Artemenko V. Weight bearing ability preservation at patients with deep trophic disorders of lower-extremity

This thesis is dedicated to the topical subject. It is a medical treatment of the patients having deep trophic disorders (DTD) of lower-extremity. The treatment is aimed at preserving the support ability of the foot. According to the results of medicostatistic research it was discovered that DTD cause amputation of the inferior limb in 94% of the incidents. Along with this, there is an inadequacy between the ischemic affection degree of the limb and the amputation level. The clinic part of the thesis is based upon the treatment results of 86 patients having DTD of the lower-extremity owing to micro- and macroangiopathies (the obliteration atherosclerosis and endarteritis, diabetic angiopathy, Raynaud’s disease) and necrotic suppurative process in the foot. These patients have experienced the system of surgical treatment including subcutaneous fasciothomy and advanced forefoot amputation system. On the grounds of biochemical analysis the positive influence of culf subcutaneous fasciothomy on the trophism of the inferior limb has been proved. Surgical treatment tactics has been elaborated for the patients having DTD of the lower-extremity. This tactics is based on the surgical infection site and expansion, on defining the limb’s arterial insufficiency (ischemia) rates as well as the characters of necrotic affection. Thanks to this tactics 71% of clinical patients saved the support ability of their lower-extremity.