Главная Тезисы Лечение диафизарных переломов длинных костей SPECIFICITY OF RENDERING MEDICAL AID TO PERSONS SUFFERING FROM THE FRACTURES OF LONG BONES COMBINED WITH THE INJURIES OF ABDOMINAL CAVITY

SPECIFICITY OF RENDERING MEDICAL AID TO PERSONS SUFFERING FROM THE FRACTURES OF LONG BONES COMBINED WITH THE INJURIES OF ABDOMINAL CAVITY

The increase of profiles of the combination of long bones' fractures with the injuries of other systems of organism immediately requires elaboration and introduction of new modern principles and forming of the adequate methods of rendering medical aid to injured persons. The special problem is a treatment of persons suffering from an abdominal systemic trauma, where a skeletal component is represented by the fractures of long bones. Such a combination, according to our data, occurs in 23,58 % polysystemic injuries or in 5,46 % fractures of long bones.

The particularities of the process of injured persons treatment are defined by the specificity of traumatic process flow, namely:

  1. The high risk of a lethal outcome as a result of the injuries of abdominal cavity.
  2. The significant limitation of the motion activity of injured person.
  3. The rather protracted factor of bones fractures influence on a traumatic process flow.
  4. The increase in a shock degree foremost as a result of significant hemorrhage and following multiple organ failure.

Our analysis of 512 cases of treatment of injuries of the given cliniconosologic group allowed to define the principles, which determine the specificity of rendering urgent medical aid to injured persons, such as:

  • Priority of the injured limb immobilization.
  • Priority of the abdominal cavity intervention.
  • Long bones operative interventions must be executed, as a rule, after terminating the wound dystrophy unstable adaptation period.
  • In a shock period and in a period of unstable adaptation the bones operative interventions must be aimed only at the splinters' stabilization, but not at their correction.
  • In light of the risk indexes the following sequence of correction is expedient: key bone, thighbone, shinbones, forearm bones.
  • The operative interference and/or immobilization method is determined individually, depending on severity and cliniconosologic form of injury.

Guryev S. О., Danilov S.L., Zhuchenko P.I., Velichko V.N. 
Ukrainian Scientific-Practical Center for Urgent Medical Aid and Accident Medicine, Kiev, Ukraine

 

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