[Treatment of patients with multiple and associated fractures of the long bones]

The authors have studied 266 patients with multiple and associated injuries, 31 of whom were performed a one-stage osteosynthesis in fractures of the bones of the femur (36), the crus (23), the humerus (5) and the forearm (3). Before 1985 the main method of surgical treatment was open intramedullary osteosynthesis with Küntscher-type nails with drilling out of the medullary canal. This method was applied in operating 21 patients with fractures of the femur, 5 patients with fractures of the bones of the crus and 2 patients with fractures of the humerus. Osteosynthesis with Ilizarov's apparatus was performed in 11 patients with fractures of the femur, in 13 patients with fractures of the bones of the crus and in 3 patients with fractures of the humerus. Since 1985 a method of closed intramedullary osteosynthesis has been worked out which was used in fractures of the femur (5 patients) and of the bones of the crus (5 patients). In the postoperative period a reposition-fixation device was used for the reposition of the bone fragments. The results of the treatment are reported.