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Experience of using arthroscopy with gunshot penetrating injuries of the knee joint
ESSKA Academy. Klapchuk J. Nov 8, 2019; 284373; epEKA-33 Topic: Knee
Dr. Juriy Klapchuk
Dr. Juriy Klapchuk
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Experience of using arthroscopy with gunshot penetrating injuries of the knee joint

ePoster - epEKA-33

Topic: TKA

Klapchuk Y.1,2, Lapta V.1,2
1Military Medical Clinical Center of the Northern Region of the Department of Health of the Ministry of Defense of Ukraine, Kharkiv, Ukraine, 2Government agency 'Institute of Spine and Joint Pathology named after Prof. MI Sitenko of the National Academy of Medical Sciences of Ukraine', Kharkiv, Ukraine

Introduction: Modern war conflicts have lost the features that are inherent in the wars of the past. The use of modern weapons during the anti-terrorist operation in the East of Ukraine has led to an increase in the severity of combat injuries. In the overall structure of the surgical trauma, the frequency of limb wounds predominates and makes up 62.6% of cases. Of these, wounds of the lower extremities prevail 36.9%, wounds of the upper limbs are 25.7%. Gunshot wounds of large joints make up about 17% of the structure of firearms of extremities.
Objectives: using arthroscopy in wounded with gunshot penetrating wounds of the knee joint.
Aims: To improve the results of surgical treatment of wounded with gunshot penetrating wounds of the knee.
Methods: During the period of 2014-2018, 95 histories of the injured persons with gunshot penetrating injuries of large joints were analyzed retrospectively. Among them, 44 patients (46.3%) were injured in knee joints. Of the 44 patients, diagnosed- treatment arthroscopy was performed on 13 wounded (14 knee joints). The indications for diagnostic and treatment arthroscopy were clinical and instrumental (X-ray, spiral-computed tomography) signs of a gunshot penetrating wound of the joint. Arthroscopy was not performed in severe wounds with
major osteochondral defects in the thighs, tibia and patella. In such cases, primary surgical treatment of wounds with arthrotomy was performed, open repositioning of the fragments with fixation of the knee joint with the rod-shaped external fixing device.
Results: In the structure of gunshot wounds of the limbs (2452 people), which was provided specialized medical care, wounds of large joints made 3.87%, in particular knee - 1.8%. Prevailing fragmented injuries - 31 people (70,5%), the bullets accordingly made 13 (29,5%). In the structure of intra-articular injury, osteochondral damage was prevalent, in particular, the patella -12, proximal epimethaphysis of the tibia and distal epimethaphysis of the thigh 11 and 19 cases, respectively. Without damage to the joint cartilage and subchondral bone - 9.
Conclusions: Due to the use of arthroscopy it became possible to carry out the audit of all departments of the knee joint, to clarify the diagnosis, to minimize invasive removal of foreign bodies using or without medical magnets, to carry out an adequate sanitation of all twists, which made it possible to improve the treatment results of patients with this localization of injuries.
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