Treatment of fractures complicated burns
Traumatology / / August 12, 2017
From a practical point of view it is advisable to divide the treatment of fractures in the preliminary and final.Pre-treatment of fractures should be considered as an important part of the complex of measures of resuscitation and intensive care, and implemented on a mandatory basis to all the victims in the first hours of hospitalization.
indications for pre-treatment of fractures are severe shock and terminal condition;mass flow of patients;inability to perform the final specialized treatment of fractures (eg, in the absence of a specialist in the provision of assistance in specialized medical institution, and so on. d.).
Pre-treatment of fractures include preliminary reduction and provisional fixation of bone fragments.The main objectives of the preliminary repositioning are: elimination of coarse angular and rotational deformities that violate local blood circulation and traumatic soft tissue, blood vessels, nerves;the orientation of the distal fragment along the axis of the proximal;reduction (if
The objectives of pre-fixation of bone fragments are: elimination of the possibility of coarse displacement of bone fragments at the forced change of position affected (for example, to perform a spinal puncture, preventing bedsores, transport, change of clothes, etc...), As well as motor stimulation;providing distraction joints with intra-articular fractures;preservation of the segment length and the entire limb in comminuted fractures;providing opportunities wound treatment and follow-up care and control.
Known means preliminary fixation of bone fragments - casts and systems skeletal traction - can not fully ensure the implementation of the tasks listed above.In this regard, several authors little traumatic techniques have been developed to carry out a satisfactory reduction and secure fixation of the bone fragments of any segment extremities.The basis of these methods is the simultaneous use of multiple devices extrafocal fixation of bone fragments in combination with plaster bandages longetnymi.The most simple means extrafocal external fixation of bone fragments are the framework structure of the two arcs, connected by two pins (Ilizarov apparatus), arc connected with the bone fragments using Transosseous conducted spokes.
- fractures combined with burns
- First aid and treatment for injuries of the abdomen
- first aid for injuries complicated burns
- Injuries in the home and at work
- struggle with pain in injuries
- Bilateral dislocations of hip
- tourniquet technique
- Transosseous osteosynthesis external fixation
- struggle with acute blood loss in trauma
during burn-traumatic shock treatment of burns and fractures carry basically conservative methods.For surgical treatment of burn wounds begin within 3-4 weeks after the removal of the affected grave condition.Internal fixation of bone fragments is possible only after the restoration of the skin.Therefore, when combined thermomechanical lesions treatment of fractures, as a preliminary, and final, should be carried out mainly by chreskostnogo osteosynthesis, which allows to keep free access to the Burn injuries, provides a strong fixation of fragments with the direction of their movement.With this type of lesions expanding indications for amputation, since it eliminates the toxic focus, "gateway" for the loss of fluid and protein, on the one hand, and for infection - on the other, reduced the area of deep burns, that can be a deciding factor in the rescue of the affected.If struck by two or more limbs, then amputation is the subject of them, the skin which struck more.
treatment of burn disease is carried out according to generally accepted rules.Fracture healing will then be entirely dependent on how efficiently manage to cope with burn depletion affected with secondary infection, pulmonary complications, disorders of the gastrointestinal tract.Therefore, the focus of the combined treatment should be directed to the treatment of burn disease.Treatment of complications of bone fractures (deformations, false joints, shortening, defects, osteomyelitis) can be effective only after the period of recovery of burn disease.
With widespread impact or rapid compression of the abdomen at the same time the front and rear can occur multiple injuries of bones.
Identifying intra-damage remote from the abdominal cavity of bone injuries (fractures of the limbs, the shoulder girdle), and in the absence of severe injuries of the skull is much easier, because the symptoms of pain, muscle protection and peritoneal irritation are well-marked and maintained contact with a patient.