Abstract

The aim of the study was to determine the stiffness of fixation of bone fragments of the humerus during Ilizarov treatment, the ability of the bone regenerate to withstand the applied axial load, as well as the effect on the duration of fixation of the transfer of patients to outpatient treatment. During the treatment, 28 patients aged from 20 to 94 years (39±3) with closed fractures of the diaphysis of the shoulder were re-examined. All patients after 16 days of treatment in the hospital switched to an outpatient treatment regimen.

Results: The axial load on the damaged shoulder did not exceed 20kg. A distinctive feature of patients with a fracture of the humerus was the fact that they did not experience a period of increase in the tensometric measurement of the micromodularity of bone fragments during outpatient treatment. The average size of the area of the X-ray shadow of periosteal callus was 153±16cm2, while the elderly and old age did not have a limiting effect on periosteal corn formation, which shortened the treatment time. The duration of the fixation period reached 82±3.4 days, which is 65% more than with inpatient treatment. Fracture of the humerus is a relatively common skeletal injury and is found in clinical practice with a frequency of 13 per 1,00,000 per year [1-3]. The incidence rate depends on age and sex with a common bimodal distribution due to peak morbidity for men aged 20 to 30 years and the second peak for women aged 60 to 70 years (mainly in the proximal bone) [4]. During osteosynthesis according to Ilizarov, the Ilizarov apparatus with the proximal and distal supports in the form of a half-ring is superimposed due to the proximity of the tissues of the proximal shoulder to the rib cage and the need to bend the forearm at the elbow joint by more than 90degrees. Consequently, the design of the external fixation device is less rigid than, for example, used in the treatment of injuries to the bones of the tibia. The recommended minimum time for fusion of fragments of the humerus are 45-55 days [5]. The aim of the study was to determine the stiffness of fixation of bone fragments, the ability of the bone regenerate to withstand the attached axial load and the ability of the vascular bed to withstand the applied loads, as well as the effect on the terms of treatment of transferring patients to an outpatient treatment.