1FGBVOU "Military Medicine Academy. SM Kirov"of the Ministry of Defense of the Russian Federation, 194044, St. Petersburg;
2LLC Нealth Technology, St. Petersburg, Russia;
3Federal State Budgetary Institution Scientific Research Center named after V.A. Almazova? Ministry of Health of Russia, 197341, St. Petersburg, Russia;
4SPb GBUZ "Elizabethan Hospital", 195257, St. Petersburg, Russia;
5SPb GBUZ "City Hospital No. 15", 198205, St. Petersburg, Russia;
6First St. Petersburg State Medical University named
after academician I.P. Pavlova, St. Petersburg.
Introduction The choice of therapeutic tactics in patients with calcaneus fractures on the background of chronic obliterating diseases of the arteries of the lower extremities, as well as smoking, causes difficulties for orthopedic traumatologists. The aim of the study was to evaluate the effectiveness of complex correction of peripheral blood circulation with closed intraarticular fractures of the calcaneus against the background of chronic arterial insufficiency of the lower extremities. Material and methods. The study included 111 patients with closed intraarticular fractures of the calcaneus against the background of chronic obliterating diseases of the arteries of the lower extremities, smoking, as well as a combination of these factors (69 patients - the control group and 42 patients - the main group). Results A comparative analysis of the results in patients (n = 69) who did not receive combined correction of peripheral circulation in the pre- and postoperative period and patients (n = 42) who underwent combined correction in the pre- and postoperative periods (p˂0,05) the difference in the main group from the control group in the direction of reducing the frequency of outcomes requiring repeated surgical interventions. Conclusions Comprehensive correction of vascular disorders in patients with closed intraarticular fractures of the calcaneus after osteosynthesis from extended lateral access included anticoagulants, antiplatelet agents, angioprotectors, drugs that improve blood rheological properties in combination with hyperbaric oxygenation sessions with a reliability of p <0.05, increased the frequency of favorable outcomes by 17,0%; A comparative analysis of the results of surgical treatment of patients with closed intraarticular fractures of the calcaneus of the main and control groups showed that wound healing by primary intention in patients of the main group was recorded more by 26,7%, secondary tension - less by 8,6%, the frequency of surface suppuration decreased 5 times, deep suppuration was not detected, while in patients of the control group this complication was noted in 5,8%, requiring repeated surgical intervention.
calcaneus fracture; immediate complications; pharmacological correction; transcutaneous oximetry; chronic obliterating diseases of the arteries of the lower extremities.