Hirurško lečenje aseptičnih pseudoartroza dijafiza butne kosti. (Serbian)

SURGICAL TREATMENT OF THE ASEPTIC FEMORAL SHAFT NONUNION. (English)

Femoral shaft nonunions is difficult complication and a big challenge for the orthopaedic surgeons. These complications occur after open femoral fractures, comminuted fractures, segmental fractures, the infection, after the inadequate fixed osteosynthesis, the systemic disease, and smokers. The paper presents the results of treatment aseptic femoral shaft nonunion in 18 patients. They were primarily operated by the method of internal compresive plate fixation and external fixation (open fractures). For fixation we used dinamic internal fixator by Mitkovic. All nonunions treated by this method are healed. In patients with atrophic femoral shaft nonunions in addition to fixation was performed and bone grafting. This implant has proved successful in the treatment of femoral shaft nonunion. During the fixation no periostal and intramedullary vascularization damage, which is an important prerequisite for bone healing. Implant enables biological and mechanical conditions for nonunion healing. [ABSTRACT FROM AUTHOR]

Pseudoartroze dijafize butne kosti predstavljaju teške komplikacije i veliki izazov za ortopeda. Ove komplikacije nastaju posle otvorenih preloma butne kosti, višefragmentnih, segmentnih preloma, kod infekcija, posle neadekvatnih fiksacija preloma (osteosinteza), kod sistemskih bolesti i pušača. U radu se prikazuju rezultati operativnog lečenja neinficiranih pseudoartroza dijafiza butne kosti, kod 18 pacijenata koji su primarno operisani metodom unutrašnje fiksacije kompresivnim pločama i spoljašnjim skeletnim fiksatorom (otvoreni prelomi). Za fiksaciju je korišćen unutrašnji fiksator po Mitkoviću. Sve pseudoartroze lečene ovom metodom su zarasle. Kod pacijenata sa atrofičnim pseudoartrozama, pored fiksacije je uradjena i osteoplastika. Ovaj implantat se pokazao uspešnim u lečenju pseudoartroza butne kosti. Prilikom fiksacije nema deperiostiranja i oštećenja periostalne i intramedularne vaskularizacije, što je važan preduslov za zarastanje pseudoartroza. Implantat omogućava biološke i mehaničke uslove za zarastanje pseudoartroza. [ABSTRACT FROM AUTHOR]

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