Clinical and morphological rationale for the term “clinically significant muscle damage”, criteria for its statement and influence on therapeutic tactics

The article presents the results of research on the clinical and morphological justification of the term «clinically significant muscle injury», the criteria for its formulation and the definition of therapeutic tactics. At the first stage of the study, a retrospective analysis of the medical records of inpatient patients with traumatic limb muscle lesions in the period from 2017 to 2019 was carried out, 245 patients with limb muscle damage of varying severity were selected. The evaluation revealed statistically significant differences in the frequency of local complications, duration of treatment, and the need for additional surgical interventions (fasciotomies) for various degrees of muscle damage considered in the AO classification. The identified features made it possible to combine moderate and severe muscle damage into one tactical group: clinically significant muscle damage. At the second stage of the study, a retrospective analysis of patients with closed and open limb injuries accompanied by clinically significant muscle damage was performed (77 patients). Signs of muscle damage were assessed in each fascial case of the limb segment using ultrasound diagnostics or during surgical treatment. The criteria of clinical detail and the algorithm of surgical tactics are determined depending on the degree of damage to muscle tissue.

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