TWO-PLANE OSTEOSYNTHESIS FOR NONUNIONS AND REFRACTURES OF THE FEMUR

Background . Fractures of long tubular bones account for up to 49.8% of all musculoskeletal injuries and are associated with a high risk of complications, including nonunion, refracture and chronic osteomyelitis. There is still no unified approach to the timing and extent of metal osteosynthesis. Objective . To evaluate the effectiveness of the developed two-plane osteosynthesis technique in the treatment of femoral fractures and in the prevention of long-term complications. Materials and Methods. A retrospective analysis of 126 medical records of patients with femoral fractures treated at the The Clinical Hospital of emergency medical care (before Bishkek Scientific Center of Traumatology and Orthopedics) from 2019 to 2024 was performed. All patients underwent surgery using the authors’ two-plane osteosynthesis technique. Clinical examination, biplanar radiography and, when indicated, computed tomography were used. Consolidation time, complication rate, length of hospital stay and anatomical-functional outcomes were assessed. Results . The most common long-term complications were nonunion (49%), refracture (28%) and delayed union (23%). The leading causes of injury were road traffic accidents (48.3%) and domestic trauma (45.3%). The two-plane osteosynthesis provided anatomically accurate reduction and stable fixation, as demonstrated by clinical cases. The mean hospital stay was 8 days, pain relief was achieved by day 3, and normalization of clinical and laboratory parameters by day 5. The anatomical-functional outcome index ranged from 3,7 to 4,0 points, indicating good treatment results. Conclusions . The two-plane osteosynthesis technique is an effective method for treating femoral fractures, reducing the need for repeated surgery, accelerating rehabilitation and decreasing the risk of long-term complications.