The clinical significance of posttraumatic malunions of lower extremities long bones

Romanenko, Kostiantyn; Doluda, Yaroslav; Prozorovskiy, Dmytro; Pariy, Vasyl

doi:10.15674/0030-59872020472-79

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…Проте виникнення різних типів ускладнень спостерігають від 3 до 54 % [10][11][12][13]. Майже кожна клінічна ситуація з ускладненнями супроводжується, зазвичай, значним обмеженням функціональних можливостей ушкодженої кінцівки та розвитком інвалідності постраждалих [10][11][12][13][14][15][16][17]. Натепер ми не зустріли наукові публікації, які б детально аналізували результати лікування хворих із травматичними ушкодженнями довгих кісток кінцівок з урахуванням помилок, ускладнень і стану інвалідності.…”

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Retrospective medico-social analisys of the results of treatment patients with the concequences of long bone fractures

Tankut¹,

Golubeva²,

Rykun³

et al. 2021

OTP

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The problem of long bones fractures treatment remains actual, despite a significant number of studies carried out on this topic. Such fractures of the musculoskeletal system occur more often and are accompanied by various complications, significantly compromise the quality of patients life and often lead to the disability. Objective. To analyze different types of traumatic injuries in patients with the consequences of long bone fractures, to evaluate the effectiveness of diagnostics, treatment and to analyze the state of disability. Methods. A retrospective medical and social analysis of the results of treatment of 333 patients (232 (69.6 %) men, 101 (30.4 %) women) with the consequences of long bone fractures, based on the obtained study group in the Kharkiv Regional Center for Medical and Social Expertise № 2, for the period 2018–2019. Results. Three main methods of surgical treatment were analyzed: internal fixation (ORIF), blocking intramedullary nailing (IMN) and treatment with external fixation devices (EF). They were applied in the following rate: ORIF — 204 (61.3 %) cases, IMN — 98 (29.4 %), EF — 31 (9.3 %). The most typical complications of the treatment of patients with fractures of the long bones were delayed union or nonunion, neuropathies of the treated extrimities, joint contractures, osteoarthritis of adjacent joints, deformities of affected extrimities, osteomyelitis. Causes of disability were: 63 % — severity of injuries, 46 % — different posttraumatic complications, 6.5 % — iatrogenic complications. Among the latter, the most common were: diagnostic — 7.1 %, incorrect method of treatment — 29.7 %, iatrogenic incorrect surgery methods — 45 %. Conclusions. The data obtained showed that the improvement of organization measures for the prevention of complications and disability in patients with consequences of long bones fractures could help to increase the efficiency and quality of specialized medical help. Key words. Fractures, long bones, limbs, consequences, complications, disability.

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Section: вступunclassified

Retrospective medico-social analisys of the results of treatment patients with the concequences of long bone fractures

Tankut¹,

Golubeva²,

Rykun³

et al. 2021

OTP

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“…М. І. Ситенка НАМН України». Усім постраждалим для планування корекції деформації виконано комп'ютерну томографію (КТ), проведено обстеження за розробленими нами методиками [11]. Технологію 3D-друку використано для 5 пацієнтів із найскладнішими випадками застарілих післятравматичних позасуглобових деформацій нижніх кінцівок.…”

Section: матеріал і методиunclassified

3D-print in the planning of surgical treatment in the case of extraarticular deformity of lower limbs

Romanenko¹,

Prozorovskiy²,

Doluda³

2021

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An adequate planning of the curative measures is an important factor providing good functional results in the treatment of consequences of long bones injuries, in particular, malunions (post traumatic deformities). 3D-modeling in the preoperative planing gives an opportunity to assess both deformity itself and joint status. Visualization of injured segment with three-dimensional model manufactured using 3D-print in actual size (1:1 scale) provides additional capacities. Objective. To analyze the capacity provided by the usage of three-dimensional models of damaged segments in scale 1:1 while the planning of corrective surgery. Methods. Practicability of the usage of 3D-models, that was worked out on the base of CT-scanning, was studied in the treatment of 52 patients with different post traumatic extraarticular deformities of femur and tibia, after the fractures with intraarticular extension. Clinical results were evaluated using SF-36 and AOFAS scales. Results. Calculation for 3D-modeling was performed mostly virtually using standard computer programs with 3D-reconstruction, but 3D-print technology was used for 5 patients with the most severe and sophisticated deformities of the lower extremities. Changes in functional outcomes, according to SF-36 and AOFAS, for the patients undergone opera- tive treatment, were positive at 12 month of follow-up. Foreign colleagues expose analogous results of the investigations and suggest that the modeling with 3D-print provides mostly more safe, reliable and standardized clinical decisions for every particular patient. Conclusions. Preoperative usage of 3D-print on the stage of preoperative planing allows the surgeons to simulate different stages of operative intervention on the physical model, thus, help him to realize possible technical problems, choose adequate fixation device and proper instrumentation. It facilitates the shortening of surgery time, elimination of possible complications rate and achievement, in sum, good functional results in the treatment of this kind of patients.

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The clinical significance of posttraumatic malunions of lower extremities long bones

Cited by 2 publications

References 18 publications

Retrospective medico-social analisys of the results of treatment patients with the concequences of long bone fractures

Retrospective medico-social analisys of the results of treatment patients with the concequences of long bone fractures

3D-print in the planning of surgical treatment in the case of extraarticular deformity of lower limbs

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