ANALYSIS OF SURGICAL TREATMENT RESULTS IN PATIENTS WITH FRACTURES OF THE TIBIAL BONES

Abstract

Relevance: By frequency, tibial bone fractures rank second, accounting for 13% to 21.4% of all musculoskeletal injuries or 64.3%-70% of lower limb bone fractures. The nature of the injury is the result of high-energy trauma and is accompanied by severe soft tissue damage and a comminuted type of fracture. Temporary disability of patients with tibial fractures varies from 8-10 weeks to 5-7 months, and for complex fractures, it can reach 10-12 months. The purpose of the study was to conduct a comparative analysis of the treatment results of patients with tibial bone fractures and to evaluate the effectiveness of different methods of osteosynthesis. Material and methods: Depending on the method of operative treatment, the patients were divided into two groups. The experimental group included 113 patients, mostly with diaphyseal fractures of the tibial bones, who underwent surgery with the use of blocking intramedullary osteosynthesis. The control group consisted of 166 patients with tibial bone fractures who underwent intracortical or trans-cortical osteosynthesis. Results: The use of low-traumatic methods of stable fixation for the patients of the main group, the possibility of early functional rehabilitation, measures to prevent joint contractures since the first days, the possibility of early dosed loading on the operated limb ultimately led to faster healing of tibial fracture and a shorter overall treatment time. In the main group of patients, fusion was observed from 8 to 22 (11.56 ± 2.56) weeks, in the control group - from 12 to 36 (18.68 ± 4.70) weeks. The general treatment period for patients in the main group ranged from 8 to 22 (14.44 ± 2.85) weeks, while for the control group, it was from 13 to 43 (21.23 ± 5.38) weeks. Conclusion: The use of blocking intramedullary osteosynthesis has demonstrated its high effectiveness in the surgical treatment of patients with metadiaphyseal fractures of the tibia, allowing for positive treatment results in 96.66% of patients. The advantage of blocking intramedullary osteosynthesis is the biomechanically justified high stability of fixation and minimal invasiveness, which enables early mobilization in patients with fractures of the tibia bones (FTB) often experience a reduced quality of life and temporary disability, which can last from 8-10 weeks to 5-7 months or even up to 10-12 months for complex fractures. FTBs account for 13%-21.4% of all musculoskeletal injuries or 64.3%-70% of all lower limb fractures. The frequency of diaphyseal tibia bone fractures is 26-32 cases per 100,000 population. The injuries are typically the result of high-energy trauma and are often accompanied by severe soft tissue damage and comminuted fractures. The use of blocking intramedullary osteosynthesis has been shown to be highly effective in the surgical treatment of patients with meta-diaphyseal fractures of the tibia bones, with positive treatment outcomes in 96.66% of patients, providing biomechanically justified high stability of fixation and minimal trauma, allowing for early mobility and reducing the frequency of early and late postoperative complications.