Surgical tactics in concomitant injury of the skull and lower extremities

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Abstract

The treatment results of 31 patients with severe craniocerebral injury in combination with the extremity fractures (mainly femur and shin) are analysed. In 13 patients the osteosynthesis of long bones was performed within 3 days after injury and in 8 patients the fractures of the extremities were treated conservatively. Early 1-3 days osteosynthesis is shown to be performed on a more favorable metabolic level and contributes to the normalization of the disturbed correlation of the lipid peroxide oxidation and antioxidation system. Early stable osteosynthesis of the extremity fractures enables to improve the efficacy of the craniocerebral injury treatment and to prevent hypostatic complications, to shorten the terms of hospitalization (by 36% in comparison with later osteosynthesis) as well as the rehabilitation period. When no contraindications exit the osteosynthesis in this group of patients should be performed within 1 to 3 days after injury.

About the authors

A. G. Suvalyan

Institute of emergency care. N.V. Sklifosovsky

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, Moscow

P. P. Golikov

Institute of emergency care. N.V. Sklifosovsky

Email: info@eco-vector.com
Russian Federation, Moscow

B. V. Davydov

Institute of emergency care. N.V. Sklifosovsky

Email: info@eco-vector.com
Russian Federation, Moscow

K. I. Rahimi

Institute of emergency care. N.V. Sklifosovsky

Email: info@eco-vector.com
Russian Federation, Moscow

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1/ Dynamics of blood urea content in patients with severe TBI in combination with limb fractures. I - the first group (osteosynthesis on the 1-3rd day after the injury); II - the second group (osteosynthesis later than 3 days).

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3. Fig. 2/ Dynamics of the coefficient K in patients with severe TBI in combination with fractures of the extremities (normally K = 1.12). I - the first group (osteosynthesis on the 1st-3rd day); II - the second group (osteosynthesis later than 3 days); III - the third group (non-operated patients).

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4. Fig. 3/ Radiographs of the thigh of the patient M. a - comminuted fracture of the diaphysis with displacement of fragments; b — after osteosynthesis with a pin and a screw; c — 10 months after the operation: the fracture healed

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5. Fig. 4/ Computed tomography of the skull of the patient M. a - fracture of the vault and base of the skull; subdural and epidural hematomas; b - after the operation.

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