[Treatment of fractures of long bones associated with extensive skin avulsion]

The work analyses the experience in the treatment of 46 patients with fractures of long tubular bones and extensive wounds with avulsion of the skin at the department of emergency traumatology from 1983 to 1988. The method of choice in the treatment of fractures of the long tubular bones in this category of patients is functionally-stable osteosynthesis mainly with external fixation apparatuses on a nail or rod basis. A rational succession of the manipulations for surgical debridement of the extensive wound was determined, which made the surgeon's work much easier and reduced the time needed for the operation. The skin defects in extensive wounds were repaired by Krasovitov's method in 16 patients, in 30 patients reimplantation of the skin was carried out by means of a split avulsed graft measuring 0.3-0.5 mm in thickness. A complex approach to the treatment of patients of bot groups was applied in the postoperative period, which improved the outcome of the treatment considerably. From comparative analysis of the immediate and late-term results of healing of the reimplanted grafts the authors conclude that dermatomic (0.4-0.5 mm) plastics with a split avulsed graft is preferable.