Aims: Developing a new effective method of clavicle osteosynthesis.

Methods: The K-wire is inserted along bone fragments (and bone autograft – in case of clavicle defect). Then K-wire is fixed near the breast-bone with the curved or threaded lug. External end of K-wire is strained in external fixation module. When having fracturing console pin with lug is inserted in acromion of frontal plane and is connected to K-wire with short bar. In cases of non-unions and defects two K-wire are inserted (through coracoid and acromion) sagittally. Both of them are strained in half-ring. The K-wire inserted along bone fragments is strained in half-ring (Patent of RF # 1657168).

Results: 238 patients were treated by CoSF: 222 with fractures, 11 – with non-unions, 5 – with defects of clavicle. Complete restoration of shoulder function during of fixation period was registered in 86,1% patients (p< 0,001). Analysis has shown that the main reason of join stiffness were delayed operation. 13,6% of patients have been operated in more than two weeks the injury had occurred, when the contracture already appeared. Pin-tract infection were arised in 3,4% cases, pin-tract osteomyelitis – in 1% cases.

Conclusions: Good and excellent results proved prospective of CoSF as well as improving this method.

Aims. The treatment of the proximal femoral fractures in the elderly people is connected with the presence of the marked somatic pathology, the forced supine position of the patients leading to hypostatic complications. According to the data of numerous studies one and only way to save such patient is to perform the early operative treatment. Methods. We made the analysis of treatment of 642 elderly and senile patients with the proximal femoral fractures, to which the unipolar or bipolar hip replacement was performed. The age of the patients was 51 to 96 years (average Ð 79,2). The operative procedures were performed as the urgent ones independently from the periods passed after the trauma. In connection with the periods of the operative procedure after trauma, all the injuried were divided into 5 groups: operated during the þrst day (219 patients), in 2–3 days (138 patients), in 4–6 days (89 patients), in 7–10 days (92 patients) and more than in 10 days (104 patients). As the principal criterion for the comparison we took the in-patient lethality. Results. The total lethality was 7,6% (49 patients). In the þrst group it was 4,1% (9 patients), in the second Ð 6,5% (9), in the third Ð 8,9% (8), in the fourth Ð 15,2% (14) and in the last Ð 8,7% (9). According to the performed analysis the lesser percentage of the lethal results was deþned in the case when the operative procedure was performed during the þrst day after trauma. Conclusions. Thus the main principle of the treatment of the patients with the mentioned pathology must be the early operative procedure performed during the þrst day after trauma. The late admission to the hospital is connected with the increasing of the operative risk, some part of the injuried die due to the underestimation of their status, insufþcient technical equipment of the specialized departments and some time due to the medical mistakes.