Установлено, что на развитие осложнений при лечении застарелых повреждений костей предплечья в дистальном отделе влияет как тяжесть анатомо-функциональных нарушений, так и ошибки при диагностике всего объема повреждений, а также использование методов лечения, требующих длительной иммобилизации.
Проведенный анализ показал, что предложенные методы лечения застарелых переломов и переломовывихов костей предплечья в дистальном отделе позволяют сократить сроки стационарного лечения и временной нетрудоспособности, получить положительные исходы у 88,4% больных.
Ключевые слова: застарелые переломы, переломовывихи, кости дистального отдела предплечья, накостный, чрескостный остеосинтез.
Makarov V. B. Medical rehabilitation of the patients with chronic fractures and dislocation-fractures of distal department of forearm. – Manuscript.
The thesis for the scientific degree of the candidate of Medical Sciences in the speciality 14.01.21 – Traumatology and Orthopedics. – Sitenko Institute of Spine and Joint Pathology Ukrainian Academy of Medical Scienses, Kharkov, 2003.
The analysis of 185 patients with chronic fractures and dislocation-fractures of distal department of forearm treatment is conducted.
It is proved, that the greatest number of unsatisfactory results of traditional treatment is connected with contracture and osteoarthritis of a wrist joint. It is closely connected with demerits of existing methods of the given pathology treatment. It forces to search ways of their improvement. The new circuit of medical quality rehabilitation estimation for the patients with the consequences of traumas of distal forearm is proposed. It is offered to plan individual measures of medical rehabilitation and to predict restoration of the patients work capacity.
For maintenance of early restoration of a wrist joint function at chronic distal forearm fractures the Т-figurative plate with “compression tooth” is proposed. For treatment radius malunion, false joints two stages external fixation, ensuring qualitative reposition and reliable fixing as well as favorable functional results was developed.
On the basis of biomechanical examination the updating external fixation of chronic distal forearm damages rod devices was offered.
Using the varied approaches to treatment of distal department chronic damage of forearm with the advanced methods of operative treatment allows to reduce terms of stationary treatment and temporary invalidity. Positive results in 88,4% cases are received and those to improve results of treatment of this difficult pathology.
Key words: chronic fractures, dislocation-fractures of distal department of forearm, malunion radius fractures, stable-functional osteosynthesis, external osteosynthesis.