One-stage operations for multiple and associated trauma

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Abstract

The question of the performance of one step operation in patients with concomitant and multiple trauma from the point of view of the choice of surgical intervention time, sequence and type of operation is considered. The advantages of one step operation include: one narcosis, one postoperative period, decrease of the risk of posttraumatic and postoperative complications, easing of treatment and nursing at intensive care unit as well as earlier rehabilitation. Criteria for the detection of the surgery time, sequence and type of operative intervention for individual patient with polytrauma were elaborated. Between 1998 and 2002,282 one-step operations (71 emergency operations (within 5 hours after trauma),135 urgent operations (within the first 3 days after trauma) and 76 delayed operations (within 10—14 days after trauma)) were performed at Moscow clinical Hospital #1 named after N.I. Pirogov.

About the authors

E. L. Litvina

City Clinical Hospital No. 1 im. N.I. Pirogov; Russian State Medical University

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

A. V. Skoroglyadov

Russian State Medical University

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

D. I. Gordienko

City Clinical Hospital No. 1 im. N.I. Pirogov

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

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2. Fig. 1. Patient A. 24 years old. Associated injury. Rupture of the left sacroiliac joint, fracture of the pubic and ischial bones with dislocation of the left half of the pelvis, closed cross-comminuted fracture of the left femur with displacement of fragments. a — radiographs at admission; b — after operations; c — radiographs and functional result after 1 year.

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3. Fig. 2. Patient G., 38 years old. Closed multi-comminuted intra-articular fracture of the distal right femur, comminuted fracture of the middle third of the left femur. a — radiographs at admission; b — intraoperative radiograph of the left thigh; an abduction fracture of the neck was detected; c — radiographs and functional result after 1 year.

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4. Fig. 3. Patient M., 34 years old. Associated injury. Transacetabular fracture of the pelvis on the left, closed pertrochanteric fracture of the right femur, closed fracture of both bones of the left forearm in the middle third with displacement of fragments. a — radiographs at admission; b — radiographs and functional result after 1 year.

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