1. Introduction into Traumatology and Orthopedics
Introduction into Traumatology and Orthopedics. History of Traumatology and Orthopedics. Regeneration of the bone tissue.
Tutor: Kostiv S. Ya.

2. „ orthopaedics” (the word „ orthopaedics” tu make from Greece „orthos” - derekt and „paes”- child.) is the brunches of medicine which studies and make proffilactice of differend deformations of the limbs, spinal cord (newborns and acquires) as results of varies pathologycal and traumatic injures of locomotor system in addults and childrens.
R. R. Vreden.

3. „Traumatology ” to make from Greece „ trauma ” ─ wound and „logos”-sciense, and attend to studies of injures of the humen body.

4. Ficsation of the fractures with palm leters

7. 1 2 3 АО - system use: 1) the rots for intramedular osteosintesis;
2) the plates;
3) the screws

8. There are two types of screws = Machine screws & Wood screws.
BONE SCREWS
There are two types of screws = Machine screws & Wood screws.
Bone screws are machine screws.
A wood screw is inserted into a small pilot hole. The screw threads compress the wood, which is less stiff than the screw, resulting in an elastic force.
A machine screw is inserted into a pre-drilled & pre-tapped hole. The screw itself deforms plastically when inserted into metal.

9. INTRAMEDULLARY
NAILS

10. anatomical reduction of the fracture with open techniques
PLATES:
Benefits: 
anatomical reduction of the fracture with open techniques
stability for early function of muscle-tendon units and joints
Disadvantages: 
risk of bone refracture after their removal
stress protection and osteoporosis beneath a plate
plate irritation, nonunion, infection

11. G. A. Ilizarov.

12. Aparates for external fixation

13. FIXATOR ILIZAROV EXTERNAL
wires= 1.5mm in adults & children; 1.8mm in adult femur.
wire types= smooth & olives (for stability/translation)
Insertion= Push-Drill-Tap
Aim for wires at 90deg. to each other & 4-5 wires per segment
Bring the ring to the wire- Not the wire to ring -Tether through muscles in joint extension
Wire Tension= 1.2mm-90kg; 1.5mm-110kg; 1.8mm-150kg
Focus = fracture / non-union site
Segments = bone fragments

14. Factors affecting construct stiffness:

15. EXTERNAL FIXATION: Advantages: Apply quickly
Tecnically easy to perform
 Adjust later
Soft tissues not disturbed
Access to wounds
Joints can be mobilised
Can dynamize
Easy removal
Reconstruction surgery

16. Patient compliance required Soft tissue reconstruction
Disadvantages:
Pin tract infection
Malunion
Patient compliance required
Useful for:
Any fracture
Bone transport
Limb lengthening
Angular correction
Soft tissue reconstruction
Contractures

17. Posttraumatic contractures of knee joints

21. The endoprothesis of the knee and hip joints.

23. The artroscopic method of treatment

24. Reparative osteogenesis to make union of the bones and accompany with reparative and inflamatory reactions.

25. There are four cindes of the bones callus:
Periostal callus;
Endostal callus;
3) Intramedular callus;
4) Paraossal callus.

26. Reparative regeneration of the bone tissue.
The resurses for reparative regeneration: periostal tissue, the marrow, endostal tissue, the endotelial cells of the vessels walls, the pericytes cells and paraossal conective tissue.
THE STAGES
I STAGE (1-5 days)
II STAGE (10-45 days)
The catabolic changes of the tissue and cells inflamation
2. The process of differantiation of the cells
The granulation tissue
The chondroids
The osteoids
Substrate of regeneration
catabolical
anabolical
periodes
IV STAGE (1 year)
4. Rebuilding of primary regenerate.
III STAGE (45-90 days)
Formation small – looping net of bones trabecules
Regenera-tion of vessels net of regenera-tion tissue
3. The formation primary osteon
Resorbtion of needless callus

27. THE STAGES OF THE BONES REGENERATIONS

28. Factors influencing bone healing
REPARATIVE
Systemic
Local
Age
Degree of local trauma
Hormones
Degree of bone loss
Functional activity
Vascular injury
Nerve function
Type of bone fractured
Nutrition
Degree of immobilisation
Drugs (NSAID)
Infection
Local pathological condition
REGENERATION