Диссертация (1154788)
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»14.01.15 –:,,– 20182.................................................................................................................. 31............................................................................... 81.1.................. 91.2......................................................... 221.3............................................. 262.................................... 302.1............................................................................. 302.2.................................................................................. 343.................................
413.1........... 413.2.............................................. 453.3...................................... 503.3.1.PIF I –................................................................................. 533.3.2.PIF II –................................................................................. 683.4............... 82.......................................................................................................... 85...................................................................................................................
90..................................................................... 91.......................................................................................... 923,,.[18, 24, 61, 66, 79, 106]...«»[65].,.,0,67,6 % [24, 33, 54, 65, 88, 89, 92, 95, 104].,.,[24, 73, 88, 92,95].,,.80-,[90].[44, 102, 104,108].,4,.,[65, 71, 82, 86, 87, 88, 89, 92, 93, 95, 118].[89, 105]...,..,7 % [14].. .(2008)[13].,,.,.,,,87, 88, 89, 92, 93, 95, 118].[65, 71, 82, 86,,,..5..:.:1..2..3..4........,–,.:1.,.,6–..2..3...III-«:» (232015 ., .«);.,.» (23–24);20162016 .,«–» (3–4«Bone & JointSurgery»2016(22–282017«2017 ., .(11–13.,..,.);,,);» (25–26XI2018 ., .).9,3,67..
.;.);17..;–.;. . .31..;.7«», 5-6-» ().105, 3,.,,41118..,1114.10481...,[109].,R. Danis, G. KuntscherA. Lambotte,. [33, 68, 69].,.,(96,3 %),,,[89, 113]..,[65].,,11, 62].[18, 39, 57].[4, 6,91.1.0,67,6 %) [24, 33, 65, 88, 89, 92, 104].,,..C. M. Robinson et al.(2002),[104].,0,52,7 %0,51,7 %(DHS) [89].– 0,5–7,6 %[13, 14].3 % [18].,,.39[51].,[56, 92].,[24, 79, 106]. R.
Norris et al. (2012)13 568.,10(2,3 %)[92].V. Mounasamy et al.[86, 87, 88]..,,..– 0,6–7,6 %,[58,65, 86, 89, 92, 93, 104, 108]...,,[23, 53, 110].,619,755 %;,,,,40 % [11, 68].,,,–[41]..[14].50-XX,1180-.90-[106].,,.19993%,200667 % [17].AO/OTA33.A2 + 33.A3,AO/OTA 33.A1[60, 63, 77, 98].,[25, 60, 77, 96, 97].[78]. M.
L. Forte et al. (2008),[40].(2014)[100].F. Muller et al. (2016),3(2,13 %)DHS (0,5 %) [89].,[20, 21, 22,23, 24, 50, 63]..Gamma12,1991–2000,,Gamma4,5,.,2000–2005,Gamma[22].,Gamma[92].,,,.,,implant-related fractures,«»,«,».[19, 104].,,[12, 50, 60]..,,,.,.,..,,,.Gamma 3,Gamma 2,20.13,,.,6,225,Gamma 2 –[13, 95, 114].[59, 67,72].(isthmus)..,,,,[115].,,.C. Kleweno et al. (2014)5594,(2,7 %)(3,2 %(1,5 %)., 3,5 %N. K. Kanakaris et al. (2015),) [59].,,,,[55, 92].,,14,[94]..,–[116].T.
H. Tosounidis et al. (2015),..,,[113].,.(),,(reverse oblique)[13, 55].G. Kuntscher“Detensor” – «» (1969),...M. T. Modny, J. Bambara,1953,.,.80261[84].,15,.. R. W. Bucholz et al. (1987),5,[31].,.«,,»A. K. Aune et al. (1994),[20].. .(2008),.Gamma 3.,,[13].,,,.,,[13].,,.16,,.,[76, 85]... .(1893).Gerhard Kuentscher1940.[88].,20[30].S. A. Green1970[45].[49].,.,[93].,,. T.
M. McLaurin et al. (2001)[80].,..,17.,.,,[93].,,,[82, 102]...,.[52, 90].,,,1–3 % [27].–,[32, 35, 43, 83].,(2,6 %) [111].,[27, 35, 39, 47,48]..,18[48,90].,.,[21, 34].M. Bottlang etal.(2009).,40 %[27].(dual plating)[81, 101, 107].20M. Hackl et al. (2015),[46].,,,,.[5, 47, 112].. .LCP(1998),,,,» [1].,.19(J. Wolff),[42].,,.,.3–21 %[16, 29, 64].,.E. Sebastian et al.,stress shielding[37].,,,.,.,.30 %.,3[56].510 %..20..,,,,[9]..2012EFFORT ()EULAR().(IOF)[15].,,,.,,.[3]..,Liaison Service (FLS – «Coordinator Programs («Manager Programs («[7].Fracture»),– Osteoporosis»)») –Care212012(«»)..,,.[2].J. Y. Y.
Lee et al.(2015),,()(AFF’s).de novo,fracture,11,[71].,,.,.:..,,..221.2..,,.,,., A. V. Kumar, G. T. Krishnaiah (2015)20.20.4,4[65].,.HongKyunKimetal.(2012)86-.huckstep[58].huckstep,,. V. Mounasamy et al. (2007, 2013)223–[86, 87].,,.,,[91]...2945,[92].,,,,–.,,.,,[53,110].[65].,27 % [6, 36,74].,30–35 %24[10].,..10,5,,,.,,,. .,.G. Arealis et al. (2014): plate on plate osteosynthesis –(1).–,,...,[18].251 – Plate on plateJe-Hyun Yoo et al. (2015),LCPoverlapping – «» (,2).,,[118].262 – Overlapping,,..,.1.3.,.27–[102, 103, 108, 112].,,,»[79].,,,[8].,,,.–. Duncan. A.
Masri [38, 70].,,.[28].,. J. Rosenbaum et al. (2016)..849,(AO 31 A1 + 2),[105].,3(3).283–(J. Rosenbaum et al., 2016)1–1A:(–).1B:().2–2A:().2B:().3–..F. Müller et al. (2016)1314,18,,,29[89].31).1–(F. Müller et al., 2016),,,,2016.,.,.,,..302.2015–20175(17. ...;..;31.–13..;.
.. .;.)).2.1.41(,,,).,.25(61 %),16(39 %) –.4.(78 %).69 %.313530102520151022531010224–:415 (12 %),(67,38 ± 2,84)90(– 36 (88 %).,272).2–4153667,3841,2570,28.2,844,822,72.17,989,6416,2927,0027,0034,0090,0048,0090,002549,5031,2559,005073,5045,0075,507580,0047,5083,00,32,,7,.,50,50.(p = 0,001),5.5–50,.,,33,60.,,(n = 32)(n = 9) (p = 0,000) (6).6–.(22,31 ± 5,00)7,–12...3343–+41324522,3124,859,1917,05.5,006,242,819,02.31,6134,755,6320,180,250,250,750,75156,00156,0012,0042,00254,003,561,883,635012,0012,003,5012,007530,0012,0039,0028,50,(): r = –0,125, p = 0,443.,..2.2..,...,35,.,.,,,.,.,....,.(3),..6–.,.,,.–36,,66(.4).4–-12012,34,516,1,,2,,.3.,,4,,56,,337412301(,,.
.),2,3)(,),45),6/:.,,..,..383D5,,().–,,.:.36 %.T–1,5.14 %7% –.,M. Singh et al. (1970).,[116].Singh(,,).Singh,–66–4-; 3–1-.,39,.(7).7–M. Singh (1970), 78 %..6.,,.:40;.,...:Microsoft Excel 2013IBM SPSSStatistics v. 21..,25-,75-,,;.2:–; t-–;(r).p < 0,05.,413.3.1.,,,.,,,.,...,(PIF – Peri-Implant Fracture).,2;.5).–:,425–(PIF)aPIF IbcaPIF IIbc..,,..,,–.,,,..,,,43().3D-,.().«»...().,.,27 %) [36].,,).,,..44.40[51].,[10]...,,,–.,()..,:1.?2.?3.?4.?8.45??8–3.2.1.,..,46,.,,.,,,.–(88 %)...,[8, 89, 92].[24, 33, 54, 65, 88,89, 92, 95, 104].«78 %.,,»,14 %7%.,.(J. Wolff),....3.47.9P.
38....9–.:...,48,,,..«».3,2() –..,.,–[65, 92].25(61 %),16(39 %) –.,69 %.,,(PIF I),.(PIF II).,..,49.7,(A10).BC10 –2215 (68 %).7 (32 %) –62.,,9%(75 %)..5(25 %).10,16350,.5– 3..(11 –11)..:3.3.,.2–5123(56 %),18(44 %)..5,.32.–(.12).3790 %.12 –.:5220(49 %),9(22 %),11 (27 %).6.6–PIFPIF I *PIF IIa6b6c10a5b3c10–*..,,78 %,.14 %...,53...PIF II,,,,.,,,,47 %[12, 66, 77].:,,,96,7 %,,[12].41,2 %,,,..54 %– 14 %,.3.3.1.PIF I –23:– 3,– 18,– 2.543490(70,14 ± 3,59)(33,93 ± 8,08)..7.7 –PIF IPIF Ia6b6c10.14– 9(61 %),(39 %)...,,–.,.[4, 26, 62, 75, 99, 117].,55[18, 118].10(PIF Ic)..86...6(PIF Ia).,.,..32.., 74.,(13).20165613 –.:,.12.2,.2017»14).5714 –.:(PIF I).,,.(PIF Ia).(15 –15)..:5836.4.,6,(316).,..16 –.6(PIF I)..6PIF Ib.,(,. .).5917.., 90.2011DHS..–.2015«»17).17 –.:(PIF I),..,.60.(27 %),(PIF Ib) [36].,(18 –18)...,,),..10..61.4.., 34.2014(19 –19)..:,.(7)..3,(2015,,)«62,27.10.2014» (20).20 –.:(PIF I).(PIF Ic).(21 –.)(21).63.3,3.1222).AB22 –C.(A),123 (B)(C),..15.III.2014.., 68.64.,.(23 –201523)..:,cut-out.,(PIF I)...65.(PIF Ic),(42,2),..(24).24 –..,..66,3«» –(25, 26).25 –26 –.:.67..,,,..26 % (6),13 % (3).(2)(–52 % (12),–9%27).9%13 %26 %52 %27 –PIF I,(2),,,.6,,..6683.3.2.PIF II –18:– 1,27– 14,– 1,90– 2.(64,00 ± 4,53).(8,11 ± 2,67)7428.8 –PIF IIPIF IIa5b3c1011(61 %)– 7(39 %)..,,.,13.5,.69.«».«».,[18, 118].()..:.5.PIF Ia,PIF IIa.,,.28.., 76.2015..,5«»(28).7028 –.:..(29 –.29).71.,6,.,..3.PIF I,,,.–,.,,,,..16.., 49.2015.,.7-.,.2,5,2015,()«.»30A).72(PIF II).(PIF IIb)(30B).().AB30 –.:,.1,5,,..5,2.«»,.735.10(PIF IIc)..3.., 63II10..,LCP-DF (A31 –31).B.:(A),(B)..2013201474,«,,»(,32).32 –(.:)(PIF II).,PFNA (PIF IIc)..33A).75,7(33B).,.,,..A33B–.:,,.76,––.(),.6.., 85.2015.7-..10«.»(34).34 –.:77.,.«».(1235).,5.35 –.11(27 %),–3.,,,78,..,..6 % (1),(56–33 % (6)–).)(33 %36).6%33 %33 %28 %36 –PIF II(33 %).2.,28 %79«»....7.19.., 43.2014..,37).5,.«.»(37 –38)..2015,8038 –.:,..(PIF Ic).,.(39 –.39, 40).8140 –.,(41).,.41 –..823.4.23,14–..,,,.,.(12,73 ± 3,34).(5,60 ± 3,24)3..,.,).–.17 %,–– 20 %44 %,–(9).20 %839–..PIF I2312623PIF II6561188818741PIF I.(– I.II): r = –0,428, p = 0,005 –I,(p = 0,008p = 0,02).,.,.10.10 –..a224311b12339c44111207818740–.,84(p > 0,05),,.,.4PIF I,,2.,,.,,..,«».«»85,,.,,[89, 113]..«»[65].0,67,6 %) [24, 33, 54, 65, 88, 89, 92, 95, 104].,,..
C. M. Robinson et al. (2002),[104].,80,[65, 89].[44, 102, 104, 108]..86,.,[18, 24, 61, 66, 79, 106]. R. Norris et al. (2012)13 568.,(2,3 %)[92].V. Mounasamyet al.[86, 87, 88].,,,.,,..[89, 105]...87,,.2015–20175(. ..–-).41(,,,).,.(78 %.),25,16 –.:5 (12 %),(67,38 ± 2,84)41– 36 (88 %).,27,– 90.(PIF).2,;.(11).–:8811 –(PIF)aPIF IbcaPIF IIbc,,:1.?2.?3.?4.?.PIF I23:34– 3,– 18,90– 2.(70,14 ± 3,59)(33,93 ± 8,08)PIF II..18:– 1,2790– 14,– 1,– 2.(64,00 ± 4,53)(8,11 ± 2,67)..8990 %.20,9,11..,78 %...,,,..17 %,––44 %,20 %–.20 %,PIF I.PIF I,.,,..,901.:(,)()..2.PIF,2: PIF IPIF II.3(a, b, c).3.,,.4.4161 %.5..(PIF II).911.,.2...3..4.,.921., . ./ .
.// Margo anterior. – 1998. –2.,.6. – . 1–3..:«...,...,..,//3.,. .)/»../,.. – 2014. –2. – . 3–6.:,. . .,..,..–.:, 2009. – 272 .4.. .,. .,:. .,. – 2009. –5.,. .//4. – . 84–87./. .,. .//. – 2015. –6.. .,. .,. .. .? /,. .,. .,1. – . 26–29./ . .,//. – 2010. –7.,,.:., . ..
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