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

Authors

  • Volodymyr Tankut Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
  • Inna Golubeva Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
  • Mykola Rykun Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
  • Kostyantyn Berenov Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
  • Viktoria Androsenkova Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine

DOI:

https://doi.org/10.15674/0030-59872021143-50

Keywords:

Fractures, long bones, limbs, consequences, complications, disability

Abstract

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.

Author Biographies

Volodymyr Tankut, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, Prof. in Traumatology and Orthopaedics

Mykola Rykun, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

PhD in Traumatology and Orthopaedics

Kostyantyn Berenov, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

PhD in Traumatology and Orthopаedics

References

  1. Gaiko, G. V., Nikitin, P. V., & Kalashnikov, A. V. (2006). Intramedullary blocking osteosynthesis in the treatment of patients with disorders of reparative osteogenesis after diaphyseal fractures. Bulletin of orthopedics, traumatology and prosthetics, 4, 5-13. [in Russian]
  2. Kozopas, V. S. (2015). Treatment of diaphyseal fractures of long tubular bones by blocking intramedullary metal osteosynthesis. Trauma, 16(2), 58–60. [in Ukrainian]
  3. Ekegren, C., Edwards, E., De Steiger, R., & Gabbe, B. (2018). Incidence, costs and predictors of non-union, delayed union and Mal-union following long bone fracture. International Journal of Environmental Research and Public Health, 15(12), 2845. https://doi.org/10.3390/ijerph15122845
  4. Krivenko, S. N., Bodnya, A. I., & Tarek, Bakkar. (2013). Comparative clinical assessment of external structures for osteosynthesis of diaphyseal fractures of the forearm bones. Trauma, 14(4), 26–29. [in Russian]
  5. Yoon, Y., Oh, C., Lee, D., Sim, J., & Oh, J. (2020). Miniplate osteosynthesis in fracture surgeries: Case series with review of concepts. Injury, 51(4), 878-886. https://doi.org/10.1016/j.injury.2020.02.044
  6. Vallier, H. A., Cureton, B. A., & Patterson, B. M. (2011). Randomized, prospective comparison of plate versus intramedullary nail fixation for distal tibia shaft fractures. Journal of Orthopaedic Trauma, 25(12), 736-741. https://doi.org/10.1097/bot.0b013e318213f709
  7. Klimovitsky, V. G., Antonov, A. A., & Makarenko, A. V. (2009). Intramedullary blocking osteosynthesis in the treatment of diaphyseal comminuted hip fractures. Trauma, 10(3), 243–246. [in Russian]
  8. Hu, L., Xiong, Y., Mi, B., Panayi, A. C., Zhou, W., Liu, Y., ... & Liu, G. (2019). Comparison of intramedullary nailing and plate fixation in distal tibial fractures with metaphyseal damage: A meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research, 14(1). https://doi.org/10.1186/s13018-018-1037-1
  9. Kutsenko, S. N., Mityunin, D. A., & Nikiforov, R. R. (2013). The role of intraosseous osteosynthesis in the system of surgical treatment of fractures of the lower leg bones of their consequences: international experience and own results. Chronicle of traumatology and orthopedics, 1–2(25–26), 157-168. [in Russian]
  10. Korzh, M. O., Yaremenko, D. O., & Goridova, L. D. (2010). Errors and complications in orthopedic and traumatological practice. Orthopedics, Traumatology and Prosthetics, 2, 5–10. https://doi.org/10.15674/0030-5987201025-10. [in Ukrainian]
  11. Litovchenko, V. A., Berezka, N. I., & Garyachiy, E. V. (2012). Errors in the treatment of multiple fractures of the limb bones with the use of intramedullary blocking osteosynthesis. Experimental and Clinical Medicine, 4(57), 132-135. [in Russian]
  12. Popsuyshapka, O. K., Litvyshko, V. O., Uzhegova, O. E., & Pidgayskaya, O. O. (2020). Frequency of complications of treatment of diaphyseal fractures of extremities according to Kharkiv traumatological MSEC. Orthopedics, Traumatology and Prosthetics, 1, 20–25. https://doi.org/10.15674/0030-59872020120-25. [in Ukrainian]
  13. Niikura, T., Yang Lee, S., Sakai, Y., Nishida, K., Kuroda, R., & Kurosaka, M. (2014). Causative factors of fracture nonunion: The proportions of mechanical, biological, patient-dependent, and patient-independent factors. Journal of Orthopaedic Science, 19(1), 120-124. https://doi.org/10.1007/s00776-013-0472-4
  14. Al Quran Jafar Taisir Mohammad. (2018). Physical rehabilitation after intramedullary osteosynthesis in athletes with diaphyseal fractures of the tibia. [Unpublished PhD dissertation]. [in Ukrainian]
  15. Artemenko, E. P. (2006). Motor rehabilitation in fractures of tubular bones. [Unpublished doctoral dissertation]. [in Russian]
  16. Miromanov, A. M. (2013). Fractures of the long bones of the extremities: prognostic criteria for the development of complications. [Unpublished PhD dissertation]. [in Russian]
  17. Romanenko, K. K., Doluda, Ya. A., Prozorovsky, D. V., & Pariy, V. B. (2020). Clinical significance of post-traumatic deformities of long bones of lower extremities. Orthopedics, Traumatology and Prosthetics, 4, 72–79. https://doi.org/10.15674/0030-59872020472-79. [in Ukrainian]

Downloads

How to Cite

Tankut, V. ., Golubeva, I. ., Rykun, M. ., Berenov, K. ., & Androsenkova, V. . (2021). Retrospective medico-social analisys of the results of treatment patients with the concequences of long bone fractures. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (1), 43–50. https://doi.org/10.15674/0030-59872021143-50

Issue

No. 1 (2021)

Section

ORIGINAL ARTICLES

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

The authors retain the right of authorship of their manuscript and pass the journal the right of the first publication of this article, which automatically become available from the date of publication under the terms of Creative Commons Attribution License, which allows others to freely distribute the published manuscript with mandatory linking to authors of the original research and the first publication of this one in this journal.

Authors have the right to enter into a separate supplemental agreement on the additional non-exclusive distribution of manuscript in the form in which it was published by the journal (i.e. to put work in electronic storage of an institution or publish as a part of the book) while maintaining the reference to the first publication of the manuscript in this journal.

The editorial policy of the journal allows authors and encourages manuscript accommodation online (i.e. in storage of an institution or on the personal websites) as before submission of the manuscript to the editorial office, and during its editorial processing because it contributes to productive scientific discussion and positively affects the efficiency and dynamics of the published manuscript citation (see The Effect of Open Access).