Chapter 6. POLYTRAUMA

6.1. Classification. Features ofclinical course and diagnosis

Polytrauma is a collective term for multiple injuries to various tissues and organs in one victim. Polytrauma accounts for 14-15% of all injuries daily. In extreme situations (natural and man-made disasters, armed conflicts), the proportion of such injuries can significantly increase up to 30-40%. Polytrauma is marked by severe condition of the victims, difficulty of diagnosis and treatment, and a high frequency of fatal outcomes.

Polytrauma can be classified as isolated injury (monotrauma) and polytrauma (Fig. 6.1).

Fig. 6.1. Types of trauma

An isolated injury is caused by one traumatic factor (for example, mechanical) of one anatomic and functional segment (of the musculoskeletal system), one internal organ, vessel or nerve within one anatomical area.

Monotrauma can be monoor multifocal. Thus, multiple fractures of both shin bones, or multiple injuries of the small intestine constitute isolated multifocal injuries, and a fracture of the femoral neck - an isolated monofocal injury. A fracture accompanied by injury to a vessel or nerve, is a complicated injury.

Polytrauma includes multiple, combined and concomitant injuries.

Multiple mechanical injury is a simultaneous injury of 2 or more organs within the same anatomical cavity or different segments of the musculoskeletal system; for example, injury to the liver and intestines (trauma within the abdominal cavity) or fractures of the thigh and lower leg.

Concomitant injury is a simultaneous injury of 2 organs or more in different cavities, or of an internal organ in combination with a fracture of a segment of the musculoskeletal system; for example, liver and lung injury (trauma in different body