Abstract text (incl. references and figure legends)
Introduction: According to domestic and foreign specialists, disorders of reparative osteogenesis occur in 2.5% to 18% of cases, and this matter is topical worldwide.
Materials and methods: Observations for 420 patients, including 147 persons with slow consolidation (CS) of bone fragments and 273 with pseudoarthroses (PA).
Results: To improve the outcomes of patients with ROD, we have elaborated an algorithm for IM nailing and bone plastics application.
In cases of slow consolidation, nonunion, or hypertrophic pseudoarthrosis without defects of bone tissue, we recommend IM nailing in its initially dynamized variant.
In cases of slow bone fragments' consolidation and bone tissue defects up to 5mm Ro, we advise static locking of the IM nail. In these situations, bone and tissue mixture extracted from the intramedullary canal while drilling will serve as a bone graft for the bone plastic procedure.
We propose IM nailing with a compression fixation for hypertrophic pseudoarthroses either without bone defects or with those of the fragments' ends, 5mm to 10mm in size. Larger bone defects combined with hypertrophic PA require static locking of the IM nail and bone plastic using the graft from the iliac crest.
For hypertrophic PA with a bone tissue defect less than 5 mm, we recommend a static type of locking with bone plastics using the bone-tissue mixture. Bigger defects concomitant with hypotrophic PA require static locking of the nail and bone plastics using the graft from the iliac crest.
Conclusions: A differentiated approach to IM nailing and bone plastics for reparational osteogenesis disorders in patients after long bone fractures, based on consideration of the ROD type by Rosen, kind of PA, presence and size of bone tissue defects has been developed and implemented into practice.
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