Associated trauma in children

Abstract

The diagnosis and treatment of poly-rheumatism remains a current problem that draws the attention of specialists from different medicine fields. Multiple forms of trauma associated with children result from mutual worsening syndrome that complicates polytraumatism diagnosis and treatment. Around 47-76% of these children are interned in extremely serious conditions (Гордев В.С., Цыбулькин Э.К., 2010). Material and methods. During the last 2 years, 188 children with associated trauma were treated in our clinic. The share of children traumatized in road accidents is about 76.2%. Associated traumas are classified as follows: 24% craniocerebral dominance, 11% dominant abdominal polytraumatism, 65% locomotor dominant. The diagnosis of a poly-traumatization follows three main principles: determining the state of conditions; rapid and complete check of lesions; prioritisation of injuries and determination of the order in which they will be treated. The assessment of seriousness of conditions and the polytraumatism condition prognosis were appreciated according to the methodology proposed by Tibin (Цыбин, 2001), to the craniocerebral trauma in Glasgow.Treatment of politraumatized patients was done in the order of the dominant syndrome. Results. The treatment methods were chosen depending on the prioritisation of the injuries regarding their dangerousness degree to the patient life. The interventions performed were: laparotomy + surgical treatment of osteoarticular lesions 12 children Laparotomy + cerebral decompression; 4 children Cerebral decompression + surgical treatment of osteoarticular lesions 11 children Surgical treatment of wounds + osteosynthesis 87 children. The results obtained were satisfactory, 2 cases complicated with infection of adjacent tissues. Conclusions. For polytraumatism diagnosis it is useful to use modern, minimally invasive methods. It is necessary to carefully monitor the change of the dominant outbreak throughout the treatment period and to surgically intervene at the right moment.