Results of the Experimental Research and Clinical Application of Cannulated Screw with Bioactive Coverage on the Basis of Natural Hydroxiapatite during Osteosynthesis of Medial Fractures of Femur’s Neck

Abstract

The goal of our research is clinical-experimental justification of differentiated application of osteosynthesis methodicsand application of cannulated screw with bioactive coverage on the basis of natural hydroxiapatitefor patients of old and senile age with the medial fracture of femur’s neck (MFFN) with taking into account the stability grade of fracture by Pauwels classification and motional activity of patients before trauma. The present research is based upon clinical observation of 110 old and senile patients with supcapital and transcervical femur’s neck fractures. With the purpose of scientific justification and detailed research of different types of MFFN osteosynthses experimental stand tests were conducted with the use of cannulated screws and methodic of vertical ostesynthesis by H. Kuntscher for determining and comparison of density and strength of experimental systems “fixator-bone” in static regime over MFFN models. Cannulated screws with bioactive coverage on the basis of natural hydroxyapatite were applied for 16 patients among all operated by us. Time of rehabilitation of supporting and motional functions of the limb has been decreased by using these implants among patients with grades I and II (by Pauwels classification). Thanks to osteoinductive and osteoconductive features of bioactive coverage on the basis of natural hydroxyapatite, rehabilitation of operated limb’s function was conducted in shorter terms and faster rate. For the purpose of obtaining the dynamic stability of osteosynthesis and conduction of accelerated rehabilitation cannulated cervical screw was developed and applied in practice. This screw is different in the design of spiral part and the presence on its surface of bioactive coverage on the basis of natural hydroxyapatite.