He New Method of Minimally Invasive Osteosythesis of Humeral Shaft Fractures With Helical Plates

Кочиш, А. Ю.; Майоров, Б. А.; Беленький, И. Г.

doi:10.21823/2311-2905-2016-22-3-99-109

Cited by 5 publications

(1 citation statement)

References 8 publications

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“…Фахівці змушені використовувати малогабаритні, але порівняні з відламками за величиною пристрої під час остеосинтезу дистального кінця плечової кістки, які повинні забезпечити жорсткість фіксації та можливість рухів у ліктьовому суглобі в ранньому післяопераційному періоді. Більшість надає перевагу активній хірургічній тактиці, що передбачає застосування різних LCP-пластин, спиць, гвинтів та дроту [4]. У цих умовах невпевненість фахівців щодо достатньої жорсткості фіксації кісткових фрагментів зумовлює тривалість іммобілізації, а під час відновлення рухів у ліктьовому суглобі змушує застосовувати найбезпечнішу амплітуду, що призводить до розвитку різних ускладнень [5].…”

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Experimental Study of Osteosynthesis Stability of the Distal Part of the Humerus

Bodnya¹,

Dubovik²,

Karpinsky³

et al. 2022

OTP

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Unresolved issue is improving of the osteosynthesis of extraarticular fractures of the distal humerus. Search for a simplified method of biological fixation, which assumes, with low trauma, to ensure the stable fixation of fragments and movements in the elbow joint in the early postoperative period. Objective.To carry out a comparative analysis of the bone fragments displacement of the distal humerus in extra-articular fractures, stabilized by extraosseous and transosseous osteosynthesis. Methods. Biomechanical study of the distal humerus model was made. Transosseous osteosynthesis was modeled using the author’s external fixation apparatus (EFA). For comparison, we chose an osteosynthesis with a Y-shaped plate. The humeral models were loaded with an interval and a stepwise increased in the load for compression along the axis, flexion in a parallel plane, as well as perpendicular to the fixing elements of the plate and EFA. The magnitude of the load gradually increased from 0 to 250 N with a step of 50 N. The magnitude of the forces at which, due to the action of various loads, a displacement at the level of the fracture appeared. Results. The analysis of experimental studies showed that the rod apparatus and the plate provide the same stability of fixation of the fragments of the humerus under conditions of axial compression load (p > 0.05). Under the influence of bending loads of more than 100 N in a plane parallel to the fixing elements, the plate had a slight advantage (10 %). A significantly better result (p < 0.01) was obtained when an external device was used under the action of bending loads in a plane perpendicular to the fixing elements. Conclusions. In the case of fractures of the distal humerus, the transosseous osteosynthesis using the proposed external fixation rod device ensures the stability of the fragments under all loading options. It is quite reliable and can be recommended for use in clinical practice.

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Section: вступunclassified

Experimental Study of Osteosynthesis Stability of the Distal Part of the Humerus

Bodnya¹,

Dubovik²,

Karpinsky³

et al. 2022

OTP

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Biomechanical evidence-based transosseous osteosynthesis in treatment of humerus fractures complicated by chronic osteomyelitis and consequences

Tsiskarashvili

Melikova

Zhadin

et al. 2020

N.N. Priorov Journal of Traumatology and Orthopedics

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Aim. To study the results of treatment of patients with fractures of the humerus and their consequences, including those complicated by chronic osteomyelitis, by the method of biomechanically grounded transosseous osteosynthesis. Materials and methods. A retrospective analysis of the results of treatment of fractures and pseudarthrosis of the humerus, including those complicated by chronic osteomyelitis, was carried out by the method of biomechanically substantiated transosseous osteosynthesis in 74 patients who were in the N.I. N.N. Priorov in the period from 2011 to 2019. Osteosynthesis with a rod-based apparatus was performed in 36 (48.6%) patients, with a spoke-rod in 38 (51.4%) patients. Results. Complete consolidation of bone fragments of the humerus and relief of the purulent-inflammatory process were achieved in all cases studied. Excellent treatment results were achieved in 25 (34%) cases, good results were obtained in 44 (60%) patients, satisfactory results were stated in 4 (6%) patients. No unsatisfactory outcomes were registered. Conclusion. The use of biomechanically based transosseous osteosynthesis in the treatment of fractures of the humerus and their consequences, including those complicated by chronic osteomyelitis, provided up to 94% of excellent and good results.

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Topographic-Anatomical Validation of a New Method for Minimally-Invasive Extra-Cortical Osteosynthesis Using Plastinated Transverse Shoulder Cuts

Starchik

Майоров

Беленький

2020

Žurnal anatomii i gistopatologii

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The aim of the study was to assess capability and benefits of this method, its technical feasibility and safety regarding a damage of the most essential anatomical structures.Material and methods. The study involved 15 natural humeral bones; their parameters - the length and shape of the plates – were measured for osteosynthesis. Bone osteosynthesis was further performed on 14 intact upper limbs taken from 7 non-fixed corpses of people died at the age of 63–77 using the discussed method; after that, the operated limbs were studied using preparating technique. Furthermore, after plate application on two shoulder sections, 12 transverse cuts with their epoxy plastination were made at three levels according to the original technology; this was followed by the preparation of histotopographic sections.Results. The results obtained have demonstrated that for the new method of bone osteosynthesis it is advisable to use metal plates 220–260 mm long with spiral twisting clockwise for the right humerus and counterclockwise for the left. Average distances from the fixed plate to the humerus, tendon of the long head of the biceps of the shoulder muscle, large blood vessels and peripheral nerves were determined using precision preparation and measurements; the measurements were also performed on transparent plate-shaped shoulder cuts. All the above validates safety of the discussed method regarding a damage of the most essential anatomical structures and allow to successfully use it in the clinical practice.Conclusion. The discussed technique of plastinated transverse shoulder cuts with further experimental fixation of metal implants for osteosynthesis ensures safety of the initial topographic and anatomical relationships of these structures with anatomical structures. In addition, high transparency of the tissues created by epoxy plastination allows determining distances between implants and important anatomical structures with high precision, the fact being of great significance in applied anatomical studies.

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He New Method of Minimally Invasive Osteosythesis of Humeral Shaft Fractures With Helical Plates

Cited by 5 publications

References 8 publications

Experimental Study of Osteosynthesis Stability of the Distal Part of the Humerus

Experimental Study of Osteosynthesis Stability of the Distal Part of the Humerus

Biomechanical evidence-based transosseous osteosynthesis in treatment of humerus fractures complicated by chronic osteomyelitis and consequences

Topographic-Anatomical Validation of a New Method for Minimally-Invasive Extra-Cortical Osteosynthesis Using Plastinated Transverse Shoulder Cuts

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