BIOMECHANICAL STUDY OF MINIMALLY INVASIVE TECHNIQUES IN SURGICAL TREATMENT OF THE TIBIA PROXIMAL EPIMETAPHYSIS FRACTURES

Abstract

The aim: Improving efficiency of the tibia proximal epimetaphysis fractures treatment by introducing minimally invasive techniques using the up-to-date metallic constructions Materials and methods: The study is based on the results of examination and treatment of 119 patients, using arthroscopic technique. The results were evaluated regarding the P. Rasmussen scheme, post-traumatic arthrosis –Kellgren – Lawrence, life quality - «SF-36 Health Status Survey» Results: The offered treatment method provided for the following: good outcomes in BI– 94.1%, satisfactory ones – 5.9%; respectively in BII – 91.7%, 8.3%; ВIII – 92.9%, 7.1%; СI- 87.5%,12.5%; СII – 91.7%, 8.3%; СIII –88.9%, 7.4%, unsatisfactory outcomes – 3.7% Conclusions: The tibia proximal epimetaphysis fractures make up from 8.9% to 11% of all lower leg fractures and up to 87% of the knee joint fractures. Such fractures are accompanied with the knee joint soft tissue injuries in up to 56% of cases. The meniscus injury is diagnosed in 50-94% of the patients; collateral ligament injury: 20% - 83%; anterior cruciate ligament injury : 20% - 69%, femoral muscle ligament injury– up to 47%, joint capsule ruptures – up to 75%, fibular nerve injury – 3% of cases. The treatment fails in 24.2-50% of cases. Operative treatment of such injuries using arthroscopic method provides for mini-invasive intervention character, visualizing and splint reposition control; the opposite compression screw provides for strong fixation.