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Registration Number

0219U005305, 0116U003611 , R & D reports

Title

Differentiated approach to the treatment of periarticular fractures of the lower extremities in diabetic patients

Head

Tribushnoy Oleg,

Registration Date

01-08-2019

Organization

State Institute "Zaporizhzhia Medical Academy of Postgraduate Education of Ministry of Health of Ukraine"

Description

Based on a retrospective analysis, the types of fractures of the periarticular zone in the distal leg region were identified. The analysis of treatment methods was carried out, mostly minimally invasive techniques were applied. However, the number of complications remains high (up to 50 percent). Delayed consolidation and poor healing of postoperative wounds on the background of diabetes mellitus remains a big problem and requires further study, taking into account modern methods of laboratory diagnostics, which are currently insufficiently introduced into clinical practice. The analysis of residual deformities in the periarticular zone of the distal leg is carried out and the types of discongruence after the treatment of fractures in the distal leg are identified. The most unfavorable is the valgus tilt of the articular surface of the tibia, which requires additional orthopedic or surgical correction. One of the risk factors for fractures in patients with diabetes mellitus can be a violation of bone mineral density, develops against the background of a fracture and leads to a decrease in bone strength, as well as to a violation of stabilization of fixation devices. The percentage of osteoporosis increases significantly with age and is up to 70% in women over the age of 80 years. In our study, women between 50 and 70 years old prevailed, and in this connection, the percentage of osteopenia and osteoporosis we received was significantly higher than the population risk of fractures. Various forms of D-deficiency, which accompany traumatic fractures, contribute to the formation of defective regenerate, which significantly increases the risk of delayed consolidation and the formation of a false joint. In this case, the correction of D-deficiency can significantly increase the efficiency of treatment of patients with a fracture. This is possible either by prescribing vitamin D, or, more effectively, by its active metabolite, alfacalcidol, at a dosage of 1–2 mcg / day. The main task of surgical correction of the distal articular end of the tibia is the restoration of support ability, axial relationships, and reduction of pain syndrome.

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Баніт Олег Васильович
Кляцкий Юрій Пантелійович
Труфанов Іван Іванович