LOW INVASIVE OSTEOSYNTHESIS FOR FRACTURES OF LIMB BONES IN POLYTRAUMA
Relevance. The share of victims with polytrauma is up to 28% of the total number of trauma patients. Polytrauma is characterized by high (up to 40%) lethality. Among the causes of death, it ranks third, second only to mortality from tumor and cardiovascular diseases, and in the group of people younger than 40 years - the first. The high social disability (more than 40%) and long periods of incapacity for work with patients with polytrauma, associated not only with the severity of the trauma, but also with the forced execution of multiple, intermittent operations of varying degrees of complexity and severity, give special social significance to the problem.
The aim of the work is to improve the results of treatment of limb fractures in patients with polytrauma.
Materials and methods. Is non-randomized prospective the study presents the result of treatment of 475 patients with polytrauma treated in the Department of Traumatology and Orthopedics of the Emergency Hospital of the Semey in the period from 1998 to 2017. The study group included 254 patients with fractures of a surgical neck of the brachium (n = 33), the humerus (n = 49), the leg bones (n = 98), lower third of the femur (n = 17), fractures of ankles (n = 32) and patel-la (n = 25). The comparison group included 221 patients with similar fractures and received some various variants of the known traditional methods of osteosynthesis (Ilizarov’s devices, external and internal methods).
Results. The developed set of treatment-and-prophylactic actions with experimentally and clinically substantiated supportive-functional scheme for management of patients with fractures of the long bones of the extremities, surgical neck of the humerus, the ankles and patella resulted in reduction of terms of hospital management 1.5-2.3 times, out-patient treatment – by 1.5 times, as well as reduced the amount of days of disability by 1.0-1.3 months, increased the rate of excellent and good results by 1.2-2.1 times respectively, and decreased the rate of satisfactory and unsatisfactory results.
Conclusion. Low invasive transosseous methods of osteosynthesis with the use of the developed devices are the preferred methods for treatment of the fractures of the above-mentioned localizations in polytrauma. The use of internal ways of fracture treatment requires a clear definition of indications, competence, with orientation to severity of the patient’s condition, presence of damages of soft tissues and concomi- tant pathologyAlmas A. Dyussupov, https://orcid.org/0000-0002-2086-8873
Askar K. Bukatov, Askar S. Serikbaev, Yelzhan M. Manarbekov
Аzhar А. Dyussupova http://orcid.org/0000-0002-8857-4118,
Ahkmetkali Z. Dyussupov, Sabyrbek A. Dzhumabekov
Semey State Medical University,
Semey, Republic of Kazakhstan
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