OPTIMAL METHODS OF CARE FOR VICTIMS WITH COMBINED BONE AND VASCULAR INJURIES OF THE LOWER EXTREMITIES

Аннотация

Objective. To improve the results of treatment of patients with open and closed combined bone and vascular injuries of the lower limbs. Material and Methods. We conducted an analysis of data from151 patients with open and closed combined bone and vascular injuries of the lower extremities. There were 113 (74%) adult males, 30 (19.9%) females, and 15 (9.9%) children of both sexes under 18 years of age. 127 (84.1%) patients were delivered in the first 1-6 h after the injury, some of the victims - 7 (4.6%) - within 6-24 h, 17 (11.3%) - later than 1 day after the injury. 52 (34.4%) patients were delivered independently, 55 (36.4%) - by ambulance, 44 (29.1%) - by transfer from other clinics. Results. Of the total number of reconstructive surgeries performed (n=137), segments were preserved in 129 (94.2%) and reamputation was performed in 8 (5.8%). Conclusions. Thus, in case of segmental circulatory disorders the most optimal approach is the preliminary fixation (with spokes or pins) of the bone fragments necessary for revascularization with the subsequent immobilization of the limb with external fixation devices after wound closure.