that does not aggravate the condition of polytraumatized patients and can be used at the early stages of treatment. The purpose of the study was to determine the peculiarities of cannulated screws application in pelvic ring and acetabular injuries. Cannulated screws were used at surgical treatment of 368 patients, aged 14–77 years, with pelvic injuries. The overwhelming majority of patients were with severe polytrauma (17 and more points by ISS score). Pelvic ring injuries (61st segment) were diagnosed in 259 (70.4%) patients, acetabular fractures (62nd segment) — in 75 (20.4%), pelvic ring injuries associated with acetabular fractures (61st and 62nd segments) — 34 (9.2%) patients. The screws were mainly used as the basic treatment technique, rarely — in combination with internal plate osteosynthesis and more rarely — in combination with external fixation device. Analysis of the results and complications was performed. Treatment results by Majeed pelvic score at terms 1 to 3 years were studied in 207 patients. Poor results were observed in 15 (7.2%) cases. Pelvic fracture osteosynthesis with cannulated screws has a number of advantages and can be referred to as one of the basic surgical techniques for pelvic fractures.

Retrospective analysis of treatment results of 157 patients with 163 fractures of the distal femur at polytrauma was perfomed. Used an osteosynthesis distal a pins with blocking, plates with angular stability, devices of external fixing. Estimated frequency and character of complications, duration and number of the hospitalisation, the remote results of treatment. It is revealed that at patients with polytrauma at supracondylaris fractures of the distal femur and sagittalis intraar- ticulate fractures without displacement by an optimum method of treatment the osteosynthesis nails with blocking is, at intraarticulate splintered fractures with displacement and a face-to- face line of a break is shown opened reposition with an osteosynthesis plates with angular stability.

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