Relevance When soft tissue release is ineffective in the treatment of persistent flexion contractures of the knee joint, external fixation devices are used. Orthopedic hexapods can be used as an alternative to the traditional Ilizarov frame with a uniaxial hinge.

Purpose To conduct a comparative analysis of the effectiveness of the clinical use of an orthopedic hexapod and the Ilizarov fixator with a uniaxial hinge in the treatment of patients with flexion contractures of the knee joint.

Materials and methods A total of 67 cases of flexion contracture of the knee joint due to spastic paresis were analyzed. All patients underwent posterior release surgery followed by the application of an external fixation device (EFD). Patients were divided into two groups: the study group (n = 35) treated using the "Orto-SUV" orthopedic hexapod, and the comparison group (n = 32) treated using the Ilizarov fixator with a uniaxial hinge. Patients were also subdivided based on the presence or absence of a preoperatively diagnosed posterior tibial subluxation. The duration of treatment stages, range of motion in the knee joint and functional outcomes (assessed with KSS, Lysholm, and LEFS systems) were evaluated at 2 days, 6 months, and 12 months after frame removal.

Results The use of the orthopedic hexapod significantly reduced the duration of the extension stage compared to the Ilizarov fixator. However, the overall duration of external fixation in both groups did not differ significantly. No statistically significant differences were found between the groups at any follow-up time-point for the main functional indicators: range of motion (flexion and extension) and overall lower extremity function (LEFS score). However, according to specialized knee joint assessment scales (KSS and Lysholm), patients in the study group demonstrated significantly better results at 12 months. The complication rate in both groups was comparable.

Discussion Factors affecting functional outcomes in both groups included preoperative tibial subluxation and patient compliance with postoperative recommendations. A specific factor affecting functional outcomes for a uniaxial external fixator is the precise positioning of the hinge on the flexion-extension axis to avoid iatrogenic knee instability. The total duration of external fixation and overall lower extremity function (LEFS) in the compared groups did not differ statistically, indicating no significant advantage of using one type of device over the other.

Conclusion With the orthopedic hexapod, the extension stage was significantly shorter than with the Ilizarov fixator; however, the total duration of externalfixation in both groups did not differ significantly. No statistically significant differences were found between the groups at any follow-up point in terms of the main functional indicators, range of motion (flexion and extension), and LEFS. Based on the KSS and Lysholm scales, patients in the study group demonstrated significantly better results at 12 months. Complication rates were comparable in both groups.

Introduction Footdrop secondary to isolated peroneal nerve neuropathy is associated with limited mobility affecting the quality of life. Objective data on comparative efficacy of surgical techniques are needed for long-term muscle denervation with nerve interventions being ineffective.

The objective was to determine the optimal surgical strategy for restoring dorsiflexion of the foot in case of isolated injury to the peroneal nerve through comparative analysis of the results of tenodesis of the extensor digitorum longus and posterior tibial muscle trasfer.

Material and methods Outcomes of 84 patients with isolated peroneal nerve neuropathy confirmed by electroneuromyography and lasting more than 12 months were prospectively analyzed. The first group included 42 patients treated with tenodesis of the extensor digitorum longus tendon to the anterior border of the tibia using a modified Lambrinudi technique. The second group consisted of 42 patients who underwent transfer of the posterior tibial muscle through the interosseous membrane with fixation to the lateral cuneiform bone using the Bridle technique. Functional assessment was produced using the AOFAS score, measuring dorsiflexion amplitude with goniometry, ankle dorsiflexor strength with dynamometer and stabilometric analysis of gait parameters at checkpoints of three, six, 12, and 24 months after surgery. Statistical processing was performed using parametric and nonparametric criteria at a significance level of < 0.05.

Results Between-the-group comparison revealed a statistically significant advantage of the muscle transfer evaluated with AOFAS (p = 0.003) and range of motion measurements (p = 0.001). Dynamometry showed dorsiflexion strength restored to 62.4 % of the contralateral limb in the first group and to 78.9 % in the second group (p < 0.001). Stabilometric analysis recorded a reduction in the center-of-pressure total trajectory length by 34.8 % with tenodesis and by 51.6 % with muscle transposition relative to preoperative values. The complication rate was 14.3% after tenodesis and 9.5 % after transfer (p = 0.386).

Discussion The superiority of the posterior tibial transfer can be explained by active muscle traction, as opposed to passive stabilization with tenodesis, which ensures a more physiological restoration of motor function. The strength and stabilometric parameters restored correlates with international data on the high effectiveness of active muscle transpositions during long-term denervation. Comprehensive postoperative rehabilitation using modern biofeedback technologies helps optimize the functional results of both techniques.

Conclusion Tibialis posterior muscle transfer demonstrated a statistically and clinically significant advantage over tenodesis of the extensor digitorum longus in restoration of the dorsiflexion function in patients with isolated peroneal nerve neuropathy lasting more than 12 months. The need to integrate personalized rehabilitation programs into the surgical treatment was supported by differences in the recovered ankle function and biomechanical gait parameters.

Introduction Open decompression of the median nerve is a common surgery performed for carpal tunnel syndrome (CTS). Transection of the transverse carpal ligament (TCL) results in impaired hand biomechanics and decreased grip strength when specific anatomy necessitate transection of the thenar muscles along with the ligament.

The objective was to compare short-term and long-term surgical results of CTS patients treated with open decompression in three different settings: without thenar muscle reconstruction, with thenar muscle reattachment and with reconstruction of the thenar muscles.

Material and methods A total of 80 patients with idiopathic CTS treated with 92 surgical procedures were included in the study. They were divided into three groups. The first group included 38 patients (39 surgeries) treated with open decompression without reconstruction of the TCL. Forty surgical procedures were produced for 31 patients of the second group including dissection and reattachment of the thenar muscles located at the site of the median nerve dissection. Median nerve decompression followed by TCL reconstruction were performed for 11 patients of the third group treated with 13 surgical procedures.

Results All patients demonstrated positive dynamics with more significant recovery of the hand function achieved after open decompression of the median nerve and reattachment of the thenar muscles and reconstruction of the spinal nerve with the outcome improved at three months and stabilized at six months of the surgery.

Discussion A differentiated approach to treatment ensured the amplitude of the M-response of the brevis muscle abducting the pollicis increased by 15.9 % in the first group, by 34.3 % in the second group, and by 30.5 % in the third group; the impulse velocity along the motor fibers of the median nerve increased by 6.6 %, 13.2 %, and 10.9 %, respectively, at six months. Less improvement in electrophysiological parameters in patients of the first group could be associated with a more advanced surgical technique employed for the patients of the second and third groups.

Conclusion A comparative analysis of the short-term and long-term surgical outcomes of CTS patients revealed clinically significant improvement with both options. However, the hand function recovery was more accomplished in the second and third groups with use of the two methods we developed. 

Introduction With increasing life expectancy and an aging population, vertebral fractures are one of the most common fractures associated with low bone mineral density.the problem of vertebral fractures associated with low bone mineral density is becoming increasingly common. Despite a variety of treatment methods, the risk of transpedicular fixation instability in the postoperative period remains.

The objective was to identify risk factors for unstable spondylosynthesis in patients with osteoporotic spinal fractures to substantiate an individualized approach to the surgical treatment.

Material and methods This A retrospective single-center study was based on the findings of 82 patients who underwent surgical treatment at the R.R. Vreden National Medical Research Center for Trauma and Orthopedics between 2019 and 2023. Patients were divided into a case group of patients who developed unstable fixation, n = 8) and controls (who had no hardware instability, n = 74). Potential risk factors included age, body mass index, fixation length, a screw placed in the involved vertebra, screw diameter, the presence and type of bone cement augmentation, the amount of decompression, the presence of local kyphosis and correction technique (Schwab vertebrotomy), duration of surgery and blood loss.

Results A screw placed into the involved vertebra was the only statistically significant (p < 0.05) difference between the groups. A logistic regression model was used to identify factors that could improve the hardware stability including intermediate fixation, augmentation of the fractured vertebra, screw augmentation and a larger screw diameter. Laminectomy, facetectomy, advanced age, and excess body weight were identified as factors negatively affecting the stability of the metal construct.

Discussion Patients with osteoporotic vertebral fractures are heterogeneous in age and medical status which complicates selection of optimal surgical approaches. Laminectomy and facetectomy are the main factors impacting stability in case of facet joint resection. Larger-diameter screws and bone cement augmentation are practical for better stability and associated with a risk of specific complications. The screw placed in the broken vertebra is a significant positive factor, as confirmed by other biomechanical and clinical studies. Limitations of the study included the retrospective design, small sample size and cohort heterogeneity, which reduce the statistical power and generalizability of the results.

Conclusion Unstable transpedicular fixation after stabilization is multifactorial in patients with chronic osteoporotic vertebral fractures. Surgical factors are most significant. Laminectomy and facetectomy increase the risk of instability with the screw placed in the broken vertebra and bone cement augmentation helps maintain the stability. The length of fixation, the extent of kyphosis correction and residual kyphosis had no significant effect in the study sample. These results support the need for individualized surgical approaches in osteoporotic patients.

Introduction Phage therapy is a promising approach to addressing the problem of antibiotic resistance in orthopedic infection pathogens. Staphylococci are the leading etiotropic agents of implant-associated infections, with 15 % of S. aureus strains being methicillin-resistant (MRSA). Bacteriophage preparations are available on the Russian pharmaceutical market, and the concentration of phages active against the microbial agent influences their effectiveness.

The objective was to compare the activity of commercial bacteriophage kits against methicillin-resistant Staphylococcus aureus isolated from patients with orthopedic infections.

Material and methods Clinical strains of S. aureus (n = 25), consecutively isolated from patient biomaterial in 2025 were examined. Identification was performed using MALDI-TOF MS, and antibiotic susceptibility assessed according to EUCAST v.15. Phage lytic activity was evaluated using meat-peptone agar and a five-point scale with the strain sensitivity to a specific drug determined as sensitive, weakly sensitive, or resistant. Statistical analysis was performed using IBM SPSS Statistics v.26.

Results The S. aureus strains included in the study were resistant to cefoxitin. Of the MRSA strains tested, the majority (76 %) were sensitive to PBP 1. A larger number of strains (60%) were classified as "weakly sensitive" to PBP 3. There were less variations in "non-susceptible" cultures, with only one strain demonstrating resistance to the three bacteriophage preparations. A comparative analysis of antistaphylococcal drugs from various manufacturers revealed differences in the activity against clinical MRSA isolates. There were 84 % isolates being sensitive to PBP 4 and 36 % to PBP 5. One isolate was resistant to the phages tested.

Discussion The differences in the activity of commercial phages could be associated with the composition of the resulting preparations, which had lower affinity for strains isolated from patients in other regions. Given the wide geographical distribution of patients with orthopedic infections hospitalized in federal centers, the ability to choose bacteriophages from a wide range of commercial kits available on the market increases the likelihood of their successful use.

Conclusion Commercial drugs presented on the Russian market were characterized by different lytic activity against clinical strains of MRSA, with Pyophag® and Staphylophag® exhibiting greater activity.

Introduction In 1991, J. Karlsson and L. Peterson proposed a system for assessing the functional state of the ankle joint. This questionnaire assesses pain, activity, instability and disturbances inf daily activities using nine assessment parameters. The Karlsson – Peterson questionnaire has been used actively in foreign studies and literature sources, but despite its widespread use, its original version is in English, and until now there was no official adapted version in Russian.

The aim of the study was to translate, cross-culturally adapt and psychometrically validate the Russian version of the Karlsson – Peterson questionnaire for clinical use in patients with chronic lateral instability of the ankle joint.

Materials and methods The study included 60 patients at the preoperative examination stage in a state of clinical stability. The Karlsson – Peterson questionnaire was translated and adapted according to the ISPOR methodology. All patients filled in the Karlsson – Peterson and AOFAS-AHS questionnaires. A total of 39 patients were re-administered after 7–14 days. The following measures were assessed: internal consistency (Cronbach's α), test-retest reliability (ICC), standard measurement error (SEM), minimally significant difference (MDC), extreme effects, and construct validity.

Results The Russian version of the Karlsson – Peterson questionnaire showed high internal consistency (α = 0.826) and good reproducibility (ICC = 0.720). SEM was 2.89, MDC was 7.95 points. There were no ceiling or floor effects. Significant correlations were found between the final scores of the Karlsson – Peterson questionnaire and AOFAS-AHS.

Discussion The study demonstrated the reliability, validity, and sensitivity of the Russian version of the Karlsson – Peterson questionnaire. The questionnaire is an informative and clinically interpretable tool for assessing the condition of the ankle joint in patients with chronic ankle instability.

Conclusion The Russian version of the Karlsson – Peterson questionnaire demonstrated high psychometric properties and can be recommended for use in clinical and research practice, as well as for assessing the functional state of patients with chronic lateral instability of the ankle joint to assess the dynamics of changes in the treatment process.

Introduction The use of ceramic materials is a promising approach to bone defect repair. Various orthobiological agents are used to improve their properties and enhance their regenerative potential. The aim of this study was to determine the efficacy of platelet-rich plasma in repairing bone defects with yttria-doped zirconia ceramic implants.

Materials and Methods Bioceramic samples were zirconium dioxide. The ceramic implants measured 0.15 × 0.15 × 1.00 cm. Male Chinchilla rabbits were used in the experiment: Group 1 (n = 10) included animals that underwent bilateral metaphyseal bone defect filling with implantation of ceramic augments; Group 2 (n = 10) included animals that underwent bone defect repair without implantation. Platelet-rich plasma (PRP) was injected into the bone defect in the right femur of rabbits in both groups; PRP was not injected into the defect in the left femur. Blood samples were collected preoperatively and at the end of the experiment, four and eight weeks after surgery. Key blood parameters, including C-reactive protein, and platelet-derived growth factor (PDGF) in PRP were determined. To assess the effect of PRP on the dynamics of osteogenesis, a comparative histological analysis of the tissue structure in the simulated bone defect area was conducted.

Results No significant differences were found between the groups in key parameters of leukocytes, erythrocytes, and platelets, or C-reactive protein levels, either preoperatively or eight weeks after surgery. The concentration of PDGF in the injected PRP did not differ significantly between the groups. Histological analysis showed that injection of PRP increased the number of regenerating bone trabeculae and reduced the number and size of fibrotic foci and osteochondral callus in both groups.

Discussion Autologous PRP has previously been shown to be a simple and effective way to enhance bone regeneration due to the release of multiple growth factors by platelets, which regulate key biological processes, including angiogenesis, inflammation resolution, and tissue regeneration. Our study aimed to investigate whether platelet-rich plasma enhances the osteogenic potential of zirconia ceramic implants in bone defect repair. Our results confirm that PRP, with a platelet concentration of 800 × 10⁹/L to 1200 × 10⁹/L, a white blood cell count of 4–7 %, and a red blood cell count of no more than 1 % of the baseline blood count, may be a useful tool for bone regeneration.

Conclusion The use of PRP is effective in compensating bone defects using zirconia ceramic implants. However, further rigorous clinical studies are needed to integrate PRP-based methods into evidence-based medical practice.

Introduction Medical implants for treating injuries and orthopedic diseases are often made of titanium and its alloys. Their physicochemical properties, including corrosion inhibition, can be improved by adding rare earth elements.

The aim of this study was to evaluate the safety of new materials based on the titanium alloy Ti6Al7Nb doped with yttrium, lanthanum, and cerium using an experimental in vivo subcutaneous implantation model.

Materials and Methods Male Wistar rats were subcutaneously implanted with titanium and titanium alloy samples: VT1-00 (control, n = 10); Ti6Al7Nb0.3Y (group 1, n = 12); Ti6Al7Nb0.3La (group 2, n = 12); Ti6Al7Nb0.3Ce (group 3, n = 12). The experiment lasted 28 days. The animals' general condition and behavioral responses were assessed, and the implantation area was visually marked. Body weight, body temperature, and local temperature at the implantation site were recorded. Hematological and biochemical blood tests were performed, and internal organs and peri-implant tissue condition were anatomically assessed.

Results In all groups, general condition, behavioral responses, body weight, body temperature, and peri-implant tissue temperature were normal, and skin wound healing occurred by primary intention. A positive effect of the rare earth elements studied was observed on reparative processes during skin wound healing. In the control group and group 1, organs retained normal size, color, and anatomical structure. In group 1, red blood cell counts were slightly elevated, along with increased concentrations of low- and medium-molecular-weight substances. In groups 2 and 3, changes in the anatomical characteristics of the liver, kidneys, and spleen were determined. Serum AST and LDH levels increased, C-reactive protein levels decreased, the proportion of neutrophils increased, and the lymphocyte count decreased. Glucose levels decreased in group 2, while glucose and urea levels increased in group 3.

Discussion Subcutaneous implantation of yttrium (Y), lanthanum (La), and cerium (Ce) at 0.3 % wt. each in titanium alloys of Ti6Al7Nb composition for one month had no negative impact on the general condition, thermoregulation, cardiovascular system, or reproductive organs of male rats. The titanium alloy doped with yttrium (Y) had a compensatory toxic effect on the body. Titanium alloys doped with lanthanum (La) and cerium (Ce) exhibited hepatotoxic and nephrotoxic effects and impaired spleen function. The results obtained are consistent with existing literature data.

Conclusion Under the conditions created, yttrium-doped materials and control samples can be considered safe. Materials doped with lanthanum and cerium raise concerns when implanted in vivo, requiring a longer-term study using histological methods.

Introduction Saturation of bone defect filling materials with antibacterial agents is used for the treatment of patients with infectious bone complications and for their prevention.

The purpose of the work was to evaluate the elution rate of vancomycin and meropenem from bone cements based on polymethyl methacrylate and polyurethane polymers impregnated into the material in their combination.

Materials and methods In an in vitro study, a comparative analysis of the kinetics of vancomycin and meropenem release from two materials was performed that were based on polyurethane polymers (PU series) and polymethyl methacrylate (PMMA series). Antibiotics were added to the materials before their polymerization in the following proportions: group 1 — polymer : antibiotic 10 g : 1 g (0.5 g vancomycin + 0.5 g meropenem); group 2 — polymer : antibiotic 10 g : 0.5 g (0.25 g vancomycin + 0.25 g meropenem). Samples loaded with one antibiotic were used as a control: group 1v — polymer : antibiotic 10 g : vancomycin 0.5 g; group 1m — polymer : antibiotic 10 g : meropenem 0.5 g; group 2v — polymer: antibiotic 10 g: vancomycin 0.25 g; group 2m — polymer: antibiotic 10 g: meropenem 0.25 g.

Results Vancomycin elution from both PMMA- and PU-based materials loaded with a vancomycin+meropenem was greater in final volume and longer in time than from materials containing vancomycin alone. Conversely, meropenem release from PMMA and PU loaded with a vancomycin + meropenem mixture was less in volume than from the materials containing meropenem alone.

Discussion The use of a vancomycin-meropenem complex in bone cements reveals the following feature: meropenem promotes the release of vancomycin from the studied materials, while the elution of meropenem itself is reduced.

Conclusion Combining antibiotics for impregnation into materials for bone defect filling has an impact on the kinetics of antibiotics release, unlike the release kinetics of an antibiotic loaded into the material as monotherapy.

Introduction Studying the reorganization of adjacent joint components due to prosthesis application and identifying predictors of arthrosis are key factors to successful functional restoration of a prosthetic limb.

The aim of this study was to evaluate the structural reorganization of the basic joint components after prosthetic application of a calcium phosphate-coated implant at long term.

Materials and Methods The study was conducted on five intact and six experimental mongrel male dogs, aged 1.8 ± 0.5 years and weighing 19.0 ± 1.2 kg. A tibial stump was modeled at the level of the upper third of the diaphysis. A Ti6Al4V calcium-phosphate coated implant was used 2.5 months later. The study was conducted at six and 12 months after prosthesis application. Histomorphometry of the synovial membrane and osteochondral component of the tibial plateau was performed on semithin and paraffin sections using an AxioScope.A1 microscope with Zenblue software (CarlZeissMicroImagingGmbH, Germany).

Results Mild synovitis detected at six months (hyperplasia of the integumentary layer, predominance of macrophage-like synoviocytes, plasma cells, and mast cells) was reversible in 70 % of cases at 12 months. Signs of impaired synovial blood supply were recorded. Articular cartilage changes according to the OARSI scale corresponded to grades 0–1 at six months and grades 1–2 at 12 months (in one case, synovial pannus). Basophilic line abnormalities were noted: vessel density (number of vessels per unit of visual field analyzed) was (0.35 ± 0.02) at six months and (0.30 ± 0.02) at 12 months. Differences between time points were statistically insignificant, p = 0.736. Subchondral bone plate thickness was significantly (p = 0.0105) lower than in the control. At 12 months, the median subchondral bone plate thickness was 33 % higher than the one in the control animals, and the bone index was 31 % higher; differences were statistically significant. Active osteoblasts that were lining bone trabeculae were noted at all stages; fuchsinophilic structures predominated in the bone matrix when stained with Masson's method.

Discussion The histological signs of inflammation and impaired blood supply to the synovial membrane, thinning of the articular cartilage, and invasion of the synovial pannus into the superficial zone and vessels into the deep cartilage zone were prognostic markers of osteoarthritis.

Conclusion Structural changes in the osteochondral component of the tibial plateau one year after application of a tibial calcium phosphate-coated implant were consistent with the initial stage of osteoarthritis. Mild non-infectious synovitis was reversible. The use of calcium phosphate-coated implants promoted the activation of reparative osteogenesis and mineralization of the bone matrix in the subchondral zone.

Introduction Nail deformity is a common condition in podiatry, affecting 15–20 % of the population at different stages of their life. The disorder can cause chronic pain with a greater risk of infectious complications and significant limitations in activities of daily living. Minimally invasive and affordable solutions are needed for the problem. The key difference between the technique proposed and similar approaches lies in a rigid wire to be replaced with elastic components to allow  adjustable gradual nail tensioning and stable fixation.

The objective was to determine the effectiveness of a minimally invasive technique using a steel wire combined with elements of elastic orthodontic chains made of medical polyurethane (elastofors) or nickel-titanium metal alloy in the form of nitinol springs to provide adjustable gradula tension for nail deformity correction.

Material and methods The method suggests creating customized corrective systems based on a steel wire and a selected active element. The systems are secured to the nail with hooks, ensuring constant, controlled tension. The study included patients with various types of nail deformities, excluding those with acute inflammatory processes. Standard orthonyxia instruments and elastic elements (Elastofors and nickel-titanium springs) were used. Results were assessed by measuring the nail width and tension force every two weeks for two months.

Results and discussion The technique demonstrated high efficacy in correcting different types of nail deformities, with the nail width increasing from 2 mm to 4.1 mm over eight weeks. The technique is minimally invasive and causes no discomfort to patients. Elastic elements provide a gentle and comfortable pressure on the nail without affecting the patient's ability to function or perform daily activities. The technique is universal and applicable to different types of deformities. Prospects for further research might include introduction of adhesive platforms for uniform pressure distribution; the study of alternative alloys (titanium-molybdenum, cobalt-chromium) and optimization of wire-free Elastofors fixation.

Conclusion The technique was shown to be effective in the nail deformity correction, combining minimal invasiveness, adaptability and aesthetics. The results offer potential for implementation in clinical practice with an emphasis on personalized treatment.

Introduction Distal humerus fractures account for about 2 % of all fractures, with annual fracture incidence up to 5.7–8.3 cases per 100,000 population. In this regard, optimal surgical treatment methods continue to be sought. Despite the widespread use of olecranon osteotomy to approach the humerus, the choice of an osteotomy type and fixator for an artificial fracture consolidation remains with the surgeon. This paper systematizes the available literature related to types of osteotomies, types of fixators, and characteristics of complications.

Purpose To evaluate the results of performing olecranon osteotomy to approach the humeral trochlea in the treatment of distal humerus fractures, to determine the optimal type of approach, type of osteotomy and type of fixators for an artificial olecranon fracture in the surgical treatment of distal humerus fractures.

Material and methods The search for publications was carried out in the PubMed, Google Scholar, eLibrary databases for the period from 2020 to 2025. Studies that described olecranon osteotomy in the surgical treatment of distal humerus fractures (DHFs) were selected. After evaluating 595 articles, 18 studies with a total sample size of 640 patients were included in the systematic review according to the PRISMA criteria.

Results and discussion The results of the review are: the overall incidence of delayed consolidation was 5 out of 112 cases (4.46 %), pseudarthrosis developed in 24 out of 416 (5.76 %), and metal implant broke in 10 out of 150 (6.6 %). Development of surgical site infection in the early postoperative period was described in 37 out of 473 (7.82 %). Metal implants were removed in the postoperative period in 55 out of 297 cases (18.51 %). The incidence was calculated based on the available data for each described complication.

Conclusion The results of olecranon osteotomy used to approach to the humeral trochlea in distal humerus fracture treatment have been evaluated. Based on the results of this systematic review, it is impossible to indicate the optimal approach, type of osteotomy and type of fixation due to the limited data. However, given the available statistics, it is possible to assume the advantage of the Tension Band Wiring (TBW) method. Therefore, the issue of conducting experimental and prospective studies remains open.