[Closed intramedullary and trans-osseous osteosynthesis in diaphyseal crural bone fractures].
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Biomedical subjects
Publications and source records attributed to N Ia Prokop'ev.
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The authors have analysed the results of the treatment of 329 patients with closed diaphyseal fractures of the femur; in 252 of them various types of osteosynthesis have been made. Preference was given to closed osteosynthesis with a massive metal rod and drilling out of the medullary canal of the femur. It is pointed out that with this method of treatment the duration of disability was the lowest possible, and there was no invalidity. The necessity of exercise therapy and isometric gymnastics during the early postoperative period is stressed.
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The authors have studied 266 patients with multiple and associated injuries, 31 of whom were performed a one-stage osteosynthesis in fractures of the bones of the femur (36), the crus (23), the humerus (5) and the forearm (3). Before 1985 the main method of surgical treatment was open intramedullary osteosynthesis with Küntscher-type nails with drilling out of the medullary canal. This method was applied in operating 21 patients with fractures of the femur, 5 patients with fractures of the bones of the crus and 2 patients with fractures of the humerus. Osteosynthesis with Ilizarov's apparatus was performed in 11 patients with fractures of the femur, in 13 patients with fractures of the bones of the crus and in 3 patients with fractures of the humerus. Since 1985 a method of closed intramedullary osteosynthesis has been worked out which was used in fractures of the femur (5 patients) and of the bones of the crus (5 patients). In the postoperative period a reposition-fixation device was used for the reposition of the bone fragments. The results of the treatment are reported.
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The experience with treatment of 35 patients with fractures of the femoral and tibial bones enabled the author to make a conclusion concerning different approaches to choice of the method of treatment. Preference is given to operative methods of treatment--intramedullary osteosynthesis on the femur, "closed" intramedullary osteosynthesis and osteosynthesis with the Ilizarov apparatus on the shinbone.
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