TREATMENT OF TIBIAL SHAFT FRACTURE. LITERATURE REVIEW

Relevance. Fractures of the shin bones, according to various data, occupy the first place, making up fr om 13 to 21.4% of all injuries of the musculoskeletal system, or 64.3 - 70% of fractures of the lower limbs. The frequency of diaphyseal fractures of the bones of the leg is 26-32 cases per 100,000 population per year.

Purpose: The study and analysis of literary data by a study of domestic and foreign authors for the treatment of diaphyseal fractures of the lower leg bones.

Search strategy. A systematic search for scientific information was conducted in the databases of Google Scholar, eLibrary.ru, PubMed, Cyberleninka, as well as the "manual method". Search depth was 40 years, fr om 1967 to 2017. About 50,000 sources were found in Russian and 525,000 in English wh ere all fractures of the bones of the leg were described, of which about 7,800 and 118,000 comprised only diaphyseal fractures, respectively. We analyzed the indications and contraindications, the advantages and disadvantages of the proposed methods for the treatment of diaphyseal fractures of the shin bones. Inclusion criteria: systematic reviews, full articles, results of a clinical randomized and non-randomized study. Exclusion criteria: advertising articles, articles in newspapers, summaries of reports, private messages.

Search results: 2 approaches to the conservative treatment of such injuries were noted. In addition to conservative treatment in recent decades, extrafocal transosseous osteosynthesis has been widely used in trauma surgery. This method provides rigid retention of bone fragments even in cases wh ere other technologies cannot be applied. Plateau osteosynthesis by tibial diaphysis plates is considered less acceptable than on other segments, due to some peculiarities of the tibia. Intraosseous osteosynthesis is a generally accepted standard in the treatment of diaphyseal fractures of the long bones, despite such negative effects as endosteal necrosis and systemic fat embolism.

Yernar N. Toktarov 1, http://orcid.org//0000-0002-5166-243X

Marat А. Zhanaspaev 1, https://orcid.org//0000-0002-0610-0112

Aidos S. Tlemissov 1, http://orcid.org//0000-0002-4239-6627

Talgat G. Dzhunusov 1, http://orcid.org//0000-0003-4140-1831

Ayan О. Myssayev 1, http://orcid.org//0000-0001-7332-4856

Kuanysh T. Kassymov 2, http://orcid.org//0000-0002-7292-4304

 

1 Semey State Medical University, Semey c., Republic of Kazakhstan;

2 Semey State emergency hospital, Semey c., Republic of Kazakhstan.

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