Original article

Treatment of Patients with Concomitant Trauma to the Organs of Several Cavities and to the Musculoskeletal System

Miziev I.A. 1, Baksanov Kh.D. 1, Akhkubekov R.A. 1, Dabagov O.Yu. 1, Ivanova Z.O. 1, Kuchmezova F.А. 1

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1 Kabardino-Balkarian State University named after Kh.M. Berbekov, Nalchik, Russian Federation

UDK 614.2: 616-001.45

P. 52–56

Abstract. The aim of the study was to improve the results of treatment of patients with severe combined trauma of the organs of several cavities (skull, thoracic and abdominal cavities, retroperitoneal space) and of the musculoskeletal system.

Materials and research methods. The study involved 72 patients treated between 2013 and 2017 in a Level I trauma center established at the Republican Clinical Hospital of the Ministry of Health of the Kabardino-Balkarian Republic.

The Injury Severity Score (ISS) index was used to determine the severity of injury; “department of military field surgery, condition, admission” scale was used to assess the state of the injured.

Results of the study and their analysis. Analysis of the findings showed the following: in severe combined injuries the main causes of death are: shock, cerebral edema and dislocation, posttraumatic pneumonia, multiple organ failure, acute respiratory failure, pulmonary embolism and DIC syndrome.

The most satisfactory treatment outcomes can be achieved only with the use of a care tactic based on the principles of staged surgical treatment “Damage control”.

The time frame and the sequence of surgical treatment of injuries depend on their severity, degree of life threatening and prevailing injury.

Keywords: musculoskeletal system, organs of several cavities, patients, severe combined trauma, treatment

For citation: Miziev I.A., Baksanov Kh.D., Akhkubekov R.A., Dabagov O.Yu., Ivanova Z.O., Kuchmezova F.А. Treatment of Patients with Concomitant Trauma to the Organs of Several Cavities and to the Musculoskeletal System. Meditsina Katastrof = Disaster Medicine. 2022;2:52-56 (In Russ.). https://doi.org/10.33266/2070-1004-2022-2-52-56



  1. Men’shikov A.A., Bondarenko A.V., Shemakh Ye.A. Operativnoye Vosstanovleniye Karkasa Grudnoy Stenki u Bol’nykh Politravmoy s Mnozhestvennymi i Fragmentarnymi Perelomami Reber = Surgical Restoration of the Chest Wall Frame in Patients with Polytrauma with Multiple and Fragmentary Rib Fractures. Materials of the IX All-Russian Congress of Traumatologists-Orthopedists. V.2. St. Petersburg Publ., 2018 P. 460-462 (In Russ.).
  2. Nazarov Kh.N., Linnik S.A. Profilaktika I Lecheniye Oslozhneniy Perelomov Dlinnykh Kostey Nizhnikh Konechnostey pri Sochetannykh i Mnozhestvennykh Travmakh = Prevention and Treatment of Complications of Fractures of the Long Bones of the Lower Extremities with Combined and Multiple Injuries. Materials of the IX All-Russian Congress of Traumatologists-Orthopedists. V.2. St. Petersburg Publ., 2018. P. 478-480. (In Russ.).
  3. Porkhanov V.A., Baryshev A.G., Blazhenko A.N., Shevchenko A.V., Mukhanov M.L., Shkhalakhov A.K., Polyushkin K.S. Results of Treatment of Patients with Polytrauma in a Multidisciplinary Clinic. Khirurgiya. Zhurnal im. N.I. Pirogova = Pirogov Journal of Surgery. 2018;12:82-85 (In Russ.).
  4. Barashov A.Yu., Pronskikh A.A. Ways to Reduce Complications and Mortality in Patients with Polytrauma in Level 1 Hospitals. Sbornik Tezisov IX S’yezda Travmatologov Ortopedov. Collection of Abstracts of the IX Congress of Traumatologists. V.1. Saratov Publ., 2010. P. 89 (In Russ.).
  5. Goncharov S.F., Bystrov M.V., Kudryavtsev B.P., et al. The Problem of Multiple and Associated Injury (Polytrauma), the Ways of Solution and the Role of Disaster Medicine Service. Politravma = Polytrauma. 2016;2:23-26 (In Russ.).
  6. Miziev I.A., Baksanov Kh.D., Zhigunov A.K., Akhkubekov R.A. Hospital Mortality in Combined Injury and the Ways of Its Reduction. Zdorov’ye i Obrazovaniye v XXI Veke. 2018;12:116-119 (In Russ.).
  7. Joyce M.F., Gupta A., Azocar R.J. Acute Trauma and Multiple Injuries in the Elderly Population. Curr. Opin. Anaesthesiol. 2015;28:145–150.
  8. Meek R.N., Vivoda E.E., Pipani S. Compozison of Mortality of Patients with Multible Iniuries According to Type of Fracture Treatment. A Retrospective Age- and Iniurymached Series. Injury. 1986;17;1:2–4.
  9. Kalinkin O.G., Gridasov Ye.I., Kalinkin A.O., Shevchenko V.T. Opyt Lecheniya Bol’nykh s Sochetannoy Travmoy Organov Neskol’kikh Polostey i Oporno–Dvigatel’noy Sistemy = Experience in the Treatment of Patients with Concomitant Trauma to the Organs of Several Cavities and the Musculoskeletal System. Diagnostika i Lecheniye Politravm = Diagnostics and Treatment of Polytrauma. Conference Proceedings. Leninsk-Kuznetskiy Publ., 1999. P. 196-197 (In Russ.).
  10. Mukhametzhanov KH., Shakenov D.I., Ivanov V.V., Grubin M.A. Cherepno-Mozgovaya Travma, Sochetannaya s Povrezhdeniyami Grudnoy Kletki i Organov Bryushnoy Polosti = Craniocerebral Trauma, Combined with Injuries of the Chest and Abdominal Organs. Lecheniye Sochetannykh Travm i Zabolevaniy Konechnosti = Treatment of Concomitant Injuries and Diseases of the Limb. All-Russian Anniversary Scientific and Practical Conference. Moscow, 30 September-1 October, 2003. Moscow Publ., 2003. P. 230-231 (In Russ.).
  11. Reviel of Patients with Multiple Inquiries Treatment at University Hospital Kuala-Lumpur. J. Trauma. 1984;24:526–521.
  12. Watt I. McA Ledingtam I. Mortality Amongst Multiple Trauma Patients Admitted to an Intensive Therapy Unit. Anaesthesia. 1984;39;10:973–981.

The material was received 08.09.21; the article after peer review procedure 08.02.22; the Editorial Board accepted the article for publication 23.06.22