ALGORITHM FOR REHABILITATION OF COMBAT-RELATED PATIENTS WITH LIMB AMPUTATIONS BASED ON MULTIPROFESSIONAL AND INDIVIDUAL APPROACH
Introduction. According to the literature, limb injuries predominate (65%). among the participants of the Anti-terrorist Оperation (AO), Joint Forces Оperation (JFO) The amputation rate is relatively high, often combined with other musculoskeletal injuries, and requires an individual and multi-professional (MP) approach.
Purpose of the study: to analyze the structure of amputations in participants of AO and JFO; to create an algorithm for the rehabilitation of military personal with amputations, taking into account the individual and MP approach.
Materials and methods. The analysis of the results of treatment of 51 patients with amputation from the participants of AO, JFO, who were hospitalized in the department of rehabilitation of patients with amputated extremities of the Military Medical Clinical Center of Occupational Pathology of the Armed Forces in the period from 26.12.2016 to 01.08.2019. The average age at the time of injury was 33 years (from 18 to 54). Distribution by gender: men - 98.1% (n = 50), women - 1.9% (n = 1).
Results. The absence of one limb due to amputation was observed in 84.3% (n = 43), double amputation - 13.7% (n = 7), triple - in 2.0% (n = 1). The main cause of the amputation was a mine-explosion injury - 78.4% (n = 40). Most often, limb amputation was combined with acubarotrauma - 47% (n = 24) and closed traumatic brain injury - 41.2% (n = 21). Adaptation disorders and depressive disorders were common concomitant disorders (56.8% (n = 29)). In 31% (n = 16) amputation was combined with fractures of tubular bones of other extremities.
These circumstances significantly influenced the course of rehabilitation. Given the above circumstances, we have proposed an algorithm for the rehabilitation of patients with traumatic amputation in the postoperative period, the period of preparation for prosthetics, prosthetics and the remote period in accordance with the individual rehabilitation program (IRP).
Conclusion. Given the specific of modern trauma (first of all the frequent association of amputation with other musculoskeletal injuries, injuries of the internal organs, psychological disorders) the algorithm for managing patients with amputation should include: complex treatment with differentiated individual approach, using modern technologies MP approach and according to IRP.
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