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    Khomenko I.P., Korol S.O., Lurin I.A., Chelishvili A.L., Sichinava R.M.


    About the author: Khomenko I.P., Korol S.O., Lurin I.A., Chelishvili A.L., Sichinava R.M.
    Type of article Scentific article
    Annotation The purpose of the work was to improve the results of treatment of inflammatory fractures of the long bones by introducing external osteosynthesis conversion to internal. An array of studies consisted of 290 wounded with gunshot fractures of the long bones of the extremities, which were damaged in 2014-2018 when conducting an anti-terrorist operation. Upon admission to the second level, 118 (40.7%) of the wounded patients underwent conversion of an external fixation rod apparatus to internal osteosynthesis, and 172 (59.3%) were the final treatment method. Osteosynthesis conversion resulted in an increase in good functional results by 20.8% and a decrease in the relative number of unsatisfactory ones by 11.9% (pα<0.05). Osteosynthesis conversion is an important method of prevention of contractures of large joints, which allows to reduce their level in wounded with gunshot fractures from 33.0% to 6.5%.
    Tags function restoration, inflammatory fractures, method conversion, bone osteosynthesis, health care system
    • Zarutskiy YaL, Korol SO, Kreshun EA. Diferenеtsiyovana taktyka nadannya travmatolohichnoyi dopomohy poranenym z boyovymy travmamy kintsivok na etapakh medychnoyi evakuatsiyi. Odeskyi medychnyi zhurnal.2017; (3):18-23. [in Ukrainian]
    • Almahmoud K, Abboud A, Namas RA, Zamora R, Sperry J, Peitzman AB, Truitt MS, Gaski GE, McKinley TO, Billiar TR, Vodovotz Y. Computational evidence for an early, amplified systemic inflammation program in polytrauma patients with severe extremity injuries. PLoS One. 2019 Jun;14(6). doi: 10.1371/journal.pone.0217577.
    • Bauhahn G, Veen H, Hoencamp R, Olim N, Tan ECTH. Malunion of Long-Bone Fractures in a Conflict Zone in the Democratic Republic of Congo. World J Surg. 2017; 41(9):2200-2206. doi:10.1007/s00268-017-4008-5.
    • Donnally CJ 3rd, Lawrie CM, Sheu JI, Gunder MA, Quinnan SM. Primary Intra-Medullary Nailing of Open Tibia Fractures Caused by Low-Velocity Gunshots: Does Operative Debridement Increase Infection Rates? Surg Infect (Larchmt). 2018 Apr;19(3):273-277. doi: 10.1089/sur.2017.211. Epub 2018 Jan 17.
    • Franke A, Bieler D, Wilms A, Hentsch S, Johann M, Kollig E. Treatment of gunshot fractures of the lower extremity: Part 1: Incidence, importance, case numbers, pathophysiology, contamination, principles of emergency and first responder treatment Unfallchirurg. 2014;117(11):975-84. doi:10.1007/s00113-014-2635-y. [In German].
    • Gustilo RB, Mendoza RM, Williams DN. Problems in the management of type III (severe) open fractures: a new classification of type III open fractures. J. Trauma. 1984;(8):742-746.
    • Lieder C, Hellman M, Haughom B, Szatkowski J. Mid to distal third tibial shaft fractures caused by gunshots: Characterization and incidence of distal intra-articular extension. Injury. 2016 Oct;47(10):2347-2351. doi: 10.1016/j.injury.2016.06.023. Epub 2016 Jun 21.
    • Matsumura T, Takahashi T, Miyamoto O, Saito T, Kimura A, Takeshita K. Clinical outcome of conversion from external fixation to definitive internal fixation for open fracture of the lower limb. J Orthop Sci. 2019 Sep; 24(5):888-893. doi: 10.1016/j.jos.2019.01.009. Epub 2019 Feb 13.
    • Nguyen MP, Como JJ, Golob JF Jr, Reich MS, Vallier HA. Variation in treatment of low energy gunshot injuries - A survey of OTA members. Injury. 2018 Mar;49(3):570-574. doi: 10.1016/j.injury.2018.01.027. Epub 2018 Jan 31.
    • Nieto H, Baroan C. Limits of internal fixation in long-bone fracture. Orthop Traumatol Surg Res. 2017 Feb;103(1S):61-S66. doi: 10.1016/j.otsr.2016.11.006. Epub 2016 Nov 15.
    • Penn-Barwell JG, Bennett PM, Mortiboy DE, Fries CA, Groom AF, Sargeant ID. Factors influencing infection in 10 years of battlefield open tibia fractures. Strategies Trauma Limb Reconstr. 2016 Apr;11(1):13-8. doi: 10.1007/s11751-016-0250-x. Epub 2016 Mar 18.
    • Rafael Arceo S, Runner RP, Huynh TD, GottschalkMB, Schenker ML, Moore TJ Jr. Disparities in follow-up care for ballistic and non-ballistic long bone lower extremity fractures. Injury. 2018 Dec;49(12):2193-2197. doi: 10.1016/j.injury.2018.09.053. Epub 2018 Oct 4.
    • Ramdass MJ, Muddeen A, Harnarayan P, Spence R, Milne D. Risk factors associated with amputation in civilian popliteal artery trauma. Injury. 2018 Jun;49(6):1188-1192. doi: 10.1016/j.injury.2018.04.028. Epub 2018 Apr 24.
    • Tuttle MS, Smith WR, Williams AE, Agudelo JF, Hartshorn CJ, Moore EE, Morgan SJ. Safety and efficacy of damage control external fixation versus early definitive stabilization for femoral shaft fractures in the multiple-injured patient. J. Trauma-Injury Infection & Critical Care. 2009;67(3):602-605. doi: 10.1097/TA.0b013e3181aa21c0
    • Von Lübken F, Achatz G, Friemert B, Mauser M, Franke A, Kollig E, Bieler D. Update on gunshot wounds to extremities. Unfallchirurg.2018;121(1):59-72. doi:10.1007/s00113-017-0449-4. [In German].
    Publication of the article «World of Medicine and Biology» №4(70), 2019 year, 177-182 pages, index UDK 616-001:355.5
    DOI 10.26724/2079-8334-2019-4-70-177-182