Using Combined Osteosynthesis in Trauma Practice in the Treatment of Diaphyseal Forearm Injuries

M. Puseva, Ch. Z. Butaev, A. Rudakov
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Abstract

The article presents the experience of surgical treatment of a rare pathology of the upper limb – the pseudarthrosis of the middle third of the radial shaft with a bone defect in combination with the pseudarthrosis of the middle and lower third of the shaft of the ulna of the forearm. Determination of reasonable and well-considered treatment tactics is of great importance in the treatment of patients aimed at restoring the anatomy and function of the injured upper limb. A feature of this case is the formation of several false joints at different levels of the forearm bones, the presence of a bone defect of 2.5 cm, which required its replacement with an autograft, and a previously performed surgical in tervention using transosseous osteosynthesis. The applied tactics of surgical treatment consisted of several stages: bone osteosynthesis of the ulna with opening of the medullary canals of the ulna; replacement of a bone defect in the area of the pseudarthrosis of the radius with an autograft from the iliac crest using combined stress osteosynthesis in com - bination with transosseous osteosynthesis. The results of surgical treatment of false joints and bone defects depend on the correct treatment tactics, according to the indications, and the correct implementation of the selected treatment tactics. The surgical tactics of treatment used in this clinical situation made it possible to create conditions for the fu sion of fragments of the radius and ulna bones, as well as to replace the defect of the radius, as a result of which the anatomy and function of the damaged segment were successfully restored.
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综合骨融合术治疗前臂干骺端损伤的创伤实践
本文介绍了一种罕见的上肢病理-桡骨轴中三分之一假关节伴骨缺损合并前臂尺骨轴中、下三分之一假关节的手术治疗经验。确定合理、周到的治疗策略对于恢复上肢损伤的解剖和功能至关重要。该病例的一个特点是在前臂骨的不同水平处形成了几个假关节,存在2.5 cm的骨缺损,需要用自体移植物代替,并且先前进行过经骨合成术的手术干预。手术治疗的应用策略包括几个阶段:尺骨骨融合术并打开尺骨髓管;桡骨假关节区域的骨缺损用髂骨自体移植物采用联合应力骨融合术和经骨骨融合术进行置换。手术治疗假关节和骨缺损的效果取决于正确的治疗策略,根据适应症,正确执行所选择的治疗策略。在这种临床情况下使用的手术治疗策略为桡骨和尺骨碎片的融合创造了条件,并取代了桡骨的缺损,从而成功地恢复了受损节段的解剖结构和功能。
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