Modern approach to the rehabilitation of patients with joint disabilities due to gunshot injuries of the musculoskeletal system
Objective: to identify factors affecting the rehabilitation potential and rehabilitation prognosis, as well as unused reserves to improve the effectiveness of medical rehabilitation of patients with joint disabilities due to gunshot injuries of the musculoskeletal system.
Methods׃ according to data from 13 regional centers of medico-social expertise of Ukraine we analyzed the state and structure of primary disability due to joint gunshot injuries for 2014–2016 period; the rehabilitation indicators of 72 patients were studied; 26 cases of disability were analyzed in detail. Using the method of expert assessments, a comparative analysis of the quality of rehabilitation was made in groups of patients from military personnel and civilians. We analyzed the effectiveness of rehabilitation measures and their impact on the rehabilitation potential and rehabilitation prognosis on the example of 28 patients and disabled people with impaired joint function due to gunshot injuries of the musculoskeletal system.
Results: the number of joint gunshot injuries in the structure of primary disability due to gunshot injuries of the musculoskeletal system increased 1.5 times and was 42.52 % in 2016 and 26.32 % in 2014. In a year after the initial establishment of the disability, 4.17 % of patients were partially rehabilitated, 2.78 % — completely, and there was no deterioration in health. High rehabilitation potential was found in 28.57 % of patients, medium — in 60.71 %, low — in 10.72 %. In the process of rehabilitation treatment, 57.69 % of patients with this pathology were not followed the basic principles of the organization of medical rehabilitation.
Conclusions׃ rehabilitation potential and rehabilitation prognosis can be significantly improved in the case of early onset and comprehensive, staged medical rehabilitation, timely rehabilitation and reconstructive surgery on bones and joints according to indications.
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Gur’ev, S. O., Kukuruz, Ya. S., Yalovenko, V. A., & Volna, I. M. (2014). Analysis of experience of treatment of gunshot injuries of limbs. Urgent medicine: from science to practice, 2, 25–32. (in Ukrainian)
Loskutov, O. E., & Zarutskiy, Y. L. (2016). Modern concept of diagnosis and treatment of gunshot and mine-explosive injuries of limbs. Orthopaedics, Traumatology and Prosthetics, 2, 5–9. doi: http://dx.doi.org/10.15674/0030-5987201625-9. (in Ukrainian)
Bryzhan, L. К. (2010). System of treatment of patient with gunshot fractures of the long bones of limbs (clinical-experimental research). (Doctoral dissertation). The State institute of improvement of Ministry of education of Russian Federation, Moscow. (In Russian)
Gumanenko, Е. К., & Samohvalov, I. М. (2011). Military surgery of local wars and armed conflicts. Moscow: HEOTAR-Media. (In Russian)
Khomyakov, V. М., Кyrychenko, А. G., Shymon, Y. G. & [et al.]. (2016). Disability of participants of АТО in Ukraine as a result of traumas of locomotorium. XVII convention of orthopaedists-traumatologists of Ukraine: collection of the published works sciences, Kyiv. (in Ukrainian)
Shevchuk, V. І., Кravchenko, V. V., Belyaeva, N. М., & Yavorovenko, О. B. (2016). Features examination of disability and rehabilitation for military officers and participants of anti-terror operation: recommendations. Research Institute of Rehabilitation of the Disabled of Vinnitsa National Medical University named after. M. I. Pirogov, Vinnytsya. (in Ukrainian)
Kih, А. U., & Volyanskiy, О. М. (2015). Form and govern for drafting of the individual program of medical rehabilitation for military officers. Science and practice: Interdepartmental medical magazine НАМS, 1–2 (5–6), 49–54. (in Ukrainian)
Moroz, О. М. (2013). Bases for drafting of the individual program for rehabilitation. Ukrainian announcer of medical and social examination, 1 (7), 18–32. (in Ukrainian)
Volyanskiy О. М., & Kih, А. U. (2018). Problem focused rehabilitation of military officers with the gunshot injuries of limbs. Pain Medicine, 3, 2/1, 17. (in Ukrainian)
Strafun, S. S., Borzykch, N. O., Kurinny, І. М. & Borzykch, О. V. (2017). Clinical and organizational aspects of firearm injuries of the upper extremities. Trauma, 18, 6, 64–68. (in Ukrainian)
Radish Ya. F., & Sokolova, O. M. (2014). Unexpected soldiery calls of peacetime (to the problem of state administration of health protection Ukraine the system). National Academy of Public Administration at President of Ukraine. Кyiv. (in Ukrainian)
Bismak, О. V. (2015). Features of organization of activity of rehabilitation establishments in Ukraine. Educational discourse, 4, 1–12. (in Ukrainian)
Korzh, M. O., Yaremenko, D. O., & Shevchenko, O. G. (2011). Modern problems and prospects for developing the organization of medical rehabilitation for patients with injuries and diseases of locomotor system. Orthopaedics, Traumatology and Prosthetics, 4, 86–89. doi: 10.15674/0030-59872011486-89. (In Russian)
Golyachenko, A. O. (2008). Scientific ground of optimization of the system of medical rehabilitation in the conditions of reformation of health protection in Ukraine. (Doctoral dissertation). Kiev Boris Grinchenko University, Kyiv. (in Ukrainian)
Instruction about establishment of groups of disability. Ministry of Health of Ukraine. Retrieved from http://zakon.rada.gov.ua/laws/show/z1295-11. (in Ukrainian)
Mattys, E. R. (1985). System of estimation for results fractures of bones of locomotorium and their consequences. (Doctoral dissertation). Moscow. (In Russian)
Kendall, M. G., Stuart, A., Ord, K., Arnold, S., & O'Hagan, A. (1994). Kendall's Advanced Theory of Statistics, Classical Inference and the Linear Model. New York, NY: Oxford University Press.
Kendall, M. G. (1975). Rank correlation methods.
Siegel, S., & Castellan, N. J. (1988). Nonparametric Statistics for the Behavioral Sciences. McGraw-Hill Humanities, Social Sciences & World Languages.
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