E.I. SOLOD^1,2, D.N. KUKSA^1,2, M.A. ABDULKHABIROV^1,2, YA.M. ALSMADI^1,2, A.V. OVCHARENKO³

 ¹Peoples’ Friendship University of Russia, Moscow

²City Clinical Hospital named after A.K. Eramishantsev, Moscow

³Kaluga Regional Clinical Hospital of Emergency Medical Care named after K.N. Shevchenko, Kaluga

  Contact details:

Kuksa D.N. — postgraduate student of the Department of Traumatology and Orthopedics

Address: tel.: + 7-915-308-58-62, e-mail: feniks_3d@mail.ru

 The article presents a clinical case of a patient being treated after a road accident in the Kaluga Regional Clinical Hospital of Emergency Medicine named after K. N. Shevchenko, delivered by an ambulance team 1,5 hours later with a diagnosis: Polytrauma. Severe closed head injury. Brain contusion of moderate severity. Fracture of the pelvic bones. Lung contusion. Respiratory failure 1-2. Traumatic shock. Taking into account the severity of the patient’s general condition, we performed minimally invasive osteosynthesis of the pelvic bones with an external fixation device of the original design of spoke arrangement and CITO screw. After 2,5 months, fracture consolidation was diagnosed and the apparatus was dismantled. Then the patient underwent a course of rehabilitation and restorative treatment. At the end of the course of rehabilitation treatment, a good recovery of the patient’s functionality was noted.

Key words: polytrauma, external fixation device of the original design, treatment tactics, injury control surgery.

REFERENCES

1. Samokhvalov I.M., Goncharov A.V., Reva V.A. Prakticheskoe rukovodstvo po Damagecontrol [A practical guide to Damagecontrol]. Saint Petersburg, 2018. Pp. 9–27.
2. Girshin S.G. Klinicheskie lektsii po neotlozhnoy travmatologii [Clinical Lectures on Emergency Traumatology]. ID «Azbuka», 2004. Pp. 7–49.
3. Roberts C.S., Pape H.-C., Jones A.L., Malkani A.L., Rodriguez J.L., Giannoudisp V. Damage control orthopaedics: Evolving concepts in the treatment of patients who have sustained orthopaedic trauma. J Bone Joint Surg Am, 2005, vol. 87 (2), pp. 434–449. DOI: 10.2106/00004623-200502000-00030
4. Bradford D.S., Foster R.R., Nossel H.L. Coagulation alterations, hypoxemia, and fat embolism in fracture patients. J Trauma, 1970, vol. 10 (4), pp. 307–321. DOI: 10.1097/00005373-197004000-00004
5. Renne J., Wuthier R., House E., Cancro J.C., Hoaglund F.T. Fat macroglobulemia caused by fractures or total hip replacement. J Bone Joint Surg Am., 1978, vol. 60 (5), pp. 613–618. DOI: 10.2106/00004623-197860050-00005
6. Ratto N. Early Total Care versus Damage Control: Current Concepts in the Orthopedic Care of Polytrauma Patients. ISRN Orthopedics, 2013, 2013:329452. DOI: 10.1155/2013/329452
7. Bone L.B., Johnson K.D., Weigelt J., Scheinberg R. Early versus delayed stabilization of fractures: a prospective randomized study. J Bone Joint Surg Am., 1989, vol. 71 (3), pp. 336–340. DOI: 10.2106/00004623-198971030-00004
8. Tomas P. Ryudi, Richard E. Bakli, Kristofer G. Moran. AO — printsipy lecheniya perelomov. Vtoroe pererabotannoe i dopolnennoe izdanie [AO — principles of fracture treatment. Second revised and enlarged edition]. Minsk: Vassa Media, 2013. 336 p.
9. Vorotnikov A.A., Anisimov I.N., Apaguni A.E., Mosiyants V.G., Enikeev M.R. Politravma i sochetannye povrezhdeniya: metodicheskoe posobie [AO — principles of fracture treatment. Second revised and enlarged edition]. Stavropol, 2003. Pp. 47–55.
10. Solod E.I., Abdulkhabirov M.A., Alsmadi Ya.M. Znachenie vybora konfiguratsii apparata naruzhnoy fiksatsii pri konversionnom osteosinteze u bol’nykh s politravmoy [The value of choosing the configuration of the external fixation apparatus during conversion osteosynthesis in patients with polytrauma]. Politravma / Polytrauma, 2021, no. 3, p. 15 (prinyato v pechat’).