Internal ( submersible ) osteosynthesis
Traumatology / / August 12, 2017
Application of internal fixation it is dictated by the following reasons:
1) a desire to achieve maximum adaptation of fragments, which is not always possible to implement in a polytrauma conservative methods;
2) the desire to create a strong internal fixation of bone fragments as well as external immobilization with multiple fractures often insufficient;
3) desire to facilitate plaster immobilization (on the length and weight) or completely avoid it, having had an opportunity early in the development of motion in the joints, which is especially important when monomelicheskih, dimelicheskih symmetric and polymetallic fractures.
operated fractures of individual locations is as follows: the shoulder - 54%, forearm - 21%, the thigh - 65%, shin - 42%.In 74.6% of the victims held a fracture osteosynthesis, at 21.1% - two, at 4.3% - three or more.In 15% of the affected operations are performed simultaneously on two or more segments of the limbs.The rest fixation on different limbs carried out in stages.T
for osteosynthesis use various, mostly metallic, construction, often used in bone-pins (pins) and of plate (plate), to a lesser extent - short (beams) and small (screws).Fixation of bone fragments with multiple fractures is most effective only if the simultaneous use of both internal and external immobilization.
strained flat osteosynthesis rods on Mityunin.
and th - if polifrakturah humerus;
Well-m - polifrakturah femur;
n t - at polifrakturah tibia.
osteosynthesis plates, screws and bolts, tie a trapeze for fractures of the condyles shoulder
(a) and hip
(b) (as GD Nikitin).
Internal fixation screws
a, b - with oblique and helical fractures of the humerus;
c, d, d - with polifrakturah tibia (with the introduction of intramedullary cortical autograft).
A large variety of fractures and bone are significant differences in their shapes and sizes do not allow to achieve a durable connection of bone fragments by a single "universal" devices.Therefore, the mechanical workshop to be organized in each trauma unit where it would be possible from existing designs (standard and others) "pick up", "fit" or re-manufactured (from standard blanks) required lock for each individual patient.
- Transosseous osteosynthesis external fixation
- tourniquet assistance program to victims with polytrauma
- Symmetric dislocations in the shoulder joints
- struggle with pain in injuries
- Plaster bandages
- Bilateraldislocation of the hips
- Bilateral fractures of the fibula
- Bilateral fractures of the foot
- bilateral calcaneus fractures
The workshop should be: durable workbench with installed locksmith vise and elektrotochilnym circle racks to accommodatehandtools, various preparations for future designs and structures themselves, a small drill press or electric drill, is desirable as a small cutting lathe.
Each plaster technician, as well as operating a trauma, should be able to prepare designs, t. E. Have certain locksmith skills.Help special masters metal is always desirable, but not always possible (eg, during the night, as well as directly during surgery).
Mechanical (metalwork) shop requires traumatologist as well as "plaster" or "hardware" of the room.