What is the definition of osteosynthesis?
The reduction and fixation of a bone fracture with implantable devices (usually made of metal)
It’sa surgical procedure with either open or pecutaneous approach to the bone fracture
what is the aim of the fixation in osteosynthesis?
maintain the reduction
to create adequate stability which allows early and optimal function
minimizes pain
what is the aim of reduction in osteosynthesis?
restore the anatomy and morphology,
restore the relationship between the proximal and distal main fragments
Immobilize the fracture while healing takes place
What are the types of osteosynthesis?
- Extramedullary: Plate and screws,tension band
- Kirschner wires or K-wires or pins
- intramedullary: rod or intramedullary nail
What are the indications for osteosynthesis?
- Displaced fracture (>2mm)
- Unstable fractures (cannot be fixated externally)
- Multi-fragmented fractures
What are the advantages for plate and screw fixation?
Tension and Compression
- Forces the bone together at the fracture
Bridging - For fragmentary bone fractures. Bridging can allow for relative stability along the bone, while not disturbing the bone fragments.
What is a potential complication of wire fixation?
Migration of K-wires can occur; instead of backing out the wire can move deeper (puncturing vessels).
What are the potential complications of osteosynthesis?
Mechanical failure (breaking, bending, migration)
Infection
Nerve injury
Vascular injury
Compartment syndrome
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1. treatment of the open fractures, guidelines, methods7
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2. Nonoperative treatment methods of fractures (traction, functional treatment, external fixation, guidelines of the treatment of fractures)12
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3. Osteosynthesis, methods8
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4. Mechanism, diagnosis and treatment of joint dislocations11
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5. Clinical symptoms of fractures, diagnosis5
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6. Primary and immediate care of skull and brain injuries, in-hospital diagnostic examination methods5
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7. Classification of skull fractures, and treatment principles14
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8. Concussion and contusion of the brain and their treatment3
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9. Epidural, subdural and intracerebral hematoma; symptoms, diagnosis and treatment10
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10. Examination of spinal injuries; diagnosis. Surgical indications in the management of spinal injuries12
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11. Fixation of vertebral fractures. Rehabilitation of spinal injuries7
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12. Rib fracture classification, treatment and prognosis9
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13. Treatment and diagnosis of hemo- and pneumothorax6
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14. Guidelines for observing patient with blunt abdominal injuries, diagnosis and treatment of parenchymal and bowel injuries8
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15. Types and treatment of the injuries of the shoulder girdle (soft tissue and bony lesion4
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16. Treatment of humeral fractures (humerus neck and diaphysis)4
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17. Diagnosis and treatment of olecranon fractures3
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18. Treatment of forearm factures in adults3
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19. Typical radial bone fracture (distal radius fracture) principals and treatment methods6
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20. Perilunal luxation and fracture of the scaphoid bone. Therapy of Bennett’s fracture. Metacarpal and phalangeal fractures.10
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21. Soft tissue and tendon injuries of the hand. Septic hand.8
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22. Types, treatment and associated injuries of pelvic fractures.5
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23,24 hip fractures ( femoral neck and intertrochanteric), intracapsular fracture of femoral neck15
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25. Principles of endoprothesis replacement (arthroplasty) surgery5
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26.Diaphyseal fractures of the femur3
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27. Intraarticular fractures of the knee and treatment methods3
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28. Diagnosis and treatment of patellar fractures5
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29. Ligament injuries of the knee – injury mechanism, diagnosis and treatment8
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30. Cartilage injuries of the knee joint (including meniscus injuries). Principles of arthroscopy6
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31. Open and closed tibia fractures – treatment and rehabilitation4
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32. Ankle sprain injuries – examination and treatment methods. Complications of ankle fractures and their treatment methods.5
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33. Types and treatment of ankle fractures4
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34. Calcaneal fracture and its therapy5
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35. Symptoms and therapy of Achilles tendon ruptures3
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36. Compartment syndrome of the lower extremity – diagnosis and treatment7
