Restorative treatment of victims with multiple gunshot fractures of long bones
Keywords:multiple gunshot fractures of long bones, system of re¬storative fracture treatment, replacement of fixation method, individual program of medical rehabilitation
Due to the large number of victims of the armed conflict in the east of Ukraine with multiple long-bones gunshot fractures, there was a need for comprehensive and step-by-step restorative treatment at all levels of medical evacuation, especially at III and IV.
Objective: to develop a step-by-step system for the rehabilitation of victims with multiple long-bone fractures and to prove its effectiveness in preventing the most common complications.
Methods: 380 patients were divided into three groups: the developed system and individual programs of medical rehabilitation were used in the main (119 people), in I (118) — modern conventional methods of treatment, in II (143 wounded in Afghanistan) — methods, used in the 80th of the twentieth century, with effective rehabilitation. To assess the results of treatment, the Luboszyce-Mattisa-Schwarzberg scale was chosen in the modification of Shevtsov.
Results: a rehabilitative treatment system was developed, including a reasoned replacement of the fixation method (biochemical and clinical blood tests, evaluation of the limb state), an algorithm for surgical treatment using modern medical techniques (VAC- therapy, ultrasound cavitation, Vivostat® PRF) and IDEP. The best long-term results (1.2–1.5 years) were obtained in patients of the main group compared with I and II. The risk of contamination of the operating wound in the patients of the main group decreased by 5.8 %, the occurrence of osteomyelitis by 4.2 %, the incidence of neurologic deficits by 2.4 %, vascular disorders by 7.3 %, the development of false joints by 2.8 %, contractures — by 11.3 %.Conclusions: the proposed system of restorative treatment of multiple long-bone fractures is effective in preventing the most common complications.
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Copyright (c) 2017 Oleksandr Buryanov, Anatoliy Kazmirchuk, Yuriy Yarmolyuk, Myroslav Vakulych, Dmytro Drychyk
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