Proximal humeral fractures constitute 5-8% of all the fractures of the limbs and 80% of fractures of the upper arm. To report about remote results of the suggested tactics of surgical treatment of proximal humeral fractures. Satisfactory results of treatment were found in 21 (80,7%) patients out of 26 (72%), who underwent closed reduction of fractures with pin fixation. This group of patients achieved consolidation in optimal terms, and the function of the shoulder joint was satisfactory with abduction angle of 90°. 2 (7,7%) patients experienced secondary dislocation of fragments and their QuickDASH score was 38.4. 3 (11,6%) patients achieved consolidation of fracture, but stable contracture of the shoulder joint occurred. Their QuickDASH score was 38.4. Osteosynthesis with plates was performed in 10 patients. 3 (30%) of them developed aseptic necrosis of the humeral bone head, 2 (20%) patients developed suppuration of the soft tissues which produced a negative effect of the patients’ ability to work ‒ QuickDASH score 42,7, 5 (50%) patients admitted satisfactory results of treatment ‒ QuickDASH score 21,5. Osteosynthesis with plates was performed in 10 patients. 3 (30%) of them developed aseptic necrosis of the humeral bone head, 2 (20%) patients developed suppuration of the soft tissues which produced a negative effect of the patients’ ability to work ‒ QuickDASH score 42,7, 5 (50%) patients admitted satisfactory results of treatment ‒ QuickDASH score 21,5. The tactics of surgical treatment of patients with proximal humeral fracturesdepends on the following: type of a fracture, patient’s age, concomitant pathology and osteoporosis available, and patient’s social needs.
One of the complicated problems of traumatology in the treatment of patients with calcaneal fractures is prevention of diabetes mellitus consequences. The work presents the analysis of treatment results of 72 patients with calcaneal fractures treated by means of surgical method at the Traumatological Adult Department, of the Regional Clinical Hospital "Emergency Rescue Hospital" (ERH), Chernivtsi, for the period from 2011 to 2018. With the purpose to examine the efficacy of treatment of calcaneal fractures all the patients were distributed into three clinical groups, patients with diabetes mellitus were isolated, and remote results of treatment were compared. Therefore, analysis of surgical treatment remote results of intra-articular calcaneal fractures in patients suffering from diabetes mellitus demonstrated that application of closed reposition under electrical optical transducer (EOT) control and fixation by means of wires leads to 44,38% improvement of treatment results, shortened terms of inability-to-work and disability. KEYWORDSCalcaneal fracture, minor invasive osteosynthesis, bone osteosynthesis, diabetes mellitus, diabetic foot syndrome, calcaneal fracture consequences.
The study presents the results of investigation of iodine deficiency condition on the bone tissue and healing post-traumatic bone defects under conditions of iodine deficiency.The experimental part of the study was performed on 63 randomized brand albino male rats of 3-month age. Peculiarities of the reparative osteogenesis were studied on the model of a traumatic injury simulated one-type in the proximal meta-diaphysis of the femoral bone irrespective of the experimental conditions in the frontal plane in the form of perforated defect. The defect was made by means of a drill 1mm in diameter.The results of the study are indicative of a negative effect of iodine deficiency produced on reparative osteogenesis manifested by inhibition of the process and associated with disorders in the formation of osseous regeneration, deterioration of the structural-functional state of the osseous tissue, development of degenerative-necrotic changes in the osseous tissue and epiphyseal cartilage.
The article analyzes the results of treating 45 patients with fractures of the calcaneus. To study the effectiveness of the treatment of patients with fractures of the heel bone, all patients were divided into three clinical groups. The first group consisted of 12 (26,60 %) patients with extra-articular fractures of the calcaneus, which was carried out surgery using the screws and wire loop. The second group is represented by 19 (42,30 %) patients with intra-articular fractures of the calcaneus, who underwent closed reduction under image intensifier control and locking the spokes. The third group included 14 (31,10 %) patients with intra-articular fractures of the calcaneus, which held an open reduction and osteosynthesis with plates and screws. In 4 (28,6 %) patients in the postoperative period were observed skin necrosis, 3 (21,4 %) patients came deforming ar-throsis of the subtalar joint with severe pain and impaired gait and only 7 (50,0 %) patients with good results treatment – 79 points on the AOFAS scale. Thus, the analysis of the long-term results of surgical treatment of intra-articular fractures of the calcaneus has shown that the use of closed reduction under image intensifier control and locking the spokes leads to better treatment results and reducing the time of disability.
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