English
Answears:1 – а, б, 2 – а, г, 3 – б, д, 4 – б, г, 5 – б, д, 6 – в, 7 – в, г, 8 – а, г, 9 – в, д, 10 – в, г. 11 – в, д, 12 – б, г, 13 – б, г, 14 – а, б, 15 – б, д.
1. For a child it is necessary to suspect acute hematogenous osteomyelitis of right thigh. Roentgenologic research in these terms will be uninforming, as roentgenologic signs of acute hematogenous osteomyelitis appear in 10-15 days from the moment of disease.
2. Judging to on clinical information, for a child it is necessary to suppose acute hematogenous osteomyelitis of right thigh, complicated a subperiosteum abscess or intermuscular phlegmon.
In the admission department of hospital it is necessary to execute the global analysis of blood, wet, roentgenoscopy of thorax and sciagram of right thigh in two projections.
3. A child has an initially-chronic form of hematogenous osteomyelitis: interosteal abscess Brodie.
4. A patient suffers chronic posttraumatic osteomyelitis of right tibia (fistulas form). From additional researches it is necessary to execute fistulography in two projections for determination of festerings pockets or computer tomography.
5. At patient intensifying of chronic gun osteomyelitis of left thigh, complicated a hypodermic phlegmon. It follows him to execute the global analyses of blood and urine and roentgenologic pictures of left thigh in two projections.
6. More credible than all, at patient intensifying of chronic gun osteomyelitis of front surface of comb of right ilium, that in real case dangerously by possibility of development of retroperitoneal phlegmon.
It should be remembered that can be complicated the phlegmon of retroperitoneal space also osteomyelitis of the XII rib and osteomyelitis of transversal sprouts of lumbar vertebrae.
7. On the sciagrams of patient in a thigh-bone a cavity will be determined with a freely lying sequestrum.
8. A patient must immobilise right lower extremity and quickly to transport in a hospital.
9. A patient is hospitalized in a surgical separation, where an urgent operation is shown him: dissection of intermuscular phlegmon, subperiosteum abscess or trepanation of bone for emptying of abscess. General treatment is conducted on principles of treatment of sharp festering-septic diseases.
10. It is necessary to send a patient in a surgical department for operative treatment. As a rule, here made trepanation of bone, scraping of internal wall of abscess with taking in of wound tight with muscular the plastic arts of bone cavity or without it.
11. Operative treatment is shown a patient. Excision of fistula and necrotic tissues is made. At end osteomyelitis with formation of false joint the ends of bones of resection and bone debris are fixed the vehicle of Ilizarov.
12. A patient is necessary to be hospitalized in the surgical infection department for operative treatment: dissections and drainage of phlegmon. It is the first stage of treatment, the second stage is sanation of hearth of infection in a bone it is necessary to conduct in the department of bone-festering surgery after clearing of wound and completion of necrolisis.
13. Most effectively for the plastic substitution of bone defect filling his bloody clot, by autogenous bone or cartilaginous pieces with adding to them of antibiotics in hard forms, and also by a muscular shred on a proximal or distal feeding leg. Stoppings are used also from a periosteum, skin, canned bone, round petiolate shreds, deprived skins.