Compression - distraction osteosynthesis according to Ilizarov in the treatment of polytrauma patients

Abstract

Introduction: Bad results of conservative treatment, prolonged bed rest of patients and inadequate anatomical and functional restoration of damaged structures of the pelvis and lower extremities force traumatologists to use active surgical tactics. Materials and methods: The study included the treatment results of 137 polytrauma patients with unstable pelvic and limb fractures, associated with chest trauma-76, abdominal organs injury–64. Pelvis was stabilized by external device, femoral shaft fractures-by rod devices, distal femur–by a combined system, forearm and leg fractures - by Ilizarov apparatus. Results: The analysis of treatment outcomes was carried out according to the Majeed scale in 134 (97.81%) patients, in the period from 1.5 to 16 years after the operation. Three patients died due to thromboembolism. Other patients presented healing of the pelvic and limb bones fractures and were functionally recovered. Patients could stand, walk and maintain the functional stability of segments of the lower limbs and the pelvic ring as a whole during static physical test and in dynamics. Long-term results were studied in 104 patients: good-67.30%, satisfactory28.85%, unsatisfactory-3.85%. Conclusions: Early compression-distraction osteosynthesis of unstable pelvic and limb fractures ensured patient stabilization, that made possible to perform the necessary investigations and surgical interventions and improved the treatment outcomes.