[Treatment of pseudarthroses and defects of the forearm bones after gunshot wounds].
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Biomedical subjects
Publications and source records attributed to I P Ardashev.
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In the article is presented an analysis of treatment of 28 patients with wounds of spine and spinal cord, associated with the other extravertebral damages. The author considers these wounds to be the most severe damage and treatment of patients of the kind should be performed with participation of the related specialists, provided with the urgent complex, instrumental examination and with due regard for the degree of criticism of wounded person. Methods and terms of treatment are strictly individual with regard to the degree of criticism of spine and associated injury.
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The case histories of 247 patients with spinal damages caused by a fall from a height are analysed. In 180 (75.3%) patients the damage to the spine was combined with traumas of other localization. The author emphasizes the specific features of the diagnosis and the tactics of management of patients with trauma attended by multiple and concurrent injuries and calling for physicians of allied specialties to take part in the examination and treatment. The methods of treatment of spinal damages are chosen strictly individually and are combined with nonoperative or operative management of injuries to other parts of the skeleton.
The report is based on the analysis of the treatment of 32 patients with false joints of the humerus after gunshot injuries. All of them were operated and had supraosseous osteosynthesis with an AO plate (6 cases) and osteosynthesis after Ilizarov (26 cases). When the false joint of the shoulder was associated with the radial nerve paralysis, the tendons were transplanted after Chaklin in 9 cases. The indications for each method of treatment are presented. The causes of the complications after the operations are analysed. In 23 cases (72%) the results of the treatment were good and in 7 cases (22%) satisfactory.
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The author has analysed the combined injuries of the spinal column and the chest in 46 (2.19%) patients. In the treatment of the spinal injuries conservative (combined and functional) and surgical (in the posterior and in the anterior compartments) methods were employed differentially which allowed to reduce the period of treatment of the patients and to restore the working capacity.
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The authors present their analysis of stability of the "scoliotic arch--Tarrington's distractor" system in various versions of surgical stabilization. A modification of Tarrington's technique is suggested which improves the initial fixation strength and reduces the risk of complications.
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An analysis of treatment of 85 patients with wounded neck during 20 years has been made. Twenty two patients (25.9%) had no clinical symptoms of injuries of the vitally important organs when admitted to the hospital and stayed under observation. Negative data were found during examination of the wound in 39 of 63 patients (61.9%) operated upon. The authors believe that in most cases no traditional revision of the wound should be performed. Selective tactics and individual approach to treatment of such injuries is necessary.
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