COMPARATIVE ANAL YSIS OF THE RESULTS OF TREATMENT OF PATELLA FRACTURES BY METHODS

He aim of the investigation was to improve the method of transosseous spinal osteosynthesis with transverse patellar fractures and its clinical approbation. Materials and methods: The study included 48 patients with patellar fractures, aged 18-77 years. All patients were divided into 2 groups: basic and comparisons - for 24 patients. In the main group, the treatment was carried out using an improved method of transosseous osteosynthesis. The patients of the comparison group underwent surgical treatment (submerged osteosynthesis) by the open method. The frequency and structure of complications, duration of inpatient and out-patient treatment, clinical and functional outcomes were subjected to a comparative evaluation. Results of the study: The overall complication rate in the main group was 12.5%, in the comparison group - 41.7% (p=0.040). Differences in duration of outpatient treatment were 2 times, inpatient treatment - 71.4% in favor of the main group (p <0.001). In the main group, only good results entered the structure - 79.2% and satisfactory - 20.8%. In the comparison group, good results were observed in 58.3% of cases, satisfactory - 33.3% and unsatisfactory ones were obtained at 8.3% (p>0,05). Conclusion: The use of the transosseous osteosynthesis technique for patella fractures in comparison with open submerged osteosynthesis methods provides a decrease in the overall incidence of complications, a significant reduction in the overall duration of treatment of patients is achieved in both inpatient and outpatient settings. The functional results of treatment for transosseous osteosynthesis by our method are better than in open operations, although the differences were insignificant.

patella, fracture, method of treatment, transosseous osteosynthesis, surgical treatment

1. Ахтямов И. Ф. Отдаленные результаты реабилитации больных после оперативного лечения внутрисуставных переломов области коленного сустава /И. Ф. Ахтямов, Г. М. Кривошапко, C. B. Кривошапко //Вестн. Травматологии и ортопедии им. Н. Н. Приорова. - 2002. -№2. - С. 42-46.

2. Бейдик О. В. Пути оптимизации лечения больных с травмами и деформациями конечностей методом наружного чрескостного остеосинтеза: Автореф. дис..д-ра мед. наук. - Самара, 1999. - 39 с.

3. Гланц С. Медико-биологическая статистика. - М.: Практика, 1999 - 459 с.

4. Дубров В. Э. Хирургическая тактика и результаты лечения при переломах наколенника /В. Э. Дубров, С. Г. Гиршин //Хирургия. -1991. - №12. - С. 36-41.

5. Каплунов О. А. Чрескостный остеосинтез по Илизарову в травматологии и ортопедии. - М.: ГЭОТАР-МЕД, 2002. - 301 с.

6. Левченко К. К. Лечение переломов надколенника с использованием аппаратов внешней фиксации /К. К. Левченко, О. В. Бейдик, М. Б. Литвак //Саратов. науч.-мед. журн. - 2008. - №3(21). - С. 95-96.

7. Литвина Е. А. Современное хирургическое лечение множественных и сочетанных переломов костей конечностей и таза: Автореф. дис.д-ра мед. наук. - М., 2010. - 38 с.

8. Рябчиков И. В. Биомеханические аспекты восстановления опорной и динамической функции пациентов с около- и внутрисуставными переломами костей нижних конечностей: Автореф. дис.д-ра мед. наук - Казань, 2014. - 22 с.

9. Сергеев С. В. Современные методы остеосинтеза костей при острой травме опорно -двигательного аппарата: Учеб. пособие /С. В. Сергеев, Н. В. Загородний, Н. А. Абдулхабибова. - М., 2008. - 222 с.

10. Bostman O. Comminuted displaced fractures of the patella /O. Bostman, O. Kiviluoto, J. Nirhamo //Injury.- 2001.- V. 13. - P. 196-202.

11. Bostman O. Fractures of the patella treated by operation /O. Bostman, O. Kiviluoto, S. Santavirta //Arch. Orthop. Trauma. Surg. - 2003. - V. 102 (2). - P. 78-81.

12. Gwinner C. Current concepts review: Fractures of the patella /C. Gwinner, S. Mardian, P. Schwabe //GMS Interdiscip. Plast. Reconstr. Surg. DGPW. - 2016. - V. 5. - Doc. 01.

13. Schuett D. J.Current Treatment Strategies for Patella Fractures /D. J. Schuett, M. E. Hake, C. Mauffrey //Orthopedics. - 2015. - V. 38 (6). - P. 377-384.