Shin both bones open fracture, complicated by purulent infection, complex surgical treatment

Митиш, В. А.; Ушаков, А. А.; Borisov, I; Иванов, А. П.

doi:10.25199/2408-9613-2018-5-3-25-39

Cited by 2 publications

(1 citation statement)

References 2 publications

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“…В настоящее время в России около 7,0-8,0 % населения страдает сахарным диабетом. Среди хирургических заболеваний, сопутствующих сахарному диа-бету, наибольший удельный вес имеют гнойно-воспалительные процессы [1,2,3] нижних конечностей обусловлено анатомо-функциональными изменениями, связанными с диабетической микро-и макроангиопатией, нейропатией [4]. Местное лечение больных с гнойной хирургической инфекцией имеет большое значение [5,6,7,8,9].…”

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Morphofunctional assessment of the regeneration of purulent wounds of the lower extremities in patients with diabetes mellitus with various treatment regimens

Nuzova

Studenikin

Stadnikov

2023

Journal of Volgograd State Medical University

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The purpose of the study was to substantiate the effectiveness of local combined use of miliacil and EHF-therapy in the complex treatment of purulent wounds of the lower extremities in patients with diabetes mellitus and its effect on morphological and functional changes in tissue defects. Our studies included 96 patients with purulent wounds of the lower extremities, localized on the thigh or lower leg against the background of diabetes mellitus. In 48 patients of the main group, miliacil and EHF-therapy were used in the local treatment of wounds, 48 patients in the control group used only miliacil. Of the 96 patients, 56 patients received complex treatment of purulent wounds, 40 received conservative treatment and plastic surgery. In all patients receiving complex conservative treatment, morphological studies of wound tissues were performed at admission, on the 7th day of conservative treatment, with the consent of the patients. When miliacil and EHF-therapy were used, the wounds healed by 13 days in most patients. Most patients in the control group showed complete wound healing by the 18th day of treatment. The positive effect of miliacil and EHF-therapy on the course of purulent wounds in patients with diabetes mellitus was also confirmed by histological research methods. An increase in leukocyte and macrophage reactions, a more active formation of poorly differentiated granulation connective tissue due to the intensification of vasculogenesis. The new method of therapeutic correction contributed to better and adequate epithelialization of the wound defect, traced after 7 days of clinical observation. Thus, with the complex use of miliacil and EHF-therapy, its high efficiency was established in the treatment of purulent wounds against the background of diabetes mellitus.

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Morphofunctional assessment of the regeneration of purulent wounds of the lower extremities in patients with diabetes mellitus with various treatment regimens

Nuzova

Studenikin

Stadnikov

2023

Journal of Volgograd State Medical University

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Clinical Results of Treating Patients With Compound Lower Leg Fractures

Davydkin

Ippolitov

Kistkin

et al. 2021

Ulyanovsk Medico-Biological Journal

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Management of patients with open diaphyseal fractures of the lower leg remains an urgent problem in traumatology and orthopedics. The aim of the study is to improve the results of surgical treatment of patients with open lower leg injuries by means of disease management. Materials and methods. The study under consideration was both retrospective and prospective. It included 67 patients with open lower leg injuries. The patients were divided into 3 groups depending on the fracture type and treatment modality. Results. The two-stage modality of surgical treatment of open lower leg fractures (types 1 and 2) made it possible to significantly shorten the time frame compared to the period of treatment in patients with open lower leg fractures with installation of the external fixator. Active surgical modelling of the open diaphyseal fractures of the lower leg reduced the purulent complications from 60 % to 11 %. Conclusion. In the case of an open lower leg fracture (type 1) blocking internal fixation is desirable, whereas in the case of open lower leg fractures (types 2, 3A and 3B) external fixation is preferable. In patients with open injuries (types 2 and 3A) two-stage fixation of bone fragments using external fixation with subsequent transition to internal one can be suggested. Keywords: intramedullary rod, non-union, Ilizarov apparatus. Ведение больных с открытыми диафизарными переломами костей голени остается актуальной проблемой травматологии и ортопедии. Цель работы – улучшение результатов хирургического лечения пациентов с открытыми повреждениями голени путем оптимизации лечебной тактики. Материалы и методы. Исследование ретроспективное и проспективное. В работу включены 67 больных с открытыми повреждениями костей голени. Пациенты были разделены на 3 группы в зависимости от типа перелома и способа лечения. Результаты. Двухэтапная тактика оперативного лечения открытых переломов костей голени I и II типов позволила значительно сократить сроки лечения по сравнению со сроками лечения больных, у которых сращение открытого перелома костей голени протекало в стержневом аппарате наружной фиксации. Активная хирургическая тактика в отношении открытых переломов диафиза костей голени позволила сократить процент гнойных осложнений с 60 до 11. Выводы. При открытом повреждении голени I типа оптимальным является применение блокирующего интрамедуллярного остеосинтеза, а при открытых переломах II, III А и III B типов – стержневого аппарата наружной фиксации. У пациентов с открытыми повреждениями II и III А типов показана двухэтапная фиксация костных отломков с применением стержневых аппаратов наружной фиксации с последующим переходом на интрамедуллярный штифт. Ключевые слова: интрамедуллярный штифт, несращение, аппарат Илизарова.

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Shin both bones open fracture, complicated by purulent infection, complex surgical treatment

Abstract: The article presents a clinical case of a successful multi-stage surgical treatment of a patient with shin both bones open fracture and an extensive defect of skin and soft tissues in the fracture zone, complicated by the development of purulent infection.

Cited by 2 publications

References 2 publications

Morphofunctional assessment of the regeneration of purulent wounds of the lower extremities in patients with diabetes mellitus with various treatment regimens

Morphofunctional assessment of the regeneration of purulent wounds of the lower extremities in patients with diabetes mellitus with various treatment regimens

Clinical Results of Treating Patients With Compound Lower Leg Fractures

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