Application of minimally invasive osteosynthesis techniques in patients with combined trauma of the thorax and musculoskeletal system

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Abstract

Introduction. The pathogenesis of the mutual negative effects of chest injury and musculoskeletal system is based on complex mechanisms in which damage to one system aggravates the condition of the other. The results of numerous studies show that early stabilization of chest injuries and concomitant fractures of the musculoskeletal system can significantly improve the prognosis of treatment for patients.

Materials and methods. The epidemiological and clinical-topographic features of combined injuries of the chest and musculoskeletal system are given. The clinical case of a 44-year-old patient admitted to the hospital with multiple thoracic trauma accompanied by a hip fracture is described. A systematic review of the literature on the research topic is presented.

Results and discussion. In the analyzed group, 38.8% of those hospitalized had a combined injury. A combination of groups of these injuries in the form of severe polytrauma with ISS>16 points was noted in 5.1% of hospitalized patients. The presented clinical case was treated without complications both at the inpatient and outpatient stages.

Conclusion. The presented clinical case clearly supports the effectiveness of minimally invasive surgical stabilization of the chest skeleton and damage to a large segment of the musculoskeletal system in a patient with a combined thoracic injury.

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About the authors

Sergey V. Glinany

Surgut clinical trauma hospital; Surgut State University

Email: trauma86@mail.ru
ORCID iD: 0009-0004-8360-8309
SPIN-code: 6737-1464

Head of the Orthopedic and Traumatology Department

Russian Federation, Surgut; Surgut

Evgeny I. Petrov

Surgut clinical trauma hospital

Email: trauma-ort86@mail.ru
ORCID iD: 0009-0002-9763-0596

traumatologist of Orthopedic and Traumatology Department No. 1

Russian Federation, Surgut

Vladimir V. Darvin

Surgut State University

Author for correspondence.
Email: darvinvv@surgutokb.ru
ORCID iD: 0000-0002-2506-9798
SPIN-code: 3312-9617

M.D, Professor, Head of the Department of Surgical Diseases

Russian Federation, Surgut

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Supplementary files

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2. Fig. 1. 3D reconstruction of CT of the chest (A and B), pelvic bones (cystography) of the victim (C).

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3. Fig. 2. Positioning the patient on the operating table, marking the proposed surgical approaches using an image intensifier.

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4. Fig. 3. View of postoperative wounds immediately after the operation (A), 8 days after the operation – a ruler with centimeter divisions is placed nearby (B).

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5. Fig. 4. Radiographs of the patient 1 day after surgery (A), 12 days after surgery (B).

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6. Fig. 5. Intraoperative photos. Patient positioning (A), pin removal stage (B), removed metal structures (C).

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7. Fig. 6. X-ray of the patient's lungs after removal of the wires (A), X-ray of the left hip (B, С).

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