ЛЕЧЕНИЕ ДИАФИЗАРНЫХ ПЕРЕЛОМОВ КОСТЕЙ ГОЛЕНИ. ОБЗОР ЛИТЕРАТУРЫ
Актуальность. Переломы костей голени занимают, по различным данным, первое место, составляя от 13 до 21,4 % от всех травм костно-мышечной системы или 64,3 - 70% от переломов костей нижних конечностей. Частота диафизарных переломов костей голени составляет 26-32 случая на 100000 населения в год.
Цель: Изучение и анализ литературных данных исследовании отечественных и зарубежных авторов по лечению диафизарных переломов костей голени.
Стратегия поиска. Систематический поиск научной информации был проведен в базах Google Scholar, eLibrary.ru, PubMed, Сyberleninka, а также «ручным методом». Глубина поиска составила 40 лет, с 1967 по 2017 год. Было найдено около 50 000 источников на русском языке и 525 000 на английском языке, где описаны все переломы костей голени, из них около 7800 и 118 000 составили только диафизарные переломы соответственно. Нами проанализированы показания и противопоказания, преимущества и недостатки предлагаемых методик по лечению диафизарных переломов костей голени. Критерии включения: систематические обзоры, полные версии статей, результаты клинических рандомизированных и нерандомизированных исследовании. Критерии исключения: рекламные статьи, статьи в газетах, резюме докладов, личные сообщения.
Результаты поиска: Отмечено 2 подхода к консервативному лечению таких повреждений. Кроме консервативного лечения в последние десятилетия в травматологической практике широко применяют внеочаговый чрескостный остеосинтез. Данный метод обеспечивает жесткое удержание отломков костей даже в тех случаях, где другие технологии не могут быть применены. Накостный остеосинтез пластинами диафиза большеберцовой кости считается менее приемлемым, чем на других сегментах, в виду некоторых особенности голени. Внутрикостный остеосинтез является общепринятым стандартом в лечении диафизарных переломов длинных костей вопреки таким негативным эффектам, как эндостальный некроз и системная жировая эмболия
Ернар Н. Токтаров 1, http://orcid.org//0000-0002-5166-243X
Марат А. Жанаспаев 1, https://orcid.org//0000-0002-0610-0112
Айдос С. Тлемисов 1, http://orcid.org//0000-0002-4239-6627
Талгат Г. Джунусов 1, http://orcid.org//0000-0001-8169-147 X
Аян О. Мысаев 1, http://orcid.org//0000-0001-7332-4856
Куаныш Т. Касымов 2, http://orcid.org//0000-0002-7292-4304
1 Государственный медицинский университет города Семей,
2 Больница скорой медицинской помощи, г. Семей, Республика Казахстан.
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