Odesa National Medical University MH of Ukraine, Odesa, Ukraine
DOI 10.54229/2226-2008-2021-5-6
Restoration of the static-dynamic function of the foot in severe fractures of the bones of the posterior part of the foot remains the most difficult and not completely solved problem of modern traumatology and orthopedics.
The aim of the study is to objectively study the dynamics of restoration of function in patients with injuries to the bones of the posterior part of the foot, depending on the treatment methods used.
Materials and methods. The patients were examined and the research indicators were evaluated at 3 months after the injury and in the long-term period up to 5 years after the completion of treatment. The patients with fractures of the talus and calcaneus with displacement were randomly selected: treated conservatively and operationally. Fractures without displacement were treated conservatively. The operations included open reposition and internal fixation, as well as closed reposition by external devices developed by us. Group I included the patients with conservative treatment (n = 35), group II included the patients with surgical treatment (n = 19).
Results. To objectively assess the results of treatment in patients with fractures of the bones of the posterior part of the foot, some biomechanical studies were carried out: goniometry, determination of the load on the limbs and parts of the foot, stabilography and plantography. Biomechanical research methods allow us to identify various consequences of injury to the posterior part of the foot and monitor the course of recovery processes. The results of these studies indicate that in case of injury of this localization, the biomechanical features of not only the butt joint, but also the entire musculoskeletal system are violated. In comparison, the best functional indicators were noted in group II of patients in whom the anatomy of damaged bones was surgically restored. For a certain time, the load on the posterior parts of the foot and the injured limb decreases. The general center of gravity shifts towards a healthy limb and, consequently, the degree of stability of the victim’s standing decreases. Recovery of lost function in group I patients is slow and depends on timely physiofunctional treatment.
Key words: calcaneus, talus, osteosynthesis, biomechanical studies, comparative analysis.
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