Surgical treatment of fractures in regional hospital

Abstract

Study objectives: The analysis of the results of fractures surgical treatment in the Orthopedics and Traumatology Department of the Regional Hospital. Methods and Materials: 1689 patients were treated in the Orthopaedics and Traumatology Department of the Regional Hospital during years 2011-2015. The surgical treatment ratio during the period covered by the study increased from 9.7% to 19.2%, as per Hospital provisioning with implants, with an average ratio of 16.3%. The methods of osteosynthesis applied in closed diaphyseal fractures: clavicula with intramedullary nail – 25 (9.5%), arm with plate – 11 (4.2%), forearm – 12 (4.6%) centromedular fixation and 22 (8.4%) plate fixation, femur – centromedular 10 (4%) and plate fixation 2 (0.5%); leg with plate fixation – 7 (2.7%), Ilizarov device – 12 (4.6%); malleolus with plate fixation – 44 (16.7%) nail fixation – 21 (7.9%); leg and hand nail fixation – 81 (30.7%). In open fractures we preferred osteosynthesis with Ilizarov device – 15 (5.8%). Surgical interventions were applied in 2-7 days after trauma. Results: Slow consolidation in diaphyseal fractures at 6 patients (2.2%), pseudarthrosis at 2 patients (0.7%). Septic complications were observed in closed fractures in 2 cases (0.7%) (soft tissues inflammation). Leg open fractures had complications in 6 patients – soft tissues necrosis. These fractures were treated with a tegumentary plasty. Osteitis in 2 patients. Conclusion: A stable osteosynthesis of diaphyseal fractures was obtained by fixation with plates and extrafocal fixation with Ilizarov device. Short term and long term results obtained were classified as good.