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Treatment of Bone Fractures and Joint Injuries: External Fixation

Treatment of Bone Fractures and Joint Injuries: External Fixation

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Posttraumatic deformities of the extremity joints resulting from various injuries of the locomotor system are rather common. Treatment of joint injuries is accompanied by the contrary activity of a physician. On the one hand, the injured tissues require a prolonged rest for healing, but on the other early movements are necessary to restore normal function of the joint. Movements in the joint maintain physiological muscle tension; they prevent muscle atrophy, formation of adhesions, obliteration of the joint slit, ossification of the joint tissues, and normal blood circulation in tissues. Movements prevent contracture of the joint and mutual pressure of the articular ends.
Traditional methods of surgical treatment of joints do not allow for restoring their shape and functions simultaneously. To provide the restoration of both the shape and function of the injured joints at the same time, we jointly with M.Volkov developed an original method of treatment by means of hinged distraction apparatuses for external transosseous fixation of the elbow, knee, wrist, metacarpophalangeal, interphalangeal and ankle joints. These apparatuses are intended for complete static and dynamic unloading of joints and restoration of their function during formation of new articular ends, for elimination of contractures of joints with subsequent restoration of their function, for fixation of periarticular fractures and pseudarthroses with mutual compression of the fragments and simultaneous restoration of movements in the adjacent joint, for fixation of the articular ends at joint grafting with simultaneous restoration of function, for reduction of complicated or old dislocations with subsequent development of movements, and for correction of abnormal position of the extremity and subsequent arthrodesis at any functionally favorable angle of fixation of the articular ends. The requisite condition for successful consolidation of bone fragments is a tight and stable contact of the correctly reposed fragments. To carry this out, a method of treating bones by means of apparatuses for external transosseous fixation came into use, among other methods, during the past decades.