Fracture treatment and osteosynthesis

Each trauma has its unique peculiarities and needs an individual approach. Treatment tactics and activity algorithm in bones fractures depend on the type of the fracture, concomitant diseases, patient’s age and lifestyle and physiological peculiarities of his organism. Fractures may be open and closed, traumatic and pathologic. In dependence on their location and mechanism they may be intra-articular, epiphyseal, methaphyseal, diaphyseal, compressive, helical, etc.

Bones fractures are treated in conservative or operative way. Conservative treatment stipulates closed reposition and immobilization of fragments with a bandage (plaster, polymer or soft one) or retention with skeletal extension method.

Operative treatment of fractures is carried out in irreparable displacement, soft tissues interposition, bones nonunion and under the threat of compartment syndrome development or nerves and/or vessels damage with bone fragments. Patient’s wish to hasten the process of consolidation and reparation is relative indication for this as well. Osteosynthesis is a main method of fractures operative treatment.

Osteosynthesis is a surgical treatment of bones fractures consisting in bones fragments reposition and fixation with mechanic constructions and implants (plates, screws, intramedular rods, pins and rods). The main advantage of this treatment methodic is preservation of functional motility of a bone and the nearest joints in reparative period, hastening of consolidation and extremity supporting function restoration. Osteosynthesis conventional principles are stability (fragments immobility creating conditions for bones reparation) and functionality (ability to move an extremity leading in blood supply preserving, contractures and muscular atrophy development prevention).

In cases when this technique is impossible due to tissues defect or fragments blood supply loss (as in femoral neck subcapital fractures and fractures of humeral head or radial bone) the methods of endoprosthesis or fragments removal are indicated.

The main directions of osteosynthesis development are operative invasions minimization, less invasiveness, hemorrhage and operation duration decrease.