DOI: https://doi.org/10.22141/1608-1706.4.19.2018.142099

Lower extremity amputations due to modern combat operations: clinical and anatomical aspect

S.O. Guriev, D.N. Lysun, V.A. Kushnir, S.P. Satsyk, І.P. Kurachenko

Abstract


Background. The article analyzes the clinical and anatomical aspect of lower limb amputations in victims of an antiterrorist operation in the East of Ukraine. Data analysis was carried out in accordance with the requirements and criteria of evidence­based medicine using computer technologies. The volume and nature of the research allows us to state that it is a cohort study with Oxford IIb level of evidence. The purpose of the study was to determine the volume and need for amputations in modern combat injuries of the lower extremities based on the risk­focused approach. Materials and methods. To perform the task of this study, we conducted a scientific analysis of 664 victims with combat injuries of the lower extremities of various origins using the random number method and the methodology of irretrie­vable randomization. Results. According to our data, lower extremity amputation at the foot level were most frequent — 6.66 %, the next is amputation at the shin — 6.44 % and hip level — 1.09 %. Conclusions. The most common is the damage to the distal parts of the lower extremities — 55.57 %, with shin injured most often — 39.25 %. The need for amputation is 6.48 % of the number of wounded persons with damage to the lower extremities, ranging from 5.76 % (hip) to 6.66 % (foot), i.e. there is a tendency to increase in the level of limb amputation from the distal to the proximal part. The effective risk of amputation when injuring the lower limb is relatively minimal in terms of qualitative characteristics and is 0.6–0.7 %. In most cases, the damage to the lower limbs is right­sided (51.13 %), monolateral (84.96 %), the ratio of combined (multiple) injuries is 1.06, (femur — 1.08, shin — 1.06, foot — 1.04). The above clinical and anatomical description indicates the need for the development of specific therapeutic and diagnostic approaches to medical care of these patients.


Keywords


lower extremity amputation; antiterrorist operation; clinical and anatomical characteristics

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