"The extremities continue to be the most frequent sites of wounding during armed conflicts despite the change of combat tactics, soldier armour and battlefield medical support. Due to the advances in prehospital care and timely transport to the hospital, orthopaedic surgeons deal with severe and challenging injuries of the limbs. In contrast to civilian extremity trauma, the most combat-related injuries are open wounds that often have infection-related complications. Data from two recent large armed conflicts (Iraq, Afghanistan) show that extremity injuries are associated with a high complication rate, morbidity and healthcare utilization. A systematic approach that consists of sequential surgical care and good transport capabilities can reduce the complication rate of these injuries. New medical technologies have been implemented in the treatment strategy during the last decade. This article reviews the published scientific data and current opinions on combat-related extremity injuries."@en . . "0001-5415" . . "I" . . . . "Principy l\u00E9\u010Dby kon\u010Detinov\u00E9ho poran\u011Bn\u00ED v soudob\u00FDch v\u00E1le\u010Dn\u00FDch konfliktech" . "Management of War Orthopaedic Injuries in Recent Armed Conflicts"@en . "000321223800003" . "Frank, Martin" . . . . . "Kon\u010Detiny jsou regionem, kter\u00FD je nej\u010Dast\u011Bji poran\u011Bn p\u0159i bojov\u00E9 \u010Dinnosti (8,21,25,26).V soudob\u00FDch ozbrojen\u00FDch konfliktech zahrnuje kon\u010Detinov\u00E9 trauma 54-70 % poran\u011Bn\u00ED (8, 25, 29).Tato poran\u011Bn\u00ED jsou charakteristick\u00E1 vysok\u00FDm v\u00FDskytem p\u0159edev\u0161\u00EDm infek\u010Dn\u00EDch komplikac\u00ED a vysok\u00FDmi n\u00E1klady na l\u00E9\u010Dbu (22, 26). Osteomyelitida se vyvine p\u0159ibli\u017En\u011B v 15 % p\u0159\u00EDpad\u016F bojov\u00FDch zran\u011Bn\u00ED kon\u010Detiny (26).Vysok\u00FD po\u010Det komplikac\u00ED je spjat\u00FD s mechanismem \u00FArazu, proto\u017Ee vojensk\u00FD person\u00E1l je mlad\u00E9ho v\u011Bku a bez komorbidit (24). Frekvence a z\u00E1va\u017Enost kon\u010Detinov\u00E9ho traumatu u p\u0159e\u017Eiv\u0161\u00EDch pacient\u016F je v sou\u010Dasn\u00FDch konfliktech ovlivn\u011Bna kvalitn\u011Bj\u0161\u00ED balistiskou ochranou trupu, standardizac\u00ED p\u0159ednemocni\u010Dn\u00ED p\u00E9\u010De, rychlou evakuac\u00ED a rozm\u00EDst\u011Bn\u00EDm p\u0159edsunut\u00FDch chirurgick\u00FDch t\u00FDm\u016F (5, 24).P\u0159i no\u0161en\u00ED balistick\u00E9 ochrany trupu jsou kon\u010Detiny relativn\u011B nechr\u00E1n\u011Bnou \u010D\u00E1st\u00ED t\u011Bla proti projektilov\u00E9mu i st\u0159epinov\u00E9mu poran\u011Bn\u00ED. Od roku 1996 jsou do bojov\u00E9 \u010Dinnosti zav\u00E1d\u011Bny standardizovan\u00E9 postupy prvn\u00ED pomoci a l\u00E9ka\u0159sk\u00E9 pomoci v poli. Asi nejv\u011Bt\u0161\u00EDm p\u0159\u00EDnosem TCCC je roz\u0161\u00ED\u0159en\u00ED \u010Dasn\u00E9 aplikace turniket\u016F p\u0159i kon\u010Detinov\u00E9m traumatu a zaveden\u00ED turniket\u016F do v\u00FDbavy jednotlivce. Toto roz\u0161\u00ED\u0159en\u00ED se obe\u0161lo bez n\u00E1r\u016Fstu komplikac\u00ED z jejich aplikace (19). Pokles \u010Dasu evakuace ran\u011Bn\u00FDch z 11 na 4 hodiny mezi druhou sv\u011Btovou a korejskou v\u00E1lkou byl d\u00E1n zaveden\u00EDm vrtuln\u00EDkov\u00E9ho transportu (24, 26).Dosa\u017Eitelnost chirurgick\u00E9 p\u00E9\u010De v soudob\u00FDch konfliktech je v rozmez\u00ED jedn\u00E9 a\u017E t\u0159\u00ED hodin od \u00FArazu (26).To je umo\u017En\u011Bno kvalitn\u00EDm transportem a taktikou rozm\u00EDst\u011Bn\u00ED p\u0159edsunut\u00FDch chirurgick\u00FDch t\u00FDm\u016F (Role 2).V sou\u010Dasnosti prob\u00EDhaj\u00EDc\u00ED operaci v Afgh\u00E1nist\u00E1nu (ISAF) je stanovena na 60 minut.N\u011Bkter\u00E9 pr\u00E1ce poukazuj\u00ED na obdobn\u00E9 \u010Dasy p\u0159ednemocni\u010Dn\u00ED p\u00E9\u010De jako v civiln\u00EDch podm\u00EDnk\u00E1ch (5).C\u00EDlem pr\u00E1ce je shrnout sou\u010Dasn\u00FD pohled na taktiku l\u00E9\u010Dby v\u00E1le\u010Dn\u00E9ho kon\u010Detinov\u00E9ho traumatu, v\u010Detn\u011B popisu technik chirurgick\u00E9ho o\u0161et\u0159en\u00ED s implementac\u00ED nov\u00FDch medic\u00EDnsk\u00FDch technologi\u00ED." . "Principy l\u00E9\u010Dby kon\u010Detinov\u00E9ho poran\u011Bn\u00ED v soudob\u00FDch v\u00E1le\u010Dn\u00FDch konfliktech"@cs . "1"^^ . "Principy l\u00E9\u010Dby kon\u010Detinov\u00E9ho poran\u011Bn\u00ED v soudob\u00FDch v\u00E1le\u010Dn\u00FDch konfliktech" . "medical support system; trauma; combat; extremity"@en . "2"^^ . "6"^^ . "Kon\u010Detiny jsou regionem, kter\u00FD je nej\u010Dast\u011Bji poran\u011Bn p\u0159i bojov\u00E9 \u010Dinnosti (8,21,25,26).V soudob\u00FDch ozbrojen\u00FDch konfliktech zahrnuje kon\u010Detinov\u00E9 trauma 54-70 % poran\u011Bn\u00ED (8, 25, 29).Tato poran\u011Bn\u00ED jsou charakteristick\u00E1 vysok\u00FDm v\u00FDskytem p\u0159edev\u0161\u00EDm infek\u010Dn\u00EDch komplikac\u00ED a vysok\u00FDmi n\u00E1klady na l\u00E9\u010Dbu (22, 26). Osteomyelitida se vyvine p\u0159ibli\u017En\u011B v 15 % p\u0159\u00EDpad\u016F bojov\u00FDch zran\u011Bn\u00ED kon\u010Detiny (26).Vysok\u00FD po\u010Det komplikac\u00ED je spjat\u00FD s mechanismem \u00FArazu, proto\u017Ee vojensk\u00FD person\u00E1l je mlad\u00E9ho v\u011Bku a bez komorbidit (24). Frekvence a z\u00E1va\u017Enost kon\u010Detinov\u00E9ho traumatu u p\u0159e\u017Eiv\u0161\u00EDch pacient\u016F je v sou\u010Dasn\u00FDch konfliktech ovlivn\u011Bna kvalitn\u011Bj\u0161\u00ED balistiskou ochranou trupu, standardizac\u00ED p\u0159ednemocni\u010Dn\u00ED p\u00E9\u010De, rychlou evakuac\u00ED a rozm\u00EDst\u011Bn\u00EDm p\u0159edsunut\u00FDch chirurgick\u00FDch t\u00FDm\u016F (5, 24).P\u0159i no\u0161en\u00ED balistick\u00E9 ochrany trupu jsou kon\u010Detiny relativn\u011B nechr\u00E1n\u011Bnou \u010D\u00E1st\u00ED t\u011Bla proti projektilov\u00E9mu i st\u0159epinov\u00E9mu poran\u011Bn\u00ED. Od roku 1996 jsou do bojov\u00E9 \u010Dinnosti zav\u00E1d\u011Bny standardizovan\u00E9 postupy prvn\u00ED pomoci a l\u00E9ka\u0159sk\u00E9 pomoci v poli. Asi nejv\u011Bt\u0161\u00EDm p\u0159\u00EDnosem TCCC je roz\u0161\u00ED\u0159en\u00ED \u010Dasn\u00E9 aplikace turniket\u016F p\u0159i kon\u010Detinov\u00E9m traumatu a zaveden\u00ED turniket\u016F do v\u00FDbavy jednotlivce. Toto roz\u0161\u00ED\u0159en\u00ED se obe\u0161lo bez n\u00E1r\u016Fstu komplikac\u00ED z jejich aplikace (19). Pokles \u010Dasu evakuace ran\u011Bn\u00FDch z 11 na 4 hodiny mezi druhou sv\u011Btovou a korejskou v\u00E1lkou byl d\u00E1n zaveden\u00EDm vrtuln\u00EDkov\u00E9ho transportu (24, 26).Dosa\u017Eitelnost chirurgick\u00E9 p\u00E9\u010De v soudob\u00FDch konfliktech je v rozmez\u00ED jedn\u00E9 a\u017E t\u0159\u00ED hodin od \u00FArazu (26).To je umo\u017En\u011Bno kvalitn\u00EDm transportem a taktikou rozm\u00EDst\u011Bn\u00ED p\u0159edsunut\u00FDch chirurgick\u00FDch t\u00FDm\u016F (Role 2).V sou\u010Dasnosti prob\u00EDhaj\u00EDc\u00ED operaci v Afgh\u00E1nist\u00E1nu (ISAF) je stanovena na 60 minut.N\u011Bkter\u00E9 pr\u00E1ce poukazuj\u00ED na obdobn\u00E9 \u010Dasy p\u0159ednemocni\u010Dn\u00ED p\u00E9\u010De jako v civiln\u00EDch podm\u00EDnk\u00E1ch (5).C\u00EDlem pr\u00E1ce je shrnout sou\u010Dasn\u00FD pohled na taktiku l\u00E9\u010Dby v\u00E1le\u010Dn\u00E9ho kon\u010Detinov\u00E9ho traumatu, v\u010Detn\u011B popisu technik chirurgick\u00E9ho o\u0161et\u0159en\u00ED s implementac\u00ED nov\u00FDch medic\u00EDnsk\u00FDch technologi\u00ED."@cs . . "Principy l\u00E9\u010Dby kon\u010Detinov\u00E9ho poran\u011Bn\u00ED v soudob\u00FDch v\u00E1le\u010Dn\u00FDch konfliktech"@cs . . "[82A6A17187EF]" . "3" . . . "RIV/00216208:11150/13:10191664!RIV14-MSM-11150___" . . "99341" . . . "CZ - \u010Cesk\u00E1 republika" . "RIV/00216208:11150/13:10191664" . "Management of War Orthopaedic Injuries in Recent Armed Conflicts"@en . "Mathieu, L." . "80" . "11150" . "Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca" .