Peschansky R. The surgical treatment of the patients with a combined trauma of a chest and extremities

Object - injureds with a combined trauma of a breast and extremities; the purpose - enriching of results of treatment of the injureds with a combined trauma of a breast and extremities by optimization of diagnostic tactics and improvement of methods of treatment; methods - clinical, laboratory, electrophysiological, sonografies, x-ray, statistical; the novelty - is investigated a state of a hemodynamics at the injureds with a combined trauma of a breast and extremities, on which establishment the features of diagnostics of predominant damage are revealed. Is proved differential the approach to tactics of surgical treatment, the devices for abjection both excision of a nerve and processing of a bone at ablation of an extremity, a new method of a transthoracic front mediastinotomy are developed,; the results - methods of diagnostics of predominant damage with the count infringements of hemodynamics have allowed to reduce quantity of complications on 9,9 %, to lower a lethality on 7,6 %. The developed method of a transthoracic mediastinotomy has allowed to avoid a bilateral thoracotomy at 40 % of the patients, offered the device for abjection both the excisions of a nerve and device for processing a bone at ablation of an extremity have allowed to lower frequency of development of a phantom-pain set of symptoms from 40 % to 17 %; is introduced - into medical practice, in educational process; area - medicine.