Practical Application of Concept "Damage Control" in Treatment of Long Bone Extremity Fractures in Patients with Poly­trauma

2005 ◽  
Vol 12 (1) ◽  
pp. 3
Author(s):  
V. A Sokolov ◽  
E. I Baylik ◽  
P. A Ivanov ◽  
D. A Garaev
Keyword(s):  
Surgical Treatment ◽  
Bone Fractures ◽  
Damage Control ◽  
Long Bone ◽  
Critical Conditions ◽  
Individual Response ◽  
Surgical Interventions ◽  
Trauma Severity ◽  
Long Bone Fractures ◽  
Surgical Methods

On the base of experience in treatment of 646 patients with polytrauma (1995—2004) the necessity to use damage control was for the treatment of long bone fractures was proved. The principle of damage control assumes subdivision of surgical treatment of patients with severe polytrauma into two steps. At the I st step only minimum traumatic procedures were performed. At the 2 nd step major surgical interventions were performed. According to trauma severity and individual response all patients were divided into four groups: stable, borderline, unstable and critical. In patients with stable and borderline conditions major surgical procedures did not result in aggravation of patient's state, therefore one-step surgical treatment was used. In patients with unstable and critical conditions no surgical methods of fixation of long bone fractures were applied at the I st step. In the last two groups definitive fracture fixation were performed at the 2' d step within 4—14 days after injury. The application of damage control allows improving the results of treatment, reducing the rate of complication and lethal outcomes in patients with severe polytrauma.

scholarly journals Surgical Treatment of Long Bone Fractures of Lower Extremities Using Locking Compression Plate

2005 ◽  
Vol 54 (4) ◽  
pp. 746-750 ◽  
Author(s):  
Takuya Ikuta ◽  
Futoshi Kuga ◽  
Yosuke Asahara ◽  
Kazunobu Arakaki ◽  
Chikara Deguchi
Keyword(s):  
Surgical Treatment ◽  
Bone Fractures ◽  
Lower Extremities ◽  
Locking Compression Plate ◽  
Long Bone ◽  
Long Bone Fractures ◽  
Compression Plate

scholarly journals DOES THE TERM OF DEFINITIVE OSTEOSYNTHESIS OF MULTIPLE LONG BONE FRACTURES OF LOWER EXTREMITIES IMPACT ON TREATMENT OUTCOMES IN POLYTRAUMA PATIENTS

2020 ◽  
Vol 4 ◽  
pp. 24-31
Author(s):  
Olexandr Burianov ◽  
Sergii Dubrov ◽  
Taras Omelchenko ◽  
Volodymyr Lianskorunskyi ◽  
Viktor Lykhodii ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Bone Fractures ◽  
Damage Control ◽  
Lower Extremities ◽  
Hospital Length Of Stay ◽  
Long Bone ◽  
Long Bone Fractures ◽  
Group I ◽  
Fracture Osteosynthesis ◽  
Group Ii

The aim: to determine the timing impact of definitive multiple long bone fracture osteosynthesis of lower extremities on complications development, duration of Mechanical Ventilation (MV), Length of Stay in Intensive Care Unit (LOS-ICU), Hospital length of Stay (H-LOS) in patients with polytrauma treated according to Damage Control Orthopedics (DCO). Materials and methods: a prospective controlled non-randomized trial in parallel groups conducted in polytrauma department of Kyiv City Clinical Hospital No. 17 from February 2016 to January 2020, which included 107 adult patients with polytrauma, multiple long bone fractures of lower extremities, one of which femur treated according to DCO. The patients were divided into two groups: Group I included 51 patients who underwent definitive osteosynthesis of long bone fractures of lower extremities after patient condition stabilization ≥24 hours ≤5 days; Group II included 56 patients who underwent definitive osteosynthesis of long bone fractures of lower extremities during the period >5 days after injury. Results: there were no statistically significant differences between Group I and Group II patients in demographics, injury mechanism, trauma severity and general patient condition. Group I patients who underwent osteosynthesis from 2nd to 5th days after injury had lower pneumonia incidence, compared to Group II patients (17.6 % vs. 26.8 %, p=0.047), shorter MV duration (9.3±6.9 vs. 14.9±9.1, p=0.048), ICU-LOS (13.5±8.3 vs. 19.1±11.0, p=0.037), and H-LOS (30.3±13.9 vs. 38.9±15.5, p=0.046). Conclusion: performing definitive multiple fracture osteosynthesis of lower extremity long bones after polytrauma patient stabilization from 2nd to 5th days after injury allowed to reduce the frequency of pneumonia, shorten the duration of MV, LOS-ICU and H-LOS, compared with its implementation after 5th days

scholarly journals Comparison of Outcome of Bone Autograft and Allograft in Union of Long Bone Fractures

2021 ◽  
Vol 48 (2) ◽  
pp. 13-18
Author(s):  
H. Valiyollahpoor-Amiri ◽  
S. M. Esmaeilnejad-Ganji ◽  
R. Jokar ◽  
B. Baghianimoghadam ◽  
S. Kamali-Ahangar ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Bone Fractures ◽  
Bone Allograft ◽  
Fracture Site ◽  
Lower Limbs ◽  
Long Bone ◽  
Long Bone Fractures ◽  
Surgical Methods ◽  
Long Bone Fracture ◽  
Bone Autograft

Abstract Background and Purpose There are few studies addressing the rate of application of bone allograft and its use; hence, the present study aimed to compare the clinical outcomes of using bone allograft and autograft in patients with long bone fracture. Method In this clinical trial study, all patients who underwent bone graft surgery with the diagnosed long bone fractures of upper and lower limbs at Shahid Beheshti Hospital were included in the research. Patients were divided into two groups, autograft and allograft, according to type of treatment. They were evaluated for their union, complications, and range of motion. Results In the present study, 124 people were studied. Among them, 100 patients were eligible and included in the study. The allograft and autograft groups did not have any statistical significant differences in terms of age, sex, location, causes of fracture, and surgical methods. Results of the present research on patients in terms of fracture site indicated that there was no significant relationship between the two groups in rate of union (P = 0.18). Allograft and autograft had no difference in terms of complications. Studied range of motion indicated that patients were not different in terms of their ranges of motion. Conclusion Based on findings of the present study, allograft could be a suitable substitute for the autograft. The two graft methods were similar in terms of complications, union, and ranges of motion.

Long bone fractures in children and adolescents treated surgically in West Pomeranian Voivodeship in 2005-2014

2017 ◽  
Vol 7 (1) ◽  
pp. 63-68
Author(s):  
A. Kamiński ◽  
M. Dzik ◽  
M. Kołban ◽  
A. Szwed ◽  
T. Bilnicki
Keyword(s):  
Surgical Treatment ◽  
Children And Adolescents ◽  
Bone Fractures ◽  
Test Group ◽  
Treatment Method ◽  
Long Bone ◽  
Long Bone Fractures ◽  
Fractures In Children ◽  
Tension Bands ◽  
K Wires

bone fractures in children is a problem that has been recently addressed with growing attention. The unique specifics of fractures in the developmental age compared with fractures in adult patients requires an appropriate approach. Disregarding the issue may lead to long-lasting complications, including severe skeletal deformities. Methods: The analysis included 821 children (575 boys, 246 girls) admitted to the hospital with long bone fractures. Data were obtained from medical records from between 2005 and 2014. Results: Long bone fractures were the cause of hospitalizations in 64.9% of cases during the spring-summer period. The average age was 12 years old. Fractures occurred more often in boys. The main cause of fractures in the test group was indirect trauma during sports activities (32%). Fractures of the distal meta and epiphysis of the radius bone were the most common result of trauma in children and adolescents (12.4 % of all fractures). A total of 32.1% of fractures of the upper limbs concerned the radius bone and 12% concerned the supracondylar humeral bone fractures. In lower limb fractures, the most common site was the distal part of the tibia bone (8.9% of all fractures). In surgical treatment, 399 (43.3%) K-wires were used. Plate stabilization was performed 225 times (24.5%), screw fixations 119 times (12.9%), FIN/ESIN fixations 141 times (15.3%), tension bands 11 times (1.2%), intramedullary nailing 19 times (2.1%), and external stabilizations 4 times (0.5%). Fracture healing complications were observed in 3 cases in patients with polytrauma. Conclusions: Risk of a long bone fracture grows with a child’s age. Fractures are more frequent in boys. We observed triple the number of fractures that needed surgery yearly from 2005 to 2014. The increase was linear. The choice of surgical treatment method depends on the fracture type, dislocation size, and the patient’s age.

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