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The outcomes of treatment of 386 victims with abdominal trauma and fractures of the long tubular bones were studied. The authors systematized the typical complications developing after the trauma, both on the part of the injured organs of the abdominal cavity and true pelvis and the fractures of the long tubular bones. This allowed the developed complications to be divided according to time into early, late, and sequelae of trauma. The early complications of injuries to the organs of the abdomen and true pelvis are as follows: suppuration of postoperative wounds, postoperative wound dehiscence with or without eventration, recurrent intracavitary hemorrhage, progressing local peritonitis, incompetence of anastomoses, intestinal obstruction, abdominal abscesses and infiltrates, abscesses and infiltrates in the true pelvis, intestinal paresis, large hematomas, phlegmons of the anterior abdominal wall. The late complications are: sluggish wounds of the anterior abdominal wall, formation of ligature fistulas, postoperative ventral hernias, suppuration of intraorganic and interstitial hematomas, subclinical forms of sepsis and sepsis, thrombophlebitic complications, chronic venous insufficiency, persistent wounds, and other complications. The sequelae of injury to the organs of the abdominal cavity and true pelvis are: intestinal fistulas, functional intestinal disorders, gastric disease, the dumping syndrome, cicatricial changes of the anterior abdominal wall, posttraumatic disease, venous insufficiency, pneumosclerosis, chronic pneumonia, pulmonary emphysema, chronic vascular insufficiency, etc. The early complications in fractures of long tubular bones in the group of studied patients: suppuration of osteomuscular wounds, recurrent displacement of bone fragments, bone necrosis in open type IIIC, IIID fractures, gangrene of the limb consequent upon crushing of skin and subcutaneous tissue, subluxations, secondary subluxations of limbs.(ABSTRACT TRUNCATED AT 250 WORDS)

The work analyses the experience in the treatment of 46 patients with fractures of long tubular bones and extensive wounds with avulsion of the skin at the department of emergency traumatology from 1983 to 1988. The method of choice in the treatment of fractures of the long tubular bones in this category of patients is functionally-stable osteosynthesis mainly with external fixation apparatuses on a nail or rod basis. A rational succession of the manipulations for surgical debridement of the extensive wound was determined, which made the surgeon's work much easier and reduced the time needed for the operation. The skin defects in extensive wounds were repaired by Krasovitov's method in 16 patients, in 30 patients reimplantation of the skin was carried out by means of a split avulsed graft measuring 0.3-0.5 mm in thickness. A complex approach to the treatment of patients of bot groups was applied in the postoperative period, which improved the outcome of the treatment considerably. From comparative analysis of the immediate and late-term results of healing of the reimplanted grafts the authors conclude that dermatomic (0.4-0.5 mm) plastics with a split avulsed graft is preferable.

The author has studied results of the early rehabilitative treatment of 155 patients with severe multiple and associated traumas. Good results were obtained in 89,5%, satisfactory--in 7,3%, bad--in 3,2%. The method of treatment and rehabilitation is described.

From 1977 each operation for chronic posttraumatic osteomyelitis was considered as a radical surgical intervention performed for the first time by the type of primary surgical treatment of the wound. Such an approach required a radical dissection of necrotic and all non-viable tissues in the focus of lesion. The method of radical surgical treatment of pyo-necrotic wounds in combination with modern means of the conservative therapy allowed 236 out of 486 patients to regain their labour ability.

The authors propose a working scheme to choose the method of treatment of diaphyseal fractures of segments of the upper and lower extremities with an obligatory application of perosseous osteosynthesis by the Ilizarov apparatus in combination with other curative measures. The scheme described was used in 26 patients and gave good anatomical and functional results.