ABSTRACT
The aim of investigation is improvement of treatment results of unstable injuries in the pelvic ring in patients with severe associated injuries. An experience of treatment of 533 patients with unstable pelvic injuries is presented. Diagnostic measures take into account the severity of the condition of the victim. Stage treatment with consecutive performing of temporary external immobilization of the pelvis and following final osteosynthesis was optimal. Replacement of external fixation for submersible osteosynthesis held in stable or terminal condition of the victim. Developed treatment of patients with pelvic injuries decreased mortality to 8.4%, number of general complications to 11.6% and number of local complications to 8.7%. Also it decreased length of hospital stay to 35.5 days and provided excellent and good functional results of treatment in 78.9% of cases.
Subject(s)
Fracture Fixation, Internal , Multiple Trauma , Pelvic Bones , Pelvis , Postoperative Complications , External Fixators , Female , Fracture Fixation, Internal/adverse effects , Fracture Fixation, Internal/instrumentation , Fracture Fixation, Internal/methods , Humans , Internal Fixators , Length of Stay , Male , Multiple Trauma/diagnosis , Multiple Trauma/surgery , Pelvic Bones/diagnostic imaging , Pelvic Bones/injuries , Pelvic Bones/physiopathology , Pelvic Bones/surgery , Pelvis/diagnostic imaging , Pelvis/injuries , Pelvis/physiopathology , Pelvis/surgery , Postoperative Complications/classification , Postoperative Complications/diagnosis , Postoperative Complications/prevention & control , Radiography , Survival Analysis , Trauma Severity Indices , Treatment OutcomeABSTRACT
The authors present their experience in the treatment of 107 patients with spinal injuries associated with polytrauma. The topical diagnosis of the spinal lesions in the severely injured patients was rather difficult both at the preclinical stage and during the clinical examination. For making the diagnosis in combined spinal trauma urgent laparoscopy and aimed roentgenography was employed with the patient in the dorsal position. When the latter technique is employed, a special attachment ("cassette holder") is used which allows to make the roentgenograms with mobile X-ray units. The authors have proposed a new construction of the reclining hammock for the treatment of the patients with the thoracic and lumbar spine traumas associated with severe injuries of the head, the breast and the extremities. It is pointed out that in the patients with complicated spinal injuries the surgical treatment of the locomotor system is most effective.