nmpЖурнал им. Н.В. Склифосовского «Неотложная медицинская помощь»Russian Sklifosovsky Journal "Emergency Medical Care"2223-90222541-8017“N.V. Sklifosovsky Research Institute for Emergency Medicine”10.23934/2223-9022-2017-6-3-238-245nmp-388Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWS OF LITERATUREПРЕИМУЩЕСТВА И ОПАСНОСТИ РАННЕГО ОСТЕОСИНТЕЗА БЕДРЕННОЙ КОСТИ ПРИ ПОЛИТРАВМЕ С ПОВРЕЖДЕНИЯМИ ГРУДИADVANTAGES AND DANGERS OF EARLY OSTEOSYNTHESIS OF FEMUR IN POLYTRAUMA WITH CHEST INJURШапкинЮ. Г.ShapkinY. G.СеливерстовП. А.SeliverstovP. A.

Селиверстов Павел Андреевич, кандидат медицинских наук, ассистент кафедры общей хирургии ФГБОУ ВО Саратовский ГМУ им. В.И. Разумовского Минздрава России

Cand. Med. Sci., Assistant of General Surgery Department, Saratov State Medical University named after V.I. Razumovsky

seliwerstov.pl@yandex.ruФГБОУ ВО «Саратовский государственный медицинский университет имени В.И. Разумовского» Министерства здравоохранения Российской ФедерацииРоссия«Saratov State Medical University named after V.I. Razumovsky», Ministry of Health Care, Russian Federation, SaratovRussian Federation20171110201763238245Copyright © Шапкин Ю.Г., Селиверстов П.А., 20172017Шапкин Ю.Г., Селиверстов П.А.Shapkin Y.G., Seliverstov P.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jnmp.ru/jour/article/view/388

В обзоре представлены результаты экспериментальных и клинических исследований влияния раннего остеосинтеза при переломе бедренной кости на развитие системных осложнений и исхода политравмы с повреждениями груди. Рассмотрена роль сочетания торакальных повреждений с переломом бедренной кости, а также ее интрамедуллярного остеосинтеза в механизмах формирования местной и системной воспалительной реакции, коагулопатии, жировой и тромбоэмболии в легких, дыхательной недостаточности. Изложены концепции «немедленной тотальной помощи», «контроля ортопедических повреждений» применительно к переломам бедренной кости, сочетанных с травмой груди. Приведены критерии относительной безопасности выполнения окончательного остеосинтеза бедренной кости при политравме с торакальными повреждениями

The review presents the results of experimental and clinical studies of the effect of early osteosynthesis in the femoral fracture on the development of systemic complications and the outcome of polytrauma with chest injuries. We explored the role of combination of thoracic injuries with a fracture of the femur, as well as its intramedullary osteosynthesis in the mechanisms of local and systemic inflammatory reaction formation, coagulopathy, fatty embolism and pulmonary embolism, respiratory failure. The concepts of “immediate total care” and “orthopedic damage control” are described with reference to fractures of the femur, combined with a chest trauma. The criteria for the relative safety of osteosynthesis of the femur in polytrauma with thoracic injuries are given.

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The authors declare that there are no conflicts of interest present.