[Treatment of femoral shaft fractures in polytrauma patients using Mitkovic type internal fixator].

Polytrauma remains a major social, economic and medicine affliction. Successful surgical treatment of polytrauma patient's requires an approach predicated on prioritizing injuries. An isoleted fractures rarely poses any threat but in association with multiple injuries, a fractures assumes greater significance. Proper management of femur fractures in po-lytrauma can gretly reduce the mortality and morbidity. In this work the results of the operative treatments of the femoral shaft fractures in polytrauma patients using Mitkovic type internal fixator (14 patients) and Kuntscher nail (9 patients) are compared. The average patients age was 28.43 years (range 16 to 61). Internal fixation using Mitkovic type internal fixator can be method of choose in treatment of femur fractures in polytrauma patient's. Its application is relatively simple. It doesn't damage the periosteal and meduullary bone vascularization, which favors osteosynthesis and provides considerable contribution in osteogensis.

[Treatment of unstable closed tibial shaft fractures by external fixation].

The fracture of tibia shaft is one of the most common fracture of long bones. The authors bring out the results of the treatment of 90 patients with unstable closed tibial shaft fractures treated by the use of Mitkovic external fixation systems. Within the analayzed group there were 66 (73%) male and 24 (27%) female. The average patients age was 43.9 years (range 15 to 82). Excellent result in treatment of unstable closed tibial shaft fractures with external fixation were achieved in 15 (16,7%) patients, very good in 38 (42,2%) patients, good in 24 (26,7%), poor in 9 (10%) and bad in 4 (4,4%) patients. With 4 (4,4%) patients pseudoarthrosis was formed. Additional treatment of patients with pseudoarthrosis (spongioplastic and placing of CD device) led to pseudoarthrosis healing. Within the analyzed group in all patients treated with extenal fixation there were no registered cases of postoperative osteitis. External fixation by the use of Mitkovic external fixation is one of the method of choose in the treatment of unstable closed tibial fractures, providing dynamic and balanced biomehanical conditions for fracture healing.