Тreatment of long bones comminuted fractures using external fixation device

Authors

  • Valeriy Litvishko

DOI:

https://doi.org/10.15674/0030-59872016440-46

Keywords:

comminuted fractures, diaphyseal fractures, long bones of the limbs, length of injury zone of injury, rod device, periosteal regenerate

Abstract

Comminuted fractures consist 35 % out of all diaphysial frac­tures and require special consideration.

Objective: to deter­mine the features treatment of comminuted diaphyseal frac­tures of extremities and evaluate the results.

Methods: we treated 63 patients — 65 comminuted diaphyseal fractures of the limbs types B and C by AO classification (7 humerus, femur 18, tibia 35, forearm 3). The length of the zone of damage was 12–20 % of the general bone length in 26 cases, 21-30 % — in 23, 30 % or more — in 16. To fix fractures rod apparatus used. The main thought axial relationships restoration, allow­ing the residual offset the width ½–⅔ in diameter. A few days later began loading dose and gradually drove him to complete within 2–2.5 months.

Results: rod device fixation of the femur was from 100 to 236 days, shoulder — from 64 to 126, lower leg bones — from 116 to 278, forearm — from 102 to 158 in 4 (6.1 %) patients with comminuted zone bone destruction of more than 30 % of its length nonunion fragments found after 4 months. They underwent autographing keeping in the place the same fixation device, then union reached. All patients fractures healed with the formation of periosteal bone regenerate. A sig­nificant limitation of function of the knee or ankle joints were in 4 (6.1 %) patients, when fracture zone extended toward me­taepiphyses.

Conclusions: in a case of comminuted diaphyseal fractures of limbs length zone of injury may affect the duration of healing. When it exceeds 30 % of the length of the segment and extends to metaephyses, increases the likelihood for non­union at diaphyseal level. Sparing of periosteal tissue provides the conditions for the formation of periosteal regenerate, which covers the area of damage.

References

  1. Gorodnichenko AI, Uskov ON. The treatment of comminuted fractures of the shin by rod and spoke fixators. Reporter of Traumatology and Orthopedics named Priorov. 2000;(4): 8-12. (in Russian)
  2. Bekchanov SZ, Nizamkhadzhaev FM, Mirdzhalimov. Some modern aspects of diagnosis and treatment polyfocal and comminuted fractures of the long bones. Orthopaedics, Traumatology and Prosthetics. 2005;(1):130-3. (in Russian)
  3. Panov AA, Kopysova VA, Kaplun VA, Petrushin IeG, Tsay DA. Osteosynthesis results for comminuted fractures of long tubular bones. Orthopaedic Genius. 2015;(4):10-6. (in Russian)
  4. Litvishko V, Uzhigova O. Treatment of diaphyseal fractures of extremities in conditions of traumatology departments of central district highway hospitals. Orthopaedics, Traumatology and Prosthetics. 2012;(2): 68-73. doi: http://dx.doi.org/10.15674/0030-59872012268-73. (in Russian)
  5. Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am. 1976;58(4):453-8.
  6. Sytenko M.I. Orthopaedics and Traumatology. elected works. Eds. Academic of AMS USSR Korzn AA and prof Pankov IeIa. Kiev: Naukova dumka, 1991: 37-48. (in Russian)
  7. Popsuishapka O, Litvishko V, Ashukina N. Clinical and morphological stages of bone fragments fusion. Orthopaedics, Traumatology and Prosthetics. 2015;(1): 12-20. doi: http://dx.doi.org/10.15674/0030-59872015112-20. (in Ukranian)
  8. Novachenko NP, Eliashberg FE. Continual traction. Moskow: Medicine, 1972. 263 p. (in Russian)
  9. Popsuishapka O, Litvishko V, Borovik I. Functional treatment of diaphyseal fractures of limbs using a rod device for the elastic-resistant joint of fragments: Guidelines. Kyiv, 2014. 46 p.
  10. Popsuishapka O, Litvishko V, Grigoryev V, Ashukina N. Treatment of bone fragments nonunion after dyaphiseal fracture. Orthopaedics, Traumatology and Prosthetics. 2014;(1): 34-41. doi: http://dx.doi.org/10.15674/0030-59872014134-41. (in Russian)

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How to Cite

Litvishko, V. (2017). Тreatment of long bones comminuted fractures using external fixation device. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (4), 40–46. https://doi.org/10.15674/0030-59872016440-46

Issue

No. 4 (2016)

Section

ORIGINAL ARTICLES

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Copyright (c) 2017 Valeriy Litvishko

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