The course of purulent-necrotic complications at the level of the shoulder.

Abstract

Annotation. Various purulent-necrotic complications (abscess, phlegmon, osteomyelitis, etc.) at the level of the shoulder occur more often after fractures of the humerus with a violation of the integrity of the skin, or after surgical interventions for closed fractures. The purpose of our study was to investigate the clinical and microbiological features of the course of purulent-necrotic complications in patients after shoulder osteosynthesis. From 2014 to June 2023, the examination and surgical treatment of 55 patients with various purulent-necrotic complications that occurred after open fractures were performed on the basis of the State University “ITO NAMSU”. Infectious complications are the main factor that prevents the successful recovery of patients with fractures of the humerus. In all the analyzed cases, an increase in the duration of treatment, the frequency of hospitalizations and deterioration of functional results were determined. As a result of the analysis, it was found that the majority of patients (60%) with osteomyelitic bone defects and nonunions of the humerus were patients with early infectious complications. In the comparative analysis of the microbial composition of the pathological focus, with the average number of surgical interventions performed on segments of the humerus, a corresponding pattern was revealed – the presence of polyresistant microflora increases the number of operations (4.25 for klebsiella pneumoniae, 3.5 for MRSA and 2 for staphylococcus aureus).