Реабилитационно-восстановительное лечение пациентов с травматическим остеомиелитом

Abstract

Purpose To improve the treatment effectiveness of long-bone posttraumatic osteomyelitis through the development and implementation of pathogenetically substantiated surgical and medicamental measures according to the stages of multiple organ dysfunction syndrome. Materials and methods Group 1 consisted of 176 (69 %) patients requiring large-volume surgical intervention (debridement of fistulae and bone sequestrae by segmental resection). Group 2 consisted of 79 (31 %) patients with traumatic osteomyelitis requiring small-volume surgical intervention (debridement of fistulae and bone sequestrae by removing a small bone part, parietal resection). Results The revealed hemodynamical, immunological, biochemical, and rheovasographic changes indicated traumatic osteomyelitis as stages I-II syndrome of polyorganic dysfunction. The average period of the hospital stay for patients with traumatic osteomyelitis of the leg was 44.6 ± 0.7 days of bed occupancy compared to 54.4 ± 0.7 days for the control group. An increase in the number and duration of remission periods was also observed (the participation of patients with traumatic osteomyelitis in working activity after undergoing complex rehabilitation-restorative treatment amounted to 77.4 %). Conclusion According to the author’s observation, the proposed complex of measures for the treatment of pyogenic complications due to injuries, in view of the current opinions on the pathogenesis of the multiple organ dysfunction syndrome, contributed to more favorable postoperative outcomes by decreasing the number of recurrences. Therefore, the periods of in-patient treatment were reduced.