TREATMENT OF PURULOUS-INFLAMMATORY COMPLICATIONS OF INJURIES AND DISEASES OF PELVIC BONES
DOI:
https://doi.org/10.34287/MMT.1(56).2023.2Abstract
Summary. Purulent-inflammatory complications of fractures of pelvic bones represent up to currently one of the most difficult and little-studied sections of traumatology. Complexity anatomical structure and topographic relations of the pelvic region, deep location a significant part of the bones under the muscle mass create objective difficulties for surgical treatment of bone damage and later in the diagnosis of purulent processes. Osteomyelitis of the pelvis is accompanied by high mortality and is from 2.5 to 52% as in acute and in the chronic stage of the disease.
Purpose: by analyzing clinical mistakes and the possibility of purulent-inflammatory complications during operative treatment and postoperative management of patients with fractures bones of the pelvis, as well as to determine methods of diagnosis, treatment and ways of prevention traumatic sacroiliitis.
Materials and methods. In the period from 2017 to 2022 in the bone-purulent surgery department of Zaporizhzhia city clinical hospital №9 treated 9 patients with purulent processes in of the pelvic region, 6 (66.3%) of them were men, and 3 (33.4%) were women. With postoperative osteomyelitis, which occurred after osteosynthesis with plates of multiple pelvic bone fractures, 4 (44.5%) patients were treated. Conservative therapy with sacroiliitis, the cause of which was abortion, received by 2 (22.2%) women, 1 (11.1%) patient suffered from right-sided sacroiliitis since childhood and repeatedly operated, and 2 (22.2%) men were treated with cause of sacroiliitis, which occurred after slaughter of the sacroiliac joint area.
Results. All patients who were treated in the bone-purulent surgery department for purulent-inflammatory processes of pelvic bones, recovered and were discharged for outpatient treatment. While treatment in the ward, patients received complex treatment, which included conservative therapy and surgical intervention. Despite the introduction of modern methods of treatment of osteomyelitis of the pelvis, a trend of steady growth in the number is noted exits of patients with disabilities, which is confirmed by world statistics.
Conclusions. Lack of hard fixation of bone fragments by implants increases the risk of purulent complications in the postoperative period. Use of additional diagnostic methods and complex treatment, which includes radical purulent sanitation foci, creation of favorable conditions for tissue regeneration, prevention of relapses suppuration, targeted antibacterial therapy, correction of homeostasis indicators and increases the protective forces of the body during purulent processes of the bones and joints of the pelvis achieving positive results in 80.2% of patients.
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