Application of the New Self-dynamisable Internal Fixator in the Treatment of Femoral Shaft Fractures - - - Primena novog samodinamizirajućeg unutrašnjeg fiksatora u lečenju preloma dijafize femura
Journal Title: Acta Facultatis Medicae Naissensis - Year 2017, Vol 34, Issue 2
Abstract
The aim of this study was to present the results of one original method application in internal fixation of long bones. The series of 27 patients with unilateral fractures of femoral shaft was analyzed. According to AO classification, 21 fractures were classified as 32A, five as 32B, and one as 32C type. Original diaphyseal self-dynamisable internal fixator (model 1) was used as a fixation implant, consisting of three components: specially designed extramedullary bar, clamps and screws. The main feature of this implant is a possibility to become dynamic in the axial direction spontaneously if there is no sufficient fracture healing. Because of that, this implant is known as an „intelligent implant“. Surgical method included a standard surgical approach and minimally invasive surgical approach. Minimally invasive technique of application required less blood transfusion and shorter surgery time when compared to the standard surgical approach. The duration of used intraoperative fluoroscopy control was 7(3-18) seconds. The average healing time was 4.3 (3.5-9.5) months. There were neither intra operative nor postoperative complications. In comparison to intramedullary nails, self-dynamisable internal fixator provides a similar treatment results, while in comparison to plates it provides fewer mechanical complications. Self-dynamisable internal fixator method preserves periosteal and intramedullary blood circulation, and it is the first fixation implant with a possibility of spontaneous axial dynamising activation when needed. This implant has been proven as suitable for routine use in the treatment of femoral shaft fractures. - - - Cilj ovog rada bio je da prikaže rezultate primene nove originalne metode i uređaja za unutrašnju fiksaciju preloma dugih kostiju. Kao klinički materijal analizirali smo seriju od 27 bolesnika sa prelomom dijafize femura. Prema AO klasifikaciji zabeležen je: 21 prelom tipa 32A, 6 preloma tipa 32B i jedan prelom tipa 32C. od implantata je korišćen samodinamizirajući unutrašnji fiksator (model 1), koji se sastoji od tri komponente: specijalne šipke, spojnica i zavrtnja. U toku hirurške intervencije korišćene su dve hirurške tehnike: klasičan i minimalno invazivan hirurški pristup. Rezultati su pokazali da je primenom minimalno invazivne ugradnje implantata potrebna manja količina krvi koju treba nadoknaditi u toku i posle operacije. Dužina rendgenske fluoroskopije bila je 7 (3-18) sekundi. Vreme zarastanja preloma bilo je 4,3 (3,5-9,5) meseca. Nije bilo intraoperativnih niti postoperativnih komplikacija. Spontana aksijalna dinamizacija bila je registrovana kod 7 pacijenata (25,9%). U poređenju sa intramedularnim klinom, prema podacima iz literature, samodinamizirajući unutrašnji fiksator obezbeđuje slične rezultate lečenja, dok u poređenju sa primenom ploča pokazuje superiornost, jer istovremeno obezbeđuje i mogućnost sponatane aksijalne dinamizacije kada je zarastanje usporeno i očuvanje kako intramedularne tako i periostalne vaskularizacije. Samodinamizirajući unutrašnji fiksator pogodan je za rutinsku primenu u lečenju preloma dijafize femura.
Authors and Affiliations
Milan Mitković, Saša Milenković, Ivan Micić, Predrag Stojiljković, Igor Kostić, Slobodan Milenković, Dražen Jelača, Milorad Mitković
Keywords
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- EP ID EP347716
- DOI 10.1515/afmnai-2017-0014
- Views 69
- Downloads 0
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