Science & Healthcare

Relevance. Fractures of the lower extremities - the most frequent localization of injuries in traumatological practice. In their treatment, it is of great importance not only to ensure the best functional outcome in the outcome, but also during the period when it is carried out, which is quite long. A patient, who lacks the ability to move independently, suffering from pain and other functional disorders, lowers the quality of life for a long time. The aim of the study is a comparative analysis of the quality of life in the treatment of fractures of the bones of the lower extremities of various localizations using transosseous and submerged osteosynthesis.

Material and methods. Is non-randomized prospective of the study was conducted at the State Medical University (GMU) in Semey, at the clinical base of the Emergency Hospital (BSMP) in the period 2012-2017.

406 patients were examined, which, taking into account localization of fractures of the lower extremities, were divided into 3 groups: I - with patella fractures (n = 81), II - bones of the lower leg (n = 93), III - with ankle fractures (n = 232).

Patients, depending on the type of treatment are divided into subgroups. In the subgroups of the main group, it was performed using transosseous osteosynthesis, in the comparison group - submerged osteosynthesis. The quality of life was examined using a common questionnaire SF-36 and specialized KOOS (with patella fractures) and FOAS (fractures of the bones of the lower leg and ankles).

The analysis of numerical series for the correspondence of the distribution to the normal and equality of the data variance was carried out [15]. Testing the hypothesis of statistical significance of the differences between groups was carried out by comparing the average in numerical series using Student's t test. In the presence of restrictions on the use of parametric analysis, the non-parametric Mann-Whitney test was used [7]. To refute the null hypothesis, the level of statistical significance was taken as p <0.05.

Results. In patients with different fracture localizations, the quality of life was exceeded in subgroups of the transosseous osteosynthesis group over the indices of the comparison group. The most significant differences with the use of specialized questionnaires were found 6-9 months after the trauma with a tendency to leveling to the end of the study after 1 year. A more pronounced improvement in the quality of life in the main group was seen in fractures of the lower leg bones.

Conclusions. The authors, based on the results of the study of QOL patients using different methods of treatment of fractures of the lower limbs, recommend the use of the method of transosseous osteosynthesis.