Possibilities of improving the technique of controlled transosseous osteosynthesis in the conditions of anatomical experiment

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Abstract

The possibilities of improving controlled transosseous osteosynthesis in anatomical experiment by changing the design of the external fixation apparatus by individualizing the design of the apparatus, ensuring accurate dynamic reposition of bone fragments, and establishing more effective X-ray control using X-ray transparent elements of the external fixation apparatus design are considered. The study was performed under wet preparations of an isolated femur of ten rabbits with a bone diaphysis fracture created. The original compression–distraction apparatus of external fixation developed was experimentally approved. In all experiments, an accurate comparison of bone fragments was obtained by dynamic reposition owing to the use of autonomous hinge modules and the presence of an individualized base module located in the pathological focus of the bone structure. The study showed the need to individualize the size of the design of the elements of the device. This is because the damaged limb does not have the correct cylindrical shape, unlike the shape of the apparatus. Changing the morphometric parameters of the damaged limb segment during osteosynthesis requires a specific individual geometry of the base module. The individualization of the shape and size of the base module should provide for the possibility of implementing the stages of moving fragments of bone structures, individual in each case. The dimensions of the X-ray transparent plastic ring or the shape of the hinge module close to the ring should correspond to the geometric dimensions of the limb segment at the fracture site and subsequently when correcting the position of bone fragments in each individual case. The most often optimal is the distance from the supports of the device to the surface of the limb segment of 5 cm, which determines the geometric dimensions of the individualized base module. In general, the directions of further improvement of the hardware of the technique of controlled transosseous osteosynthesis are determined. The effectiveness of X-ray control owing to the use of X-ray transparent structural elements of the device is shown. It has been revealed that in the conditions of anatomical experiment, controlled transosseous osteosynthesis may be more effective by improving the hardware owing to the individualization of the structural elements of the apparatus in combination with the use of autonomous hinge modules.

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About the authors

Alexander I. Lapynin

Orenburg State Medical University

Author for correspondence.
Email: lapynin1952@mail.ru
SPIN-code: 1813-8763

MD, Cand. Sci. (Med.)

Russian Federation, Orenburg

Andrey M. Guryanov

Orenburg State Medical University

Email: guryanna@yandex.ru
SPIN-code: 6684-7052
Scopus Author ID: 57202980956

MD, Cand. Sci. (Med.), associate professor

Russian Federation, Orenburg

Valery I. Kim

Orenburg State Medical University

Email: kim@orgma.ru
SPIN-code: 3558-6444
Scopus Author ID: 7102754741

Dr. Sci. (Med.)

Russian Federation, Orenburg

Dmitry A. Lapynin

Clinical Hospital No. 4

Email: lapynind1983@mail.ru

traumatologist orthopedist

Russian Federation, Orenburg

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Supplementary files

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2. Fig. 1. Compression–distraction apparatus to eliminate the bone fragment displacement

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3. Fig. 2. X-ray of fixed bone fragments with compression–distraction apparatus to eliminate bone fragment displacement after reduction of all types of displacement

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4. Fig. 3. Angular displacement of bone fragments before its elimination

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5. Fig. 4. X-ray of fixed bone fragments by compression–distraction apparatus to eliminate the displacement of fragments in width before (a) and after (b) reposition

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6. Fig. 5. X-ray of fixed bone fragments by compression–distraction apparatus to eliminate the displacement of fragments in width before (a) and after (b) reposition

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