[Osteosynthesis by means of a corrugated splint.].
The authors submitted the clinical results of an investigation of 43 patients where in 1986 - 1995 at the Orthopaedic Clinic of the Institute for Postgraduate Training in Prague, Bulovka osteosynthesis by means of a corrugated splint was implemented. The predominating part of the patients was formed by men - 29 (67 %), women 14 (33 %). The mean age of the patients at the time of osteosynthesis war 36.7 years (12-77 years). The time interval between primary osteosynthesis and osteosynthesis by means of a corrugated splint was on average 23 months (4 - 65 months). The mean total period of treatment, i. e. the time from primary osteosynthesis to complete cure after osteosynthesis with the corrugated splint was 35.2 months (9 - 74 months). The primary diagnosis was in the majority of patients comminutive diaphyseal fracture of the femur - 39 times (91 %), in 32 instances (77 %) closed, 7 times open (14 %). In 4 instances the corrugated splint was used when osteosynthesis of prolonged femurs failed. The major part of patients did not have, before ostesynthesis with a corrugated splint, more than 1-2 operations (31 patients, i. e. 72 %). There were, however, also patients with five to six operations. Osteosynthesis with a corrugated splint was indicated mainly on account of the diagnosis of pseudoarthrosis of the femur (18 times, i. e. 42 %), splitting of the splint with refracture of the femur 22 times, i. e. 51 %. In one third of the patients (15, i. e. 34 %) the osteosynthesis with a corrugated splint was supplemented by compression, always in case of the diagnosis of hypertrophic pseudoarthrosis of the femur. In the final clinical evaluation 40 patients were included. As to complications, in particular failure of the corrugated splint was investigated. The authors recorded four cases (9 %). In these patients re-osteosynthesis with a corrugated splint was performed and after that after the usual intervals cure of the complication occured. The mean period of recovery in the investigated group of patients was 6.9 months (3-15 months). The authors evaluated also the difference in time between osteosynthesis with a corrugated splint with compression and without compression. The difference between the mean time of recovery in osteosynthesis with compression (6.1 months) and without compression (7.2 months) was 1.1 months. The authors conclude that compression in osteosynthesis with a corrugated splint is not the dominating factor for healing of the osteosynthesis. They evaluate osteosynthesis with a corrugated splint as a safe and reliable method suitable in particular for diaphyseal pseudoarthroses or in failure or failing osteosynthesis in the diaphyseal area of the femur. Key words: plate osteosynthesis, ostheosynthesis of femur.
Soukup
B
B
Ortopedická klinika IPVZ, FN Praha - Bulovka.
Malkus
T
T
Pilnácek
J
J