Surgical tactics of treatment of the wounded persons with the gun-shot injuries of the hip on all levels of medical support

Abstract

Objective. To substantiate the introduction of differentiated surgical tactics, taking into account the trauma severity for improvement of the treatment results in the wounded persons, suffering the gun-shot injuries of the hip (GSIH). Маterials and methods. Differentiated surgical tactics was substantiated by the authors, using as a measure for trauma severity estimation the AdTS (Admission trauma Scare) on different levels of medical support, and introduced in 57 wounded persons, suffering the GSIH. Medical efficacy of the tactics and treatment elaborated for the wounded persons was compared in accordance to conventional methods without application of the AdTS scale. Results. There was reduced the mortality from 7.3 tо 1.8%, the extremities amputation performance rate - from 24.4 tо 8.8%, the local complications quantity, calculated for one wounded person, - from 1.07 tо 0.58 (рα < 0.05), relative quantity of poor functional results - from 34.1 tо 19.3% (рα < 0.05), while the specific weight of good functional results increased - from 29.3 to 47.4 due to introduction of differentiated surgical tactics, taking into account the trauma severity on various levels of medical support. Conclusions. In the wounded persons, suffering nonsevere trauma (lesser, than 5 points) it is necessary to perform a complete volume of surgical aid; while in severe one (5 - 9 points) and in extremely high (more than 9 points) trauma the help must be delivered in a shortened volume, using the damage control principle.

Keywords

• gun-shot wounds of the hip; gun-shot fractures of the hip bone; treatment measures; levels of medical support.