Abstract
Backgrоund. Polytrauma is the main reason for incapacitation and death in children of all ages. The appropriate timing of specialized medical care plays a crucial role for the outcomes of the polytrauma.
 Aim. The aim of the study is to analyze the results of the treatment of musculoskeletal injuries with the use of a decision-making algorithm in pediatric patients with polytrauma.
 Materials and methods. This is a prospective, observational, controlled, single-center study. The research included 130 children who were divided into two groups. In the main group, the children were provided with specialized medical care by a multidisciplinary team. After stabilization, the patients were transferred to a specialized center for final surgical treatment by minimally invasive fracture osteosynthesis. After the elimination of existing life-threatening conditions and the fitting of skeletal traction, the patients in the control group received surgical treatment only after transferal to a specialized center.
 Results. In the main group, pain regressed significantly earlier (1.7 0.6 vs 3.2 0.4, p 0.05), and the duration of the postoperative ICU stay was significantly reduced (1.5 0.9 vs 2.4 1.4 days, p 0.05). The optimization of the surgical treatment of injuries facilitated a reduction in the duration of the ICU stay of patients in the main group (5.6 0.3 vs 6.5 0.4 days), in the surgical department (21.5 0.7 vs 25 0.9 days), and the overall hospital stay (up to 27.5 days).
 Conclusions. This study developed a decision-making algorithm for administering medical care to children with polytrauma based on the principle of stabilization of the condition and early low-trauma surgery in the hours following injury.
Highlights
Polytrauma is the main reason for incapacitation and death in children of all ages
The appropriate timing of specialized medical care plays a crucial role for the outcomes of the polytrauma
The aim of the study is to analyze the results of the treatment of musculoskeletal injuries with the use of a decision-making algorithm in pediatric patients with polytrauma
Summary
Для цитирования: Юнусов Д.И., Александрович В.Ю., Миронов П.И., и др. Алгоритм оказания помощи детям с сочетанной травмой // Ортопедия, травматология и восстановительная хирургия детского возраста. Детям основной группы была оказана специализированная медицинская помощь силами мультидисциплинарной выездной бригады, и после стабилизации состояния пациенты были переведены в специализированный центр для хирургического лечения путем малоинвазивного остеосинтеза переломов. Оптимизация тактики хирургического лечения повреждений позволила снизить длительность пребывания пациентов основной группы в отделении реанимации и интенсивной терапии (5,6 ± 0,3 vs 6,5 ± 0,4 сут), в профильном отделении (21,5 ± 0,7 vs 25 ± 0,9 сут) и стационаре (до 27,5 сут). Предложен алгоритм принятия тактического решения при оказании помощи детям с сочетанной травмой, заключающийся в стабилизации состояния и проведении ранних малотравматичных операций в ближайшие часы после травмы.
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