Characteristics of reactions of neuromuscular and vascular functions in the treatment of fractures of the tibial shaft in children

Traumatic damage to the tubular bones of the limb leads to dysfunction of its musculoskeletal system. Compensatory reactions of the body systems that occur in response to damage to bone tissue are aimed at creating optimal conditions necessary for restoring the anatomical structure of the bone and altered functions of the limb. The development and introduction of new technologies into modern medicine has made it possible to develop methods of minimally invasive surgical treatment of tubular bone fractures aimed at stabilizing the fracture and ensuring rapid bone tissue regeneration processes in children. The return of the support ability and physical shape of the lower limb largely depends on the state of the neuromuscular and vascular apparatus, the mechanisms of restoration of which in children at the stages of reparative osteogenesis remain poorly understood. The purpose of the study is to determine changes in neuromuscular activity and regional blood flow in the lower limbs in children with tibial diaphysis fractures under conservative and surgical treatment. Materials and methods. Electrophysiological and Doppler studies were performed in 20 patients (mean age 11 ± 1.1 years) with tibial shaft fractures, divided into two clinical groups depending on the treatment method. Study periods: 1.5–2, 3, 6, 9 and 12 months after the treatment. Results. The obtained data of electromyographic and Doppler studies indicated the advantages of treating tibial shaft fractures using the method of minimally invasive osteosynthesis with titanium elastic rods. A faster restoration of the support capacity of the injured limb with this treatment method was due to the possibility of early dosed loading on the injured limb, a higher level of blood filling of the foot of the injured limb and, accordingly, a rapid increase in the motor activity of the corresponding muscle groups.