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"Институт токсикологии Федерального медико-биологического агентства"
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Институт теоретической и экспериментальной биофизики Российской академии наук.

ООО "ИЦ КОМКОН".




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199406, Санкт-Петербург, ул.Гаванская, д. 49, корп.2

ISSN 1999-6314

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«
Vol. 12, Art. 53 (pp. 631-645)    |    2011       
»

Treatment of long-bone fractures in polytraumatized patients
V.V.Khominets, I.G.Belenkiy, D.I.Kutyanov, Pechkurov A.L.



Brief summary

We have analyzed the Russian and foreign works dealing with the problem of treatment of long-bone fractures in polytraumatized patients. We have carefully studied various aspects of the problem of choice of optimal tactics of treatment of such patients. The majority of specialists agree that early total care (ETC) is justified in case of stable and borderline patients with ISS < 25. It includes also the definitive fixation of bony fragments with the use of the internal minimal invasive ostheosynthesis. In other cases the use of damage control orthopedics (DCO) is optimal. Yet we cannot say that the problem of choice of the optimal tactics of treatment long-bone fractures in case of severe polytrauma has been solved by nowadays. The main difficulties occur not in the nearest but in the early and tardive posttraumatic period. It is caused by the lack of strict criteria for determing the opportunity of operating extremities. Working out the criteria determing the optimal terms of use of the external devices as the initiate osteosynthesis, opportunity of performing the initiate internal osteosynthesis and the consistent use of the internal fixation in the early posttraumatic period should be considered the main direction of the further scientific research.


Key words

polytraumatized patients, long-bone fractures, early total care, damage control orthopedics, posttraumatic disorders, external osteosynthesis, internal osteosynthesis





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