EFFECT OF EXOGENOUS AND ENDOGENOUS FACTORS ON THE RATE OF CONSOLIDATION OF FRACTURES OF THE LONG BONES IN OSTEOSYNTHESIS

Abstract

Purpose. Determine endogenous and exogenous factors influencing the pace of consolidation in osteosynthesis implants with different types of coatings. Based on the characteristics of the selected offer the best conditions for the application of bioactive structures.Material and methods. The work is based on an analysis of surgical treatment of 1265 patients with hip fractures, tibial and shoulder. Take into account the influence of age, gender, thе timing of the operation, quality reposition, comorbidities, location and severity of the fracture, implant сoating violation bone repair.Results. Received consolidation using bioactive plates in 99.3 % of patients. Well executed reposition 4.5 times reduced cases of delayed consolidation. The main reason for delayed fracture healing in patients older than 60 years is osteoporosis. Males under 40 years compared with women of the same age often observed slow formation of callus, which is associated with frequent presence in them of comminuted fractures. The most frequently observed sustained fusion in patients with tibial fractures, which is primarily due to the prevalence of lesions in this segment. The main mechanism of action of bioactive positive plates can be explained by the peculiarities microarchitectonics coverage closer to the physiological structure of bone, increasing the concentration of osteogenic cells around the implant and stimulation of their function. Application of bioactive plates most appropriate for osteoporosis, type C lesions, pseudoarthrosis, reoperations during migration and metal fracture, in multiple and combined injuries.