R.R.YAKUBJANOV, M.Y.KARIMOV, N.R.KOBILOV
Tashkent medical Academy Tashkent, Uzbekistan Long bone fractures with diabetes are becoming a major global health problem.
The goal is to improve the results of treatment of fractures of long bones on the background of diabetes.
Material and methods
We observed 404 patients with limb fractures. 102 cases are diabetes which were observed. There are 41 males (40.2%) and 61 females (59.8%). The victims ranged in age from 44 to 86. Closed fracture of the proximal end of the femur 47 cases (including femoral neck fractures-22, femoral spits fractures -25), closed fracture of the femoral shaft 29 cases, closed fracture of the tibia 26 cases. All patients were examined according to the standard: clinical examination, radiography, laboratory blood tests, ECG, blood sugar. In the preoperative period he was consulted by an endocrinologist. More than 90% of patients were transferred to different insulin regimens.
In 56 (65.1%) cases, BIOS was performed, which is a biomechanical biologically justified method of fixing fragments, recognized as the “gold standard” for shart fractures. 8 (9.3%) patients with diabetes mellitus underwent open osteosynthesis with AO plate. It was decided to transfer 22 (25,6%) patients with deterioration of somatic status, absolute contraindications of anesthetic aid to conservative treatment after injury.
Results and discussion
Evaluation of the treatment results was carried out according to our modified Schwarzberg scheme, which includes 10 clinical, functional and radiological parameters of restoration of the damaged limb.
Long-term results of treatment were studied in 82 patients (95%) with fractures of the long bones of the lower extremities, of which femoral fractures were observed in 65 cases (79.3%), and damage to the Shin bones in 17 cases (20.7%). Excellent results were achieved in 41 patients (50%), good results – 25 (30.4%), satisfactory – 9 (11.1%), unsatisfactory – 7 (8.5%).
Conclusions
- Patients with fractures of long bones, on the background of diabetes, belongs to the somatically severe category of patients. The findings indicate that a differentiated approach can reduce intra-and postoperative complications.