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 þeld of External Fixation devices and methods is lacking uniform, comprehensive terminology and description. The aim of our work is to introduce ÒMethod of Uniþed Designation of External FixationÒ(MUDEF), which will allow simple and systematic communication, documentation and approach to this widely-used treatment modality. Methods: Developed and applied in the research lab and clinical practice MUDEF is based on 8 standard and 6 additional (elaborating) symbols (http:// www.aotrf.org, the ÒFor the orthopedic surgeonsÒ chapter). Results: Use of MUDEF providing comprehensive objective information on the External Fixation system: accurate location of the elements of external þxation device on the extremity; type and orientation of the pins or wires as well as order and direction of their placement; visual imagination of the geometry and dimension of the external þxation device. This method allows to accurately documenting any external þxation device, facilitate study of different aspects of external þxation technique and interpretation of the results based on universal and clear information of comparable data. This method will facilitate analysis of complications of external þxation technique, provide basis for clear communication in the þeld of research and publications and assisting improving existing technique and technology. Conclusions: We are suggesting and hopeful that MUDEF will have appropriate role and place in documentation in the þeld of orthopaedic practice, research and literature supplementing other existing classiþcation systems.

Aims: The extensor contracture of the knee joint happens in the case of external þxation of low femoral fractures nearly in 100% of cases. This complication appears due to the þxation of soft tissues (skin, fascia, muscles) to the bone with transosseous elements Ð K-wires and S-screws. Methods: We have performed the Òlay-to-layÒ deþnition of soft tissue displacement (skin-fascia-muscles) relative to femoral bone during knee joint ßexion 90/0/0 using 15 human cadavers. The femur was divided into 17 proportional segments. The co-ordinate system included 12 positions in each segment. Results: Our data revealed that the minimal soft tissue displacement was seen in 4th and 8th positions at each tested level (0–5mm). In the positions 3 and 9 the indices were worse (4–10mm). It was stated that most of all the muscles were displaced, the skin was less displaced, and the displacement of fascia was the least. In the projection of the found positions the vessels and nerves are absent. Using the ÒMethod of Uniþed Designation of External FixationÒ (see www.aotrf.org, the chapter ÒFor the orthopedic surgeonsÒ) the possible variant of arrangement of the distal support can be represented by the following way: VII,4,110;VII,8,110;VIII, 3Ð9 or VII,9-3;VII,8,110;VIII, 3Ð9.Conclusions: The data of the experimental test were used during the treatment of 9 patients. During the whole period of þxation in the device the range of motions in the knee joint was from 80/0/0 to 110/0/0. After the dismantling of the device the whole range of motions was achieved in 2–3 weeks. There were no cases of soft tissue inßammation in the zone of exit of transosseous elements of the distal support.