2 research outputs found

    Case mortality evaluation, medical errors and sequelae in multisystem and concomitant injuries, treatment

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    1250 cases of polytrauma have been analysed concerning mortality, medical errors and sequelae. Mortality rate was 25,4%. Treatment process in 220 cases of multisystem and concomitant injuries of patients deceased in hospital was evaluated. Mean age at death - 43,5 years. 45% of victims have been injured in condition of intoxication. In the acute period of traumatic disease, 52,3% of the victims died from decompensated shock, fat embolism, compression and dislocation of the brain structures. In the early period, death of 37,7% of patients was caused by progressive circulatory hypoxia or hematic origin. In the delayed period 10% of the victims died due to pyoinflammatory complications and multiple organ failure. Diacritic mistakes were mostly associated with an incomplete diagnosis (40,4%). Tactical erΠŸΡ€Π΅Π΄ΡΡ‚Π°Π²Π»Π΅Π½ Π°Π½Π°Π»ΠΈΠ· Π»Π΅Ρ‚Π°Π»ΡŒΠ½ΠΎΡΡ‚ΠΈ, ошибок ΠΈ ослоТнСний ΠΏΡ€ΠΈ Π»Π΅Ρ‡Π΅Π½ΠΈΠΈ 1250 Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… с ΠΏΠΎΠ»ΠΈΡ‚Ρ€Π°Π²ΠΌΠΎΠΉ. Π›Π΅Ρ‚Π°Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ составляла 25,4%. ΠŸΡ€ΠΎΠ²Π΅Π»ΠΈ Π°Π½Π°Π»ΠΈΠ· лСчСния 220 Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… с сочСтанными ΠΈ мноТСствСнными Ρ‚Ρ€Π°Π²ΠΌΠ°ΠΌΠΈ, ΡƒΠΌΠ΅Ρ€ΡˆΠΈΡ… Π² стационарС. Π‘Ρ€Π΅Π΄Π½ΠΈΠΉ возраст Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… составлял 43,5 Π³ΠΎΠ΄Π°. Π’ состоянии алкогольного опьянСния Π±Ρ‹Π»ΠΈ Ρ‚Ρ€Π°Π²ΠΌΠΈΡ€ΠΎΠ²Π°Π½Ρ‹ 45% ΠΏΠΎΡΡ‚Ρ€Π°Π΄Π°Π²ΡˆΠΈΡ…. ΠœΡƒΠΆΡ‡ΠΈΠ½ ΡƒΠΌΠ΅Ρ€Π»ΠΎ Π² 3 Ρ€Π°Π·Π° большС, Ρ‡Π΅ΠΌ ΠΆΠ΅Π½Ρ‰ΠΈΠ½. Π’ остром ΠΏΠ΅Ρ€ΠΈΠΎΠ΄Π΅ травматичСской Π±ΠΎΠ»Π΅Π·Π½ΠΈ 52,3% ΠΏΠΎΡΡ‚Ρ€Π°Π΄Π°Π²ΡˆΠΈΡ… ΡƒΠΌΠ΅Ρ€Π»ΠΎ ΠΎΡ‚ дСкомпСнсированного шока, ΠΆΠΈΡ€ΠΎΠ²ΠΎΠΉ Π·ΠΌΠ±ΠΎΠ»ΠΈΠΈ, сдавлСния ΠΈ дислокации структур Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°. Π’ Ρ€Π°Π½Π½Π΅ΠΌ ΠΏΠ΅Ρ€ΠΈΠΎΠ΄Π΅ ΠΏΡ€ΠΈΡ‡ΠΈΠ½ΠΎΠΉ смСрти 37,7% Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… являлась ΠΏΡ€ΠΎΠ³Ρ€Π΅ΡΡΠΈΡ€ΡƒΡŽΡ‰Π°Ρ гипоксия циркуляторного ΠΈΠ»ΠΈ гСмичСского Π³Π΅Π½Π΅Π·Π°. Π’ ΠΏΠΎΠ·Π΄Π½Π΅ΠΌ ΠΏΠ΅Ρ€ΠΈΠΎΠ΄Π΅ 10% ΠΏΠΎΡΡ‚Ρ€Π°Π΄Π°Π²ΡˆΠΈΡ… ΡƒΠΌΠ΅Ρ€Π»ΠΎ Π² связи с Π³Π½ΠΎΠΉΠ½ΠΎ-Π²ΠΎΡΠΏΠ°Π»ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹ΠΌΠΈ ослоТнСниями ΠΈ ΠΏΠΎΠ»ΠΈΠΎΡ€Π³Π°Π½Π½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ. ДиагностичСскиС ошибки Π±Ρ‹Π»ΠΈ связаны, Π² ΠΏΠ΅Ρ€Π²ΡƒΡŽ ΠΎΡ‡Π΅Ρ€Π΅Π΄ΡŒ, с Π½Π΅ΠΏΠΎΠ»Π½Ρ‹ΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ (40,4%), Π° тактичСскиС с нСдостаточной ΠΏΠΎ Ρ‚Π΅ΠΌΠΏΡƒ, качСству ΠΈ ΠΎΠ±ΡŠΠ΅ΠΌΡƒ ΠΈΠ½Ρ„ΡƒΠ·ΠΈΠΎΠ½Π½ΠΎ-трансфузионной Ρ‚Π΅Ρ€Π°ΠΏΠΈΠ΅ΠΉ (30,9%)

    METHOD OF FIXATION OF TENDINOUS TRANSPLANT IN TENDOPLASTY OF DEEP FLEXOR MUSCLE OF FINGERS

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    The authors supposed the method of tendinous transplant application in tendoplasty of deep flexor muscle of fingers based on usage of a new variant of tendon suture and modified device for its external cutaneous fixation. Firm and safe junction of transplant with tendon parts of the deep flexor muscle allowed an early activation of the hand function and high efficacy of operative treatment
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