International Medical Journal, Vol. 22., Iss. 3, 2016, P. 88−92.
THE CAPABILITIES OF INTEGRATED ULTRASOUND DIAGNOSIS OF GUNSHOT WOUNDS TO EXTREMITIES
National Military Medical Clinical Centre "Main Military Clinical Hospital" Kyiv
Kharkiv Medical Academy of Postgraduate Education
Clinical Hospital "Feofania", Kyiv, Ukraine
A retrospective study of 172 case histories of patients who received gunshot wounds to the extremities while participating in anti−terrorist operation in the east of Ukraine in 2014−2015 was performed. Gray−scale ultrasound, Doppler ultrasonography and sonoelastography were used to estimate anatomic integrity, acuity of contours, structure, the condition of the surrounding tissues. Wound channels, hematomas of the surrounding tissues, foreign bodies (shells, bullets, metal fragments), and hemodynamics of the vessels were determined. Gunshot wounds were found in 27.9 % of the patients, gunshot shell fragment wounds in 63.9 %, mine and explosive wounds in 8.1 %. According to the nature of the wound channel, blunt gunshot wounds were found in 60,4 %, penetrating wounds in 34.4 %, gutter wounds in 5.2 %. 77.9 % had single bodily injuries; 22.1 % patients had multiple injuries. The greatest amount of damage was at the level of the tibia and femur. The damage to major vessels and nerves were noted, these rates were higher in patients with penetrating gunshot wounds. Ultrasound examination as a screening method should be comprehensive and integrated, involving gray−scale, color Doppler ultrasound, sonoelastography of wounded extremities and adjacent anatomical and topographic zones.
Key words: ultrasound diagnosis, gunshot wounds, anti−terrorist operation.