Principles for Surgical Treatment of Long Bones Fractures Complicated by Purulent Infection


Modern concept for the treatment of long bones fractures complicated by purulent infection is presented. The main principles of this concept are the determination of volume and pattern of bone and soft tissue injury, radical debridement, stable bone fragments' fixation, use of primary and early reconstructive-restorative operations for substitution of bone and soft tissue defects. Treatment results for 268 patients (289 extremity segments) have been analyzed. Applied method of grouping patients with complicated long bone fractures by the pattern and volume of injury enables to determine the volume of debridement, terms and steps of osteosynthesis and reconstructive-plastic operations. Good and satisfactory results have been achieved in 88% of cases.


  1. Амирасланов Ю.А., Светухин А.М., Борисов И.В. и др. Выбор хирургической тактики при лечении больных остеомиелитом длинных костей в зависимости от характера поражения //Хирургия. - 2008. - N 9. - С. 46-50.
  2. Иванов П.А. Лечение открытых переломов длинных костей конечностей у пострадавших с множественной и сочетанной травмой: Автореф. дис. … д-ра мед. наук. - М., 2009.
  3. Зайцев А.Б. Реконструктивно-восстановительное лечение больных остеомиелитом голени: Автореф. дис. … д-ра мед. наук. - Н. Новгород, 2009.
  4. Никитин Г.Д., Рак А.В., Линник С.А. и др. Хирургическое лечение остеомиелита. - СПб, 2000. - С. 33-34.
  5. Уразгильдеев З.И., Бушуев О.М., Роскидайло А.С. Комплексное одноэтапное лечение несросшихся переломов и ложных суставов и дефектов длинных костей конечностей, осложненных остеомиелитом //Вест. травматол. ортопед. - 2002. - N 4. - С. 33-38.
  6. Шевцов В.И. ,Попова Л.А., Лапынин А.И. Проблема лечения хронического остеомиелита (обзор литературы) //Гений ортопедии. - 2009. - N 1. - С. 116-120.
  7. Charalambous C.P., Siddique I., Zenios M. еt al. Early versus delayed surgical treatment of open tibial fractures: effect on the rates of infection and need of secondary surgical procedures to promote bone union //Injury. - 2005. - Vol. 36, N 5 - Р. 656-661.
  8. Сierny G. 3rd. Infection following open fracture //Complications in orthopaedics. Open Fracture. AAOS /Eds. Levine L.S. - 2009. - Р. 71-87.
  9. Clasper J.C., Rowley D.I. Outcome, following significant delays in initial surgery of ballistic femoral fractures managed without internal or external fixation //J. Bone Jt Surg. (Br.). - 2009. - Vol. 91, N 1. - Р. 97-101.
  10. Court-Brown C.M., McQueen M.M., Quaba A.A. Management of Open Fractures. - London, 1996.
  11. Dinh P., Hutchinson B.K., Zalavras C. et al. Reconstruuction of osteomyelitis defects //Sem. Plast. Surg. - 2009. - Vol. 23, N 2. - Р. 108-118.
  12. Heppert V., Wagner C., Glatzel U. et al. Osteitis unterschenkel //Trauma Berufskrankh. - 2002. - N 4. - Р. 114-120.
  13. Giannoudis P.V., Harwood P.J., Kontakis G. et al. Long-term quality of life in trauma patients following the full spectrum of tibial injury (fasciotomy, closed fracture, grade IIIB/IIIC open fracture and amputation) //Injury. - 2009. - Vol. 40, N 2 - P. 213-219.
  14. Maksimoviж J., Markoviж-Deniж L., Bumbasireviж M. et al. Surgical site infections in orthopedic patients: prospective cohort study //Croat. Med. J. - 2008. - Vol. 49, N 1. - Р. 58-65.
  15. Om L.P. Analysis of surgeon-controlled variables in the treatment of limb-threatening type-III open tibial diaphyseal fractures //J. Bone Jt Surg. (Am.). - 2009. - Vol. 91,N 2. - Р. 489-490.
  16. Pape H.C., Webb L.X. History of open wound and fracture treatment // J. Orthop. Trauma. - 2008. - Vol. 22, N 10. - Р. 133-134.
  17. Tulner S.A.F., Schaap G.R., Strackee S.D. et al. Long-term results of multiple-stage for posttraumatic osteomyelitis of the tibia //J. Trauma. - 2004. - Vol. 56. - Р. 633-642.



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