Evaluating long-term results of treatment in the victims with adjacent and contralateral fractures of the bones of the legs, who were treated on the base of Kharkiv Regional Clinical Hospital — Center for Emergency Medical Care and Disaster Medicine

V.V. Grigoruk

Abstract


Background. During 2016, there were 140,000 road accidents in Ukraine. Most people with trauma had high-energy injuries. Till now, there are not clear algorithms for the treatment of persons, who have adjacent and contralateral fractures of the bones of the legs. There are no full description of the methods, terms, volume and order of the surgeries for fractures in these persons. There are no recommendations for the most correct ways to fix the fractures of the femur and the bones of the lower extremities, terms and order of osteosynthesis in segments, the methods of fixation of a segment on the period of osteosynthesis of another segment. That is why from 2005 to 2016, at the department of polytrauma and the department of traumatology, there was implemented own algorithm to manage such patients, and evaluation of its effectiveness was performed 1.5 years after the moment of trauma and in 2016. Purpose of the work is to assess the long-term results of the treatment in victims with adjacent and contralateral fractures of the bones of the legs, who were treated on the base of Kharkiv Regional Clinical Hospital — Center for Emergency Medical Care and Disaster Medicine. Materials and methods. The study involved 27 victims of road accidents. There were 19 males and 8 females. They underwent treatment from 2005 to 2010 for adjacent and contralateral fractures of the bones of the lower extremities in Kharkiv Regional Clinical Hospital — Center for Emergency Medical Care and Disaster Medicine. Average age of patients was 36.02 years. Treatment modality was based on staged approach from the moment of hospitalization to the moment of fracture healing, according to own algorithm (Patent of Ukraine N 57016). Results. In 2013, the number of perfect results was 74.1 %, another 25.9 % were good. Functional recovery of the extremity correlated with the average terms of bone fracture healing. Similar analysis of the treatment outcomes was made in 2016 year. 15 % of patients had posttraumatic arthrosis of the joints adjacent to fractures, 4 % — progression of osteochondrosis, 2 % — screw migration. The disability was detected and is being detected now in 19 % of victims. Сonclusions. So, as the result of treatment, patients with adjacent and contralateral fractures of the bones of the legs had perfect and good results of treatment owing to the use of the algorithm. Deterioration in the state of patients in 2016 wasn’t detected.

Keywords


osteosynthesis; fractures of the diaphysis; adjacent and contralateral fractures; treatment approach

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DOI: https://doi.org/10.22141/1608-1706.2.18.2017.102569

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