ABSTRACT
The article discusses the pathogenetical approach to an early prophylaxis of local disorders of blood circulation in the cases of gunshot fractures of limbs. The authors emphasize the negative influence of the post-traumatic edema of muscles inside osseous-fascial bursas. On the background of blood losses and centralization of blood circulation edema causes the decompensation ischemia of tissue, which leads to the appearance of centres of secondary necrosis. An early recovery of optimal tissue blood circulation is propounded as one of the goals during the primary surgical management of wounds. A rational sequence of immediate surgery, which was practically tested is proposed. Basic methods of operations on limb segments are enclosed.
Subject(s)
Fractures, Bone/therapy , Military Personnel , Triage , Wounds, Gunshot/therapy , Combined Modality Therapy/methods , Emergencies , First Aid/methods , Fractures, Bone/etiology , Humans , USSR , Wounds, Gunshot/complicationsABSTRACT
For experimental verification of the authors' hypothesis on the role of the mechanism of adaptative disintegration in pathogenesis of trauma disease the essence of which consists in inadequacy of emergency adaptation of the organism to a critical and middle degree of the injury by the time and amplitude, an investigation on 89 rabbits has been performed with modeling of extensive wound of soft tissues of the femur. The correction of the neuroendocrine response of the organism to trauma by injection of synthetic opiopeptide dalargin++ was made. The use of dalargin changed quantitatively and qualitatively the neuroendocrine reaction to the injury and optimized the wound process and restoration of the homeostasis parameters.
Subject(s)
Adaptation, Physiological/physiology , Disease Models, Animal , Hindlimb/injuries , Homeostasis/physiology , Shock, Traumatic/etiology , Wounds, Gunshot/complications , Adaptation, Physiological/drug effects , Animals , Enkephalin, Leucine-2-Alanine/administration & dosage , Enkephalin, Leucine-2-Alanine/analogs & derivatives , Homeostasis/drug effects , Male , Rabbits , Shock, Traumatic/physiopathology , Shock, Traumatic/prevention & control , Wounds, Gunshot/physiopathologyABSTRACT
The results of experiments with axial loading of human tibia preparations used for simulation of oblique (spiral) fractures and different methods of osteosynthesis by screws revealed that higher strength was ensured by the method of bone connection with the screws directed perpendicular to the segment axis (4.1 times more than in case of screws directed perpendicular to the plane of fracture). Explanation of the obtained facts necessitated development of more precise biomechanical model of deformation. Practical recommendations have been formulated.
