Application of transosseous extrafocal osteosynthesis in the treatment of gunshot injuries of the limbs

Abstract text (incl. references and figure legends)

Introduction

The aim of the study is to show the effectiveness of the use of external fixation devices as an intermediate stage in the treatment of gunshot injuries of the limbs with long bone fractures and soft tissue defects in order to track the dynamics of soft tissue healing and to resolve the issue of the further choice of final fixation.

Preventive immobilization using external fixation devices is performed: in cases of multiple fractures of long tubular bones with contusion or extensive soft tissue defects in the first hours after hospitalization in the system of mandatory anti-shock measures; in case of a combined or combined injury, especially if vital indications require surgical treatment of the chest and abdominal organs.

Materials & Methods

Transosseous extrafocal osteosynthesis with Kostyuk's rod devices for gunshot and mine-explosive fractures of long tubular bones was performed in 27 patients. Explosive mine fractures prevailed - 17 cases, gunshot shrapnel fractures - 10. Localization of injury: tibia - 12, femur - 8, humerus - 7.

Results

Postoperative infectious complications were found in 7 (25.9%) patients who underwent limb amputation. Another 20 patients underwent autoplasty or alloplasty of bone defects with periosseous or intramedullary osteosynthesis after skin and soft tissue healing. If necessary, skin plastic or skin-muscle flap plastic is also applied. The functional result of the limb after the use of external fixation devices was on average - 65.4%.

Conclusions

The simplicity of the design of rod devices, convenience and speed of use provide the possibility of correction and reposition of bone fragments during treatment, and if necessary, replacement of preventive immobilization with treatment by other methods.

References

Manual on the technique of osteosynthesis with AZF-K external fixation devices / A.N. Kostyuk - K.: Lazurit-polygraph LLC, 2015. - 144 p.

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