Peculiarities of gunshot wound treatment of the wrist in modern conditions [Особенности лечения огнестрельных ранений кисти в современных условиях]
Journal Title: Orthopaedics, Traumatology and Prosthetics - Year 2018, Vol 611, Issue 2
Abstract
The analysis of injuries as a result of military conflicts shows that gunshot wounds are 9–25 %. Objective: to find out the peculiarities of the gunshot wound treatment of the wrist at the stages of medical evacuation on the materials of the specialized center and to determine the most optimal options. Methods: results of the treatment of 238 victims are analyzed (average age 34.4 years) with wounds of the wrist and their consequences: fire-fighting — 135 (56.72 %), mines and explosives — 91 (38.24 %), explosives — 12 (5.04 %). Terms of hospitalization were 154 days after injury. Patients were divided into three groups: I —without complications (40.34 %); II — wound infection or tissue necrosis (32.77 %); III — consequences (26.89 %). Results: in the I group terms of treatment were (43.8 ± 1.16) days, in the II group — (64.4 ± 2.8) with the transfer to the next stages of rehabilitation. Treatment of the patients of the III group was conducted in prolonged terms with reconstructive surgeries. Conclusions: fire-fighting and mines and explosives wound (94.96 %) are prevailed in the structure of gunshot wounds. Timeliness, quality of primary surgical treatment of wounds, prevention of complications, planning and reconstructive surgeries on the wrist play a very important role in achievement of positive results. Inappropriate execution of the primary surgical treatment leads to an increase in the timing of treatment, appearance of additional anatomical and functional disorders and further reconstructive surgeries. Patients with isolated injuries after primary medical care of 0–II levels should be transferred to the stages of medical evacuation for the specialized care (III–IV level). In cases of complex injuries, in those who have pathological condition, emergency treatment in other medical establishments is in priority. Medical care by wrist surgeons on the place is relevant.
Authors and Affiliations
A. E. Loskutov, Sergey Bilyi, Ruslan Daragan
Keywords
Related Articles
- EP ID EP574262
- DOI 10.15674/0030-59872018257-62
- Views 164
- Downloads 0
Application of polypropylene mesh in patient with recurrent femoral head dislocation after total hip arthroplasty (case from practice) [Применение полипропиленовой сетки у пациента с рецидивирующим вывихом бедренного компонента эндопротеза тазобедренного сустава (случай из практики)]
One of complications after total hip arthroplasty is femoral head dislocation. It occurrence in case of primary replacement can happen from 0,2 till 2 %. In such cases after primary dislocation and close reduction recurr...
Analysis of surgical treatment of tibial fractures fractures during the antiterrorist operation
Objective: To analyze the surgical procedures performed at all levels of medical care in the wounded with gunshot fractures of the tibia and severed limbs during the anti-terrorist operation (ATO). Methods:it is analyze...
Study of secondary changes in patients tissues after posttraumatic extraarticular femur and tibia deformities [Дослідження вторинних змін у тканинах хворих із післятравматичними позасуглобовими деформаціями стегнової кістки та кісток гомілки]
One of complications after shaft fractures is formation of angular deformities. Clinical significance of axial infringement can influence on the leg function. Objective: to study the changes which occur in the tissues o...
Functional spine analysis at surgical treatment of burst fractures of thoracic and lumbar spine [Аналіз функціонального стану хребта за умов хірургічного лікування вибухових переломів грудного та поперекового відділів]
Burst fracture — is traumatic injury under the influence of high-energy axial compression which results multifragmentary vertebrae fracture with penetration of bone fragments into spine canal and paravertebral tissues. O...
Effect of natural hydroxyapatite and β-tricalciumphosphate on dynamic changes in the mechanical properties of experimental compact bone defect
Objective: to compare the effects of natural hydroxyapatite and β-tricalcium phosphate (β-TCP) on the dynamics of changes in the mechanical properties of experimental defect of cortical bone. Methods: the experiment wa...