Experience in surgical treatment of 519 patients with bone fractures of different localization been treated during 2000 - 2009 was analyzed. In 335 patients low-invasive percutaneous osteosynthesis with application of original and known low-invasive technologies was performed. In 184 patients with similar fractures osteosynthesis by standard conventional techniques was performed during the period from 2000 to 2004. Comparative analysis of early and long-term treatment outcomes showed the advantage of low-invasive osteosynthesis techniques at treatment of fractures with different localization. Main principles and peculiarities of low-invasive osteosynthesis were determined.
Original technique of percutaneous osteosynthesis was applied for the treatment of 24 patients with acetabular columns fractures. The achieved results were compared to the results of osteosynthesis performed using open direct reposition of bone fragments (39 patients). The efficacy of low-invasive surgery in acetabular column fractures with regard to provision of fragments consolidation, prevention of femoral head aseptic necrosis development and achievement of early medical and social rehabilitation of patients was showed. Maintenance of fragments blood supply, use of minimal surgical approach and closed reposition are considered to be the progressive direction of internal osteosynthesis development.
Objective. The development of pelvic surgeries is now making new evolutionary jump for us to witness; this would be unimaginable without significant achievements in anesthesiology and new technologies of blood replacement. Methods. This overview presents analysis of 41 domestic and 20 foreign references sources that are devoted to the problematics of treating patients with fluid injuries of pelvis accompanied by retroperitoneal haemorrhage. Results. The following considers details on determination of endopelvic haemorrhage nature, its intensity, volume, and duration, as well as the treatment methods for circulatory injuries and surgical haemostasis. Conclusions. Energy of mechanical influence of traumatizing agent determines the damage levels (system disintegration) for pelvic ring, the bone core, and soft tissue mass. Diagnosis tactics and treatment of patients with disintegrating pelvic damage in the end are determined with volumes and intensity of haemorrhage as well as the character of related damage.
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