ОПЫТ ЛЕЧЕНИЯ ВДАВЛЕННЫХ ПЕРЕЛОМОВ КОСТЕЙ СВОДА ЧЕРЕПА У ДЕТЕЙ С ПРИМЕНЕНИЕМ АВТОРСКОЙ МЕТОДИКИ ОБРАБОТКИ КОСТНЫХ ЛОСКУТОВ ПО ПШЕНИЧНОМУ

Abstract

Objective of the study: to improve the results of treatment of patients with depressed fractures of the cranial vault with concomitant trauma by developing a new technique of depressed fracture treatment. Materials and methods of research: from 2015 to 2020 at the Regional Children's Clinical Hospital, Rostov-on-Don, 80 children have undergone reconstructive surgical interventions for damage to the skull bones. Thirty patients with a depressed skull fracture, who underwent a one-stage reconstructive operation according to the method developed by the authors (patent № 2017143056 dated 08/12/17), and concomitant trauma made up the main group. Fifty patients, who underwent reconstructive correction of skull bone defects using the standard technique (cranioplasty with an allograft – titanium plate), made up a comparison group to analyze the effectiveness of the author's method of treating a depressed fracture. All children with concomitant injury underwent X-ray computed tomography (CT) of the brain, cervical spine, chest organs, abdominal cavity, pelvic bones, which made it possible to quickly diagnose and begin the required treatment. Results: no inflammatory changes were observed in the early/late postoperative period among 30 children in the main group. Patients in satisfactory condition were discharged 10–12 days after surgery. Conclusion: the presented author's method of one-stage reconstructive surgery allows to improve the results of treatment of patients with depressed fractures of the cranial vault with concomitant injury and their quality of life in general. This method of correcting a depressed fracture of bones of the cranial vault in children has a significant economic effect due to reduction of the length of hospital stay of the inpatients and saves budgetary resources on alloplastic materials used for bone defect hiding. In the presence of a concomitant injury and the severity of the patient’s condition, it is necessary to perform an X-ray examination of the damaged organs and systems in order to quickly establish a diagnosis and prescribe appropriate treatment. In case of damage to several organs and systems requiring surgical treatment, at the first stage, surgical intervention for brain damage is recommended, in the second stage, in the absence of a life-threatening condition, on the same day or at delay, depending on the patient's condition, further surgical correction of other damaged organs and systems should be carried out.