On the basis of the data of topography-anatomical study, carried out at 30 upper extremities, are proposed zones and directions of safe application of wires of the compression-distraction apparatus at 4 forearm levels, developed with allowance made for individual differences in structure and topography of vessels and nerves as well as functional position of the segment. An experimental examination (30 extremities) and clinical approval (30 patients) of the proposed zones and directions have confirmed the practical use of the obtained data that allows to recommend them to be widely introduced into the clinical practice.

Bone Nails↗

PubMed1991

[Transosseous osteosynthesis in the system for treating victims with penetrating gunshot wounds of the large joints of the upper extremity].

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Afghanistan↗

PubMed1991

[The surgical aspects of the lessons of the war in Afghanistan].

There were no two identical wars in human history. From the medical point of view, the civil war, which is still going on in Afghanistan, also has its own face. The structure of sanitary losses, the character, gravity, and peculiarities of gunshot pathology give the possibility to call it as a mine war, because of its massive and, above all, effective mine warfare. The war in Afghanistan conclusively proves the predominance of blast injuries over other sanitary losses in the structure of combat surgical pathology, that may be considered as a common feature for the wars of century XX. The mine blast trauma must be regarded as a combat heavy concomitant trauma or gunshot blast polytrauma. This statement is the basic one for the rest of medical lessons gained from the war in Afghanistan. Using the comparative analysis of the different functions of medical service of two armies, the article shows the priority of organizational aspects for care and treatment of the wounded in war.

Afghanistan↗

PubMed1991

[The pathogenetic and treatment characteristics of general suppurative infection in multiple gunshot wounds].

A profound analysis of 32 cases of general purulent infection that led to aggravation of multiple gunshot injuries proves the pathogenetical connection between the character of trauma, health status of patient and possibility for sepsis development. The main factors which determine the appearance and the course of wound sepsis are the following: the character of reaction of the organism to trauma, volume of invaded tissues, adequacy of health care, type and virulence of agents of the infection. The state of vital systems of human organism as well as the possibilities of medical care play an important role in the sepsis development in the acute period of wound illness. The major part of repeated interventions was conditioned by defects of the first surgical management. The opportune diagnosis on an early phase of sepsis, i.e. toxemia, is of great importance for the determining of tactics for the treatment and for complex intensive therapy in which hyperbaric oxygenation will assume a key role.

Combined Modality Therapy↗

PubMed1991

[The potentials for hyperbaric oxygenation in the combined treatment of the victims of explosive mine wounds to the extremities].

Hyperbaric oxygenation was used in the combined post-operative treatment of 63 victims with distal segments of lower extremities torn off or damaged by mine and burst effect. The patients consecutively received medicamentous therapy, which improved tissue microcirculation (rheopolyglucinum, haemodesum), surgical intervention, course of hyperbaric oxygenation, and after it anticoagulant preparations (heparinum) were used. The article shows that the combined application of hyperbaric oxygenation and medicinal preparation, that improve microcirculation in traumatized tissues, has a pathogenetic approvement.

Adult↗

PubMed1990