Abstract. Unsatisfactory results of treatment of severe patients with pelvic trauma in medical institutions are explained by a number of reasons, which can be divided into three groups: organizational, medical-diagnostic and tactical. Primary disability in severe pelvic injuries averages 14%, and in patients with a combination of pelvic and acetabular injuries complete social rehabilitation is achieved in no more than half of cases. pelvic bones and ways to prevent them. Materials and methods. In the period from 2013 to 2018, 155 patients with pelvic fractures were treated. Results. Refusal of surgical treatment for fractures of the posterior-upper edge of the acetabulum with rotation of the fragment and dislocation of the thigh and other fractures of the pelvic bones, which are difficult to exercise and poorly maintained, is extremely dangerous. In such cases, it is impossible to eliminate the displacement by conservative methods and the refusal of surgical treatment entails improper fracture fusion and disability. Conclusions. Active surgical tactics of primary care for patients with pelvic fractures reduces the risk of death, allows to transport the patient to pelvic surgery clinics. Careful preoperative planning reduces the risk of tactical errors. Postoperative rehabilitation should be aimed at the prevention of osteoarthritis and aseptic necrosis of the femoral head.

The purpose of the study. Is to analyze the medical and social consequences of pelvic fractures in combination with polysegmental injuries, study the health care system for these injuries, predict complications and mortality to assess the quality of life of patients with pelvic fractures and other segments (lower or upper limb). Materials and methods. The examination reports were examined according to the Zaporizhia Regional Trauma expertise commission code ICD-10 codes/manual S32 (Fracture of the lumbar spine and pelvic bones). Results. According to the Zaporizhia Regional Trauma expertise commission, the number of patients after bone fractures in 2014–2018 is 44 people. The analysis of the material revealed the general tendencies of steady growth of the number of patients with pelvic trauma to disability, which confirms the world statistics. During the period 2016–2019 on the basis of «Сity hospital of emergency medical care» and «City Hospital № 9» were operated on 28 patients with fractures of the acetabulum, of which as a result of osteoarthritis of the hip joint surgery was performed in 3 cases (10, 7%). Conclusions. Some methods of trauma care need to be improved, aimed at reducing their trauma, as well as preventive measures for the development of general and local complications in victims with combined pelvic trauma, refusal of surgical treatment entails improper fracture fusion and disability Keywords: polytrauma, disability, temporary disability, polysegmental injuries, quality of life.

The purpose of the study. Is to analyze the medical and social consequences of pelvic fractures in combination with polysegmental injuries, study the health care system for these injuries, predict complications and mortality to assess the quality of life of patients with pelvic fractures and other segments (lower or upper limb). Materials and methods. The examination reports were examined according to the Zaporizhia Regional Trauma expertise commission code ICD-10 codes/manual S32 (Fracture of the lumbar spine and pelvic bones). Results. According to the Zaporizhia Regional Trauma expertise commission, the number of patients after bone fractures in 2014–2018 is 44 people. The analysis of the material revealed the general tendencies of steady growth of the number of patients with pelvic trauma to disability, which confirms the world statistics. During the period 2016–2019 on the basis of "Сity hospital of emergency medical care " and "City Hospital № 9" were operated on 28 patients with fractures of the acetabulum, of which as a result of osteoarthritis of the hip joint surgery was performed in 3 cases (10, 7%). Conclusions. Some methods of trauma care need to be improved, aimed at reducing their trauma, as well as preventive measures for the development of general and local complications in victims with combined pelvic trauma, refusal of surgical treatment entails improper fracture fusion and disability. Keywords: polytrauma, disability, temporary disability, polysegmental injuries, quality of life

Актуальность. Количество неудовлетворительных результатов лечения внутрисуставных переломов пяточной кости достигает 34 %. Поиск оптимальной мини-инвазивной методики лечения, которую можно применить даже в скомпрометированных состояниях, уменьшить травматичность, начать раннюю реабилитацию и оптимизировать процессы репаративной регенерации, является актуальной проблемой. Одним из путей оптимизации процесса репаративной регенерации является применение обогащенной тромбоцитами плазмы. Цель: проанализировать результаты лечения больных с внутрисуставными переломами пяточной кости и оптимизировать репаративную регенерацию костной ткани плазмой с повышенным содержанием тромбоцитов. Материалы и методы. В период 2017–2019 гг. (I полугодие) в отделении травматологии Коммунального некомерческого предприятия «Городская больница № 9» Запорожского городского совета проходили лечение 79 больных с переломами пяточной кости. Двусторонние переломы имели место в 11 случаях (13,9 %). Гендерный состав: мужчины — 71 (89,9 %), женщины — 8 (10,1 %). Механизм травмы: падение с высоты (более 1,5 м) — 47 (59,5 %) человек, бытовые — 32 (40,5 %) человека. Были выполнены следующие оперативные вмешательства: металлоостеосинтез спицами — 62 (74,7 %), винтами — 7 (8,4 %), пластины и аппараты внешней фиксации не применялись. Отказались от оперативного лечения 14 (16,9 %) человек. Результаты. В основной группе пациентов рентгенологическое сращение перелома наступило через 6 недель у 6 больных (85,7 %), у 1 больного (14,3 %) — через 12 недель (случай тяжелого обломочного внутрисуставного перелома). В контрольной группе сращение на 8-й неделе выявлено у 14 пациентов (58,3 %), у 8 (33,3 %) — на 16-й неделе, у 2 пациентов (8,4 %) послеоперационный период осложнился полостью резорбции костной ткани. Выводы. Применение обогащенной тромбоцитами плазмы для регенерации костной ткани имеет значительный клинический потенциал. Предложенная мини-инвазивная методика оперативного лечения в сочетании с введением обогащенной тромбоцитами плазмы позволяет применять ее в осложненных случаях, когда есть противопоказания к оперативному вмешательству.

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.