Medical treatment 02.03.2015

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Medical treatment and rehabilitation programs

As a result of ongoing terrorist attacks in Ukraine there is the growing importance of providing humanitarian aid and assistance to conflict-affected civilian population, as stated in the Resolution of the European Parliament (2014/2965(RPS)).

Assisting Ukraine to cope with the dire humanitarian crisis, echoing the alerts issues by the WHO, also entails providing adequate medical treatment and rehabilitation for the Ukrainian servicemen wounded in the course of the anti-terrorist operation.

Particular attention is focused on providing medical treatment for those, who lost functionality limbs and require prosthesis and orthesis by high technology medical equipment that lacks in Ukraine.

According to the recommendations of medical experts Ukrainian nationals V.M.Donos, A.V.Kazachenko,

V.O.Kuznyetsov, V.O.Maznichenko, V.P.Pelysh, O.L.Tereschenko, V.P.Hilchyshyn require such kind of treatment abroad.

For instance, medical experts recommend making a prosthetic of V.O.Kuznyetsov’s upper limb by bionic prosthesis manufactured by Touch Bionics Company (www.touchbionics.com).

State Service of Ukraine on the Affairs of ATO Participants and Veterans prepared the individual medical materials of above-mentioned wounded Ukrainians (profiles, photos, videos, x-rays) which are available at the following link: http://www.ex.ua/439148749083 .

The Embassy of Ukraine in the Republic of Finland would appreciate if the relevant Finnish governmental institutions, agencies and donors could provide Ukrainian wounded servicemen with the assistance in the form of appropriate medical treatment/or rehabilitation programs.

Contact diplomat: Ms. Olha Bas, e-mail: bas@mfa.gov.ua

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LIST OF UKRAINIAN MILITARY PERSONNEL REQUIRING MEDICAL TREATMENT AND REHABILITATION

Gender

Male Female

Age Diagnosis

Transport possibility

Surface Air

Degree of depende ncy

Remark/Special needs

Current situation with medical treatment

1. √

2. √

3.

4.

5.

6. √

7. √

Mine-blast trauma. Postresuscitation disease. Coma III degree.

Artificial lung ventilation with imperceptible positive dynamics.

Gunshot ballistic injury of neck with cleavage of vertebral body and arcus vertebrae C5, spinal cord injury.

Gunshot fragmental diametrical injury of scull and brain.

Gunshot fracture of bregma bone from the left with intracerebral migration of fragments. Heavy brain concussion with contusion focuses in the left frontoparietal of temporal region.

Combined gunshot fragmental wounds of face, thoracic cage, abdomen, extremities. Gunshot penetrating wound of abdomen with injury of liver, small and blind intestines. Traumatic abruption of right forearm. Gunshot fracture of right femur and phallus.

Gunshot ballistic wound of left upper arm with fracture of humerus. Penetrating wound of thoracic, hemothorax, neck injury on the level of C6 with spinal cord injury, lower paraplegia.

Awake, breathes without physical assistance.

Open penetrating blind craniocerebral trauma with crash injury of right temporal lobe, depressed multifragmental fracture of temporal bone with penetrating of fragments to the temporal lobe. Injury of soft tissues of temporal region. Fragmental gutter wound of soft tissues of right upper arm.

Condition after mine-blast open fragmental fracture of IV-V basidigital bones of left wrist with displacement of fragments, injury of digital joints of IV-V fingers. Posttraumatic neuropathy of ulnar and radial nerves from the left. Complex contracture of

II-V

No

No

No

No

Yes

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

I

III

III

III

IV

III

IV

Needs neurorehabilitation

--

8.

9.

10.

11.

12.

13. √

14.

15.

16. √

17.

18.

19.

20.

21. √

22. √

35

22

Posttraumatic, after surgery complex contracture of right knee joint with mild functional impairment of right lower extremity.

Condition after open reduction surgery.

After-effect of mine-blast trauma (19.07.14). Posttraumatic gunshot chronic osteomyelitis, abacterial coxarthrosis of the left femur. Posttraumatic neuropathy of left sciatic nerve, fibularis communis. Chronic bilateral parietal maxilloethmoidal sinusitis

(remit). Osteoma of left frontal sinus. Deviation of nasal septum without respiratory malfunction.

Gunshot fragmental fracture of left femur with injury of clunis and sciatic nerve. Condition after surgery (20.11.14) of left femur and clunis wounds, open resection, osteosynthesis of the femoral bone. Badly healing wound of back side of left femur.

Gunshot fragmental non-penetrating wound of left shoulder with massive injury of soft tissues (04.02.15).

Gunshot penetrating fragmental wound of hip joint and left clunis. Gunshot fracture of upper third of left femur.

Absence of right upper extremity at level of middle 1/3 forearm, absence of left upper extremity at level of middle 1/3 of upper arm.

Mine-blast trauma. Gunshot fracture of body Th3 vertebra with damage of spinal medulla in frame of lower paramidal paraparesis.

Traumatic amputation of left lower extremity on 1/3 of femur.

Condition after amputation of right lower extremity at 1/3 level of femur.

39

Gunshot fracture of left ankle-joint. Treated in accordance with

Ilizarov method. Functional ileostomy.

Condition after gunshot wounds of s/3 and n/3 of left femur.

Opened fracture of right femur with injury of vascular-nerve tract.

Amputation of right extremity at 1/3 level of femur.

20 Absence of right upper extremity at 1/3 level.

37 Absence of right upper extremity at 1/3 level.

Spinal trauma (04.06.14). Fracture of Th3-Th5 vertebra with compression of spinal medulla. Lower paraplegia.

40 Amputation of left upper extremity at 1/3 level.

33

Penetrating gunshot wound of right thigh with multifragmental fracture

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

IV

III

IV

IV

III

III

III

IV

III

Needs prosthetics

Needs prosthetics

III

IV

III

III

IV

IV

Needs prosthetics

Needs prosthetics

Needs prosthetics

Needs prosthetics

Needs rehabilitation

--

23. √

24. √

25. √

26.

27.

28. √

29. √

30.

31.

32.

33. √

34.

35. √

24

Fragmental wound of both hands. Abruption of both wrists on joints level.

Yes

20

Open craniocerebral trauma. Penetrating fragmentation blunt wound of left eye pit. Foreign objects in left eye pit, chest, brain.

Open fracture of parental occipital bone.

No

19 Gunshot wound of right femur, left cnemis. Intestinal tract injury. No

57

Gunshot fragmental blind penetrating segmental wound of frontopariental area from the left. Gunshot multifragmental fracture of the frontal bone from the left with displacement of bone splinters into the cavity of skull. Heavy brain contusion with formation of contusional and hemoreological focuses . After surgery (08.10) of wound trema with removal of bone splinters and foreign objects.

Heavy combined penetrating fragmental mine-blast wound with exit perforation in left frontal region. Brain contusion III level.

Intracerebral hematoma of left frontal lobe. Heavy subdural hematoma from the left. Injury of both eyes and left forearm.

Amputation of two fingers of left wrist. Multiple fragmental wounds of extremities and soma. Injury of abdominal cavity organs. Retroperitoneal hematoma. Hemiparesis of right lower extremity.

Open catatrauma. Open craniocerebral injury. Heavy brain contusion, subdural hematoma. Fracture of pelvic bones, pubic bone, pertrochanteric fracture. Closed trauma of thoracic cage and abdominal cavity.

Condition after subcapital fracture with displacement of splinters. Closed sprain of acromial extremity of clavicle. Closed fracture of I-IX neural spines. Closed trauma of thoracic cage.

Ribs fracture from the right.

Gunshot wounds of lower jaw.

Gunshot wound of right cheek, maxilla, jaw and tongue.

Maxillofacial trauma.

Gunshot nonpenetrating wound of left lower leg with defect of the skin and soft tissues, with gunshot multifragmental joint fracture of proximal femur and displacement of splinters.

Gunshot injury of soft tissues of right femora (back part) and lower leg. Posttraumatic anemia.

Mine-blast trauma, fragmental fracture of the left radial bone with splinters displacement.

Mine-blast trauma. Gunshot fragmental fracture of right femur.

No

No

No

No

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

III

III

III

III

III

III

III

III

IV

IV

Rehabilitation

Rehabilitation

IV

IV

IV

Needs prosthetics

Needs rehabilitation

Neuro-rehabilitation

Under consideration by

Slovenia

Rehabilitation

Rehabilitation

Rehabilitation

Rehabilitation

--

36.

37. √

38.

39

40.

41.

42.

43.

44.

Gunshot non-penetrating wound of left lower leg with multifragmental displaced fracture of radial shaft. Gunshot blind wounds of soft tissues of the left gluteal region. Fasciotomy.

Wiring of splinters.

Gunshot multifragmental fracture of left femur. Gunshot blind fragmental wounds of groin of both femurs. Closed trauma of abdominal cavity with breakage of caul. Intra-abdominal flood.

Hemoperitoneum.

Gunshot wound of right shoulder.

Open gunshot fracture of left femur on 1/3 level with tissue ischemia IV degree, extensive necrosis in the area of injury.

Thermal burn V degree of right lower extremity.

Condition after amputation at 1/3 level of femur (16.10.14).

Condition after amputation of right lower extremity

Complex trauma with thoracic cage injury, open fracture of forearm, amputation of right lower extremity at 1/3 level.

Closed craniocerebral trauma. Brain concussion. Fracture of face bone from the left. Penetrating wound of left eye. Fracture of left clavicle.

Sequence of mine-blast trauma:

penetrating abdominal wound (02.06.14) with injury of ileum,

Yes

Yes

Yes

Yes

Yes

Yes

No

Yes

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

IV Rehabilitation

IV

IV

IV

IV

IV

III

III

II

Rehabilitation

Rehabilitation

Needs prosthetics

Needs prosthetics

Needs prosthetics

--

45.

√ ascending colon, segmented intestine and duodenum, entire eventration of intestines due to gunshot injury of anterior abdominal wall, gunshot fragmental fracture of flank bone from the right, postprimary cerebrospinal trauma, fragmental fractures of acanthas L3-L4-L5, spines of vertebra L1-L2-L3 and costovertebral joint Th12 from the left, spine medulla contusion

(Frankel classification), lumbar plexus injury from the right on the level of L1-L2-L3-L4 spinal roots, lower right monoparesis, sensory impairments, right kidney contusion, intra-abdominal hematocelia, traumatic shock II degree, hemorrhagic shock III degree.

Condition after: (02.06) laparotomy, hemicolectomy from the right, sealing of duodenum, abdominal cavity drain (04.0613.06,

22.06, 25.06), bleeding control of the wound on lumbus (13.06), revision of anterior abdominal wall wounds (14.06), establishing of drain to perforating ostium of duodenum (16.06), reticular endoprosthesis replacement of abdominal wall from the right

(14.07.), transposition of musculocutaneous flap, closing of injury defect of spine (24.07).

Condition after polytrauma (12.07.14), closed craniocerebral trauma, cerebral commotion, closed abdominal trauma, retroperitoneal hematoma, gunshot fragmental wound of soft tissues of right femur with large hematoma, unstable bilateral fracture of lateral masses, compression fracture of spinal bone

S2,S3, pubic articulation breakage, open left ankle joint fracture with transverse fracture of ankle bone and its internal migration inside-out, part cleavage of shin bone, 5 spine of vertebra fracture, fracture of radial bone belemnold.

Condition after: (13.07) laparotomy ; abdominal cavity sanitation and drain; open reduction of ankle joint; osteosynthesis of pubic articulation; (06.11) removal of metal fixators from pubic articulation and ankle joint; necretomy; fistulotomy; osteosynthesis of sacral bone with Lsp sheet; pelvis frontal stabilization (03.12).

No Yes III

--

47.

48.

49.

50.

51. √

52.

53.

46.

29

26

24

48

31

31

20

Gunshot wounds of: thoracic cage, lumbus with spinal medulla injury on level of 10-12 thoracic vertebras, lungs, urinary bladder, and scrotum. Hemopneumothorax. Gunshot fragmental fracture of right shinbone.

Condition after: (11.10) drain of right pleural space, thoracectomy from the left, atypical resection of lower lung lobe, laparotomy, extraction of foreign object, suture of urinary bladder wound, epicystostomy, drain of abdominal cavity and small pelvis, osteosynthesis of right shinbone with external fixation device; (12.01) decompression laminectomy Th11Th12, part Th10, wash off the brain dendrite.

Gunshot penetrating abdominal wound with injury of left pleural space, lien, back side of stomach, left kidney, with fracture of

Th-12 vertebra, spinal medulla injury with full dysfunction.

Explossive trauma. Traumatic amputation of right upper extremity at level upper 1/3 of forearm. Shrapnel injury of right earflap, face, neck, lower upper extremities, chest, craniocerebral trauma, brain concussion , acubaro-trauma of the right ear, thermal burn of right ear II-III grade. Posttraumatic perforation of eardrum from the right.

Gunshot wounds of the left forearm with gunshot fracture of bones and injury of neurovascular plexus and left shin. Surgical amputation of the left forearm on 2/3 level.

Gunshot avulsion of the left lower limb on 2/3 level of the shin.

Soft tissues deformity, burn injury of right femur.

Gunshot fragmental blind non -penetrating wound of the occipital region of the head with heavy brain contusion, with contusion focuses in the right fronto-temporal lobe and in the left cerebellar hemisphere. Cerebral compression by acute subdural hematoma in the left side postcranial fossa. Gunshot missile fracture of mastoid bone and occipital bone from the left side.

Closed chest injury. Right-side hemopneumothorax. Functioning tracheostoma. Bilateral pneumonia. Suppurative tracheobronchitis.

Mine-blast trauma. Brain concussion. Multiple missile wounds of body and extremities. Compound thigh fracture.

Closed craniocerebral injury. Brain concussion. Fracture of cheekbone-orbital complex. Penetrating wound of the left eye.

Fracture of the left clavicle.

No

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes III

Yes IV

Yes IV

Yes IV

Yes III

Yes IV

Yes IV

III

Prosthetics needed

Prosthetics needed

Prosthetics needed

Requires rehabilitation on recovery of cognitive and mnestic functions of brain

Needs rehabilitation

Needs rehabilitation

--

1

)

Used degrees of Dependency:

Dependency I.

Patients who require intensive support during the transport. For example, patients requiring ventilation, monitoring of central venous pressure and cardiac monitoring. They may be unconscious or under general anaesthesia. Dependency II.

Patients who, although not requiring intensive support, require regular, frequent monitoring and whose condition may deteriorate during transport. For example, patients who have a combination of oxygen administration, or one or more intravenous infusions and multiple drains or catheters.

Dependency III.

Patients whose condition is not expected to deteriorate during transport but who require nursing care of, for example, simple oxygen therapy, and intravenous infusion or a urinary catheter.

Dependency IV.

Patients who do not require nursing attention during transport but who might need assistance with mobility or bodily functions. Dependency

V.

Patients who do not require nursing attention during transport and don’t need assistance with mobility or bodily functions. Patients are not dependant.

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