Kopitchak I. Clinical and morphological features and treatment of the tibia fractures in patients with polytrauma

The thesis is dedicated to improving the treatment strategy for tibia fractures in patients with polytrauma. On the basis of comparative analysis of the clinical picture and course of post-traumatic period tibia fractures in 241 patient with polytrauma and in 450 patients with isolated tibia fractures were studied clinical characteristics, frequency, structure and causes of mortality and complications of tibia fractures in polytrauma. In experimental studies revealed characteristic structural changes in the parenchymatous organs and the violation of oxidative processes in polytrauma. On the basis of clinical and experimental data is based treatment tactics with the definition of the optimal timing and methods of operative stabilization of fractures of the shin bone, taking into account the severity of the victims and the risk factors for adverse outcomes. The introduction of treatment algorithm tibia fractures in patients with polytrauma allowed significantly reduce the incidence of cardiovascular events from 18.9 to 6.1 %, complications in the central nervous system from 18.2 to 5.1 % and the frequency of suppurative complications is uncertain from 32.2 to 20.4 %, compartment syndrome from 6.3 to 2.0 %. Case fatality decreased significantly from 25.9 to 11.2 %.