Osteosynthesis is a surgical method for the treatment of complex fractures, which involves the connection of bone fragments and their fixation in an anatomically correct position until complete fusion. For stable fixation of fragments, fixators made of biologically inert metals and alloys that do not cause allergies are used. Metal osteosynthesis (MOS) is considered one of the most effective methods of fracture treatment. It allows you to reduce the risk of bone deformation and accelerate the process of its fusion. In the medical center Ladisten Clinic in Kyiv, osteosynthesis operations are performed by experienced specialists, including the author’s minimally invasive technique of Dr. Veklich V.V.
The main indications for bone osteosynthesis are:
Modern osteosynthesis is used not only in traumatology for bone fractures, but also in orthopedics for the treatment of valgus deformity of the feet and hands or the correction of flat feet.
The surgical operation of metal osteosynthesis is contraindicated if the patient has:
All types of metal osteosynthesis used in modern surgical practice can be divided into two main types:
In addition to the main types of MOS, ultrasonic osteosynthesis can be distinguished separately, in which the bonding of bone fragments is performed using ultrasound.
This type of MOS provides for the fixation of fragments using plates of various configurations and sizes, applied to the bone and attached to it with screws. Bone osteosynthesis can be carried out not only using plates, but also semi-rings, rings, tapes or wires made from materials such as:
The plates are applied for fractures of the clavicle, legs and bones of the upper limbs. They are used for osteosynthesis of the calcaneus and humerus (shoulder neck), as well as for fractures of the forearm, jaw and femoral neck.
This type of MOS is also called intraosseous, since the reposition and fixation of fragments during the operation by this method is performed using pins inserted into the medullary canals of both fragments. Intraosseous osteosynthesis can be divided into the following types:
Intramedullary osteosynthesis is used for fractures of the tibia, femur and humerus, which are long and have a bone marrow cavity of sufficient diameter for the insertion of a pin.
Osteosynthesis of the metatarsal bones of the hand or foot, as well as other small tubular bones, can also be performed by the intramedullary method. Only instead of pins, knitting needles are used to connect the fragments.
The medical center Ladisten Clinic does not use extramedullary and intramedullary osteosynthesis, but only a minimally invasive method of transosseous osteosynthesis is used.
Steosynthesis using external fixation devices.
Transosseous minimally invasive osteosynthesis using compression-distraction AVF is performed without exposing the fracture zone. Fixation of bone fragments in the correct position is provided by the spokes. They are introduced through soft tissues, passed through the bone outside the fracture zone, and their ends, which are outside the body, are fixed in the external fixation apparatus. With the help of AVF, the wires subject the bone fragments to compression (compression) or stretching (distraction). The device allows you to change the force of impact on the bone, since during the operation, during the period of fusion, healing and recovery, it is required to exert different forces on bone fragments.
The advantages of transosseous osteosynthesis using AVF include:
An external fixation device and titanium wires are used for ankle fractures, as well as for osteosynthesis of the lower leg, radius, ulna, humerus, femur (femoral neck), foot and collarbone.
Preparing a patient for metal osteosynthesis includes the following studies:
If necessary, consultation with specialized specialists and bone scintigraphy may be required if osteoporosis is suspected.
The operation of osteosynthesis includes two stages:
The period of time between these stages depends on the complexity and location of the fracture, and takes 2-7 months.
In our medical center, for a minimally invasive operation of external metal osteosynthesis, a patented external fixation device developed by Dr. V. V. Veklich is used. It is an improved Ilizarov apparatus, in which fragments are fixed not with knitting needles, but with titanium rods inserted from one side only, which makes its installation less traumatic. The Veklich apparatus provides reliable retention of bone fragments and significantly reduces the risk of osteomyelitis.
Doctor Veklich’s method can be used to treat:
The price of osteosynthesis is calculated individually in each case. It depends on the volume of the operation, the area of intervention, the complexity of the fixed structure, its dimensions and the material of manufacture.
If you want to treat a complex fracture or congenital orthopedic pathology using osteosynthesis, sign up for a consultation with Ladisten Clinic specialists at the numbers listed on the website, or write to us in Viber and WhatsApp messengers!
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