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CNAA / Theses / 2011 / June /

Surgical treatment of proximal humeral fractures


Author: Chirilă Vitalie
Degree:doctor of medicine
Speciality: 14.00.22 - Orthopedics and Traumatology
Year:2011
Scientific adviser: Gornea Filip (decedat)
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific council: DH 50-14.00.22-27.03.08
Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 29 June, 2011
Approved by NCAA on the 5 October, 2011

Abstract

Adobe PDF document – 0.65 Mb / in romanian

Keywords

proximal humeral fractures, rotator cuff, minimally traumatic osteosynthesis

Summary

Structure of thesis. Itis exposed on 131 pages of typed text and it contains: introduction, 5 chapters, conclusions, practical recommendations, bibliography based on 157 sources. The thesis is illustrated with 24 tables, 61 diagrams, 5 annexes and 5 formulas. The results were published in 8 scientific papers and 1 inventions.

Domain and aim of the research. The research included 262 patients with proximal humeral fractures treated exclusively surgical, including 200 patients treated using plates and 62 patients treated using K-wires and metallic tension band.

Study determined the frequency of proximal humeral fractures and manifestation of osteoporosis depending on injury mechanism, age, sex in order to obtain optimal anatomical and functional results for broad application in medical practice. Experimental biomechanical study estimate comparative degree of stability and the results of osteosynthesis of proximal humeral fragments with different types of implants. Materialization the instructions for making plate fixation, development and implementation of osteosynthesis with K-wires and metallic tension band to determine indications and analysis results at the distance.

Novelty and scientific originality. Biomechanical and clinical studies of different types of implants, used extensively in medical practice, with determine their stability and rigidity in proximal humeral fractures, showed priority of rigid osteosynthesis with plates and for elastic fixtures ors with K-wires in two planes supplied with metallic tension, made by certain guidelines in strict compliance with approved behavior.

The theoretical significance and the applications value of the research. Low invasive character of method with K-wires and metallic tension band allowed applying postoperative immobilization on a soft scarf and starting postoperative early resumption of movement in shoulder joint.