ALGORITHM OF PROVIDING SPECIALISED MEDICAL CARE OF THE WOUNDED WITH FRACTURES OF EXTREMITIES WITH INJURY OF NEUROVASCULAR BUNDLE

The study is relevant due to the large proportion of the wounded with damage to the limbs, which makes up 54-70%, of which the proportion of the wounded with gunshot bone fractures reaches 35-40% [13]. With mechanical injuries, comminuted fractures of the tubular bones occur in 15.4 -16.1% of cases [5]. There is high frequency of injuries of the limb due to the lack of coverage by individual armor protection [3]. The problem of treating these injuries is the difficulty in restoring the function of the affected limb. This study aims to develop the most effective algorithm for the treatment of wounded with a fracture of long tubular bones and damage to the main vascular-uneven bundle. A comparative analysis of the results of the treatment of fractures of long bones of the extremities was conducted. The main criteria in the analysis are the frequency of complications (infectious and non-infectious) [5] and the length of hospital stay [1, 2, 10]. The analysis found that the most effective method of bone tissue restoration is intraosseous osteosynthesis, in which the treatment duration is 24.1 ± 9.7 days, and the complication rate is 18.05% [10]. However, it can be used only after achieving stabilization victims with isolated wounds. If it is impossible to switch to intra-focal osteosynthesis, it is necessary to remount the external fixation apparatus with the final reposition of bone fragments [3]. Preference should be given to spokerod devices, in which a minimum treatment period of 30.1 ± 9.5 days is observed [1], and the complication rate is 20.02% [5]. Analysis of the complete treatment algorithm for the wounded with a fracture in the length of the tubular bone and damage to the main neurovascular bundle was made.

comminuted fractures, osteosynthesis, fracture of extremities, extra-focal, intra-focal, complications, terms of treatment, intraosseous, spokes-rod apparatus