The strategy for the surgical treatment of femoral fractures in polytrauma

Shapkin, Yu. G.; Seliverstov, P. A.

doi:10.18821/0023-2149-2016-94-5-346-352

Klin. med.

2016

DOI: 10.18821/0023-2149-2016-94-5-346-352

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The strategy for the surgical treatment of femoral fractures in polytrauma

Yu. G. Shapkin

P. A. Seliverstov

Abstract: The review describes peculiarities of the choice of time and methods of osteosynthesis offemur fractures of different localization in patients with multiple injuries in accordance with modern concepts of treatment of severe multiple and associated lesions. Analysis of domestic and foreign literature shows that earlyfixation of the femur in case of polytrauma can reduce the mortality rate associated with complications and improve the functional outcome. Terms of osteosynthesis of the femur in polytrauma should … Show more

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Cited by 4 publications

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“…Treatment of this group of patients, despite the latest achievements in medicine, is a complex, but at the same time unresolved and priority problem of modern traumatology [21][22][23][24][25][26][27][28][29][30][31][32][33]. All this indicates the need to create an improved optimal tactics for the treatment of this contingent of victims.…”

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confidence: 99%

New Strategies In The Treatment Of Hip Fractures In Patients With Combined Injuries

Valiev,

Muhammedova M.G

et al. 2024

Texa. Jour. of Medi. Scie.

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This article is a study aimed at analyzing and improving the results of surgical treatment of patients with hip fractures in concomitant injuries using modern technologies. Within the framework of the study, the results of treatment of 233 patients with concomitant hip injuries were analyzed, a surgical method - osteosynthesis was used. early period of a traumatic disease. The results of the study made it possible to determine the optimal methods of fixation depending on the patient's condition. The findings of this study are important for improving the results of surgical treatment of patients with concomitant hip injuries and can be used in practical medicine to optimize treatment tactics and reduce complications

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mentioning

confidence: 99%

New Strategies In The Treatment Of Hip Fractures In Patients With Combined Injuries

Valiev,

Muhammedova M.G

et al. 2024

Texa. Jour. of Medi. Scie.

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A combined application of extracorporal detoxification techniques in children at the acute stage of severe concomitant traumtic brain injury

Novikova

Yeletskaya

Ivanova

et al. 2021

Russian Journal of Pediatric Surgery

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Introduction. In modern literature, there is a limited information on the techniques of extracorporeal detoxification in children with severe concomitant injuries. Moreover, in fact there are no data on their application in children with severe concomitant traumatic brain injuries. It has defined the relevance of this research.Purpose. To improve outcomes of treatment in children with severe concomitant traumatic brain injuries who have manifestations of toxic-resorptive syndrome (TRS), septic complications, acute renal failure of mixed genesis using a combined application of extracorporeal detoxification techniques.Material and methods. The article describes authors’ experience in a combined application of extracorporeal detoxification techniques, including continuous veno-venous hemodiafiltration (CVVHDF) and membrane plasma separation (MPS) in ICU patients with severe concomitant traumatic brain injuries complicated by toxic-resorptive syndrome, sepsis and septic shock.Results. The combined application of extracorporeal detoxification techniques promoted the regression of toxic-resorptive syndrome, shock reversal, stabilization of hemodynamic parameters, parameters of internal homeostasis as well as the regression of multiple organ failure.Conclusion. Early extracorporeal detoxification improves clinical course at the acute stage of trauma. The authors underline that the key requirement for safety in extracorporeal detoxification in patients with severe concomitant traumatic brain injury is the invasive monitoring of intracranial pressure.

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Surgical Treatment of Closed Fractures of Long Bones of Extremities with Polytrauma

Isaev¹,

Mammadov²,

Matiev³

2022

Ukr. ž. med. bìol. sportu

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The purpose of the study was to improve the functional results of treatment of patients with closed fractures of long bones of the extremities with polytrauma. Materials and methods. The results of treatment of 95 patients with fractures of long bones of the extremities with polytrauma were analyzed. Among them there were 70 (73.9%) men and 25 (26.1%) women. The victims had one or more closed fractured of the long bones of the limbs. Persons of young and able-bodied age from 31 to 50 years old prevailed – 47 (48.9%) patients. Results and discussion. Active restorative treatment was started on the second and third days after the operation at the beginning of passive movements in the joints then, as the postoperative wound healed, on the sixth and seventh days, it was active. Depending on the nature of the fractures various implants were used, in most cases, low-contract ones, which in a particular case allow achieving maximum anatomical reposition and achieving stable fixation of fragments, which provides the possibility of an early start in the development of the joint. In the immediate postoperative period in 11 patients with open fracture type B3, superficial suppuration of the soft tissues around the pins was noted, which was easily dealt with using a device for injecting drugs into the infected pin channel. Four patients with granulating wounds of the lower leg underwent autodermoplasty with a free skin graft, all 100% were healed. Phlebothrombosis developed in three patients with hip fractures: they underwent an urgent operation by angiosurgeons – vessel plexization. Long term results of treatment in terms of 8 months to 5 years were studied in 76 patients. Treatment outcomes were assessed with some criteria (union, neuro vascular disorder, varus or valgus, rotation, shortening of the limb, movement in the knee and hip joint, pain, walking hanging activity). Four patients developed chronic osteomyelitis, they underwent seguestrectomy with sub segment recovery. Delayed consolidation was noted in six patients with complex fractures (type C). Two patients developed a defect in the bones of the lower leg up to 5 sm, they subsequently underwent lengthening of the segment. Post-traumatic contracture was noted in four patients. Three patients had persistent leg edema, chronic post-traumatic thrombophletitis, equinus deformity of the feet, significant chromate – the result was rated as “poor”. According to the results of ratings as “excellent”, “good”, “satisfactory” and “poor”, quantitative designations were assigned as 5, 4, 3, 2 points, respectively. In the 76 patients studied, the long-term results were assessed as follows: in 24 (31.6%) patients the result was regarded as excellent (5 points), in 37 (48.7%) patients it was good (4 points), in 12 (15.8%) %) – satisfactory (3 points), in 3 (3.4%) – poor (2 points). Conclusion. As a result of the use of low-contact on-bone plates in the osteosynthesis of complex comminuted fractures of long bones, with combined injuries, 90.3% gave excellent and good functional results. With a combined chest injury, intramedullary osteosynthesis with a pin with reaming is contraindicated, due to the risk of developing fat embolism. In these patients, it is necessary to operate with bone plates

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The strategy for the surgical treatment of femoral fractures in polytrauma

Cited by 4 publications

References 19 publications

New Strategies In The Treatment Of Hip Fractures In Patients With Combined Injuries

New Strategies In The Treatment Of Hip Fractures In Patients With Combined Injuries

A combined application of extracorporal detoxification techniques in children at the acute stage of severe concomitant traumtic brain injury

Surgical Treatment of Closed Fractures of Long Bones of Extremities with Polytrauma

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