Главная Тезисы Лечение диафизарных переломов длинных костей The treatment of multiple and combined fractures of long extremities bones in conditions of traumatological department of central town hospital

The treatment of multiple and combined fractures of long extremities bones in conditions of traumatological department of central town hospital

 

Multiple and combined fractures of long extremities bones are characterized by general condition severity of injured, accompanied with massive blood loss, acute disorders of blood circulation, respiration, metabolism.

435 damaged with above mentioned injures were treated in traumatological department setting of central hospital in Sverdlovsk, Luhansk region during the period 2000 to 2005. Men were 343 in number (78,8%). Multiple fractures were noted among 156 patients (35,9%), combined trauma - in 279 (64,1%). Traumatic shock of various degree of severity was observed during these injuries in 39,8% patients. 100 patients (23%) had open fractures. Most of the patients - 338 (77,7%) - got trauma at work, 69 (15,9%) - as a result of road accidents and only 28 patients (6,4%) were injured at home. At multiple trauma in 16 cases (10,3%) there were fractures of three segments, in other cases two-segment fractures were observed. We can speak of severity of multiple and combined fractures of long extremities bones, going by the fact that all fractures were with dislocation of broken units.

Surgical treatment was performed after recovery from traumatic shock. In 92 patients with open fractures primary cross-bone osteosynthesis was done with shaft apparatus or with Ilyzarov apparatuses. All the rest patients were applied with skeletal traction. Primary delayed (in 10 days) bone surfacial osteosynthesis with plate "AO " was performed in 103 cases, in-bone - in 205 patients. Spontaneous surgery of all fractures with their various combination was being done. In 35 patients the treatment was conducted with skeletal traction. We think that this

curing tactics of this category of patients for decrease of disability is the most appropriate, taking into account staff potential of traumatological department of central hospital, carrying out round the clock charges.

In most of the wounded the fractures knitted without complications. Traumatic osteomyelitis was noted at open fractures in 6 cases. Fracture knitting remained uneventful in 11 cases, which required secondary surgery.

Ivchenko K.K., Ivchenko V.K.
Central hospital in Sverdlovsk, Lugansk region, Lugansk State Medical University, Ukraine.

 

 

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