From Big Medical Encyclopedia

IMMOBILIZATION (Latin immobilis motionless) — creation of an immovability or immobilization of parts of a body at some diseases and mainly at damages. The immovability of area of a focus of the disease or the place of damage reduces pains, prevents emergence of additional damages, reduces danger of emergence of shock, somewhat reduces danger of development of an infection and provides a possibility of transportation of the wounded or patient. Special value has And. at treatment of changes since the acute ends of fragments which kept mobility can damage the vessels and nervous trunks located close or injure skin and turn the closed change into open. Mobility of fragments complicates an union of a change. Therefore than more perfectly And., the process of formation of a bone callosity proceeds more successfully.

And. it was applied in an extreme antiquity. So, at excavation of the Egyptian burial grounds it was established that for several thousands of years B.C. at fractures of bones various immobilizing devices were used (plates, pieces of bark or the dried leather of animals, etc.). About And. it is mentioned in Hippocrates's compositions (5 — 4 century BC). So, in the composition «About a medical office» it is reported about use of popular prints at treatment of changes. In the head «About changes» the extension per continuitatem by means of original adaptation is described. Data about And. are available in Old Russian literature. E.g., in the «Front annalistic arch» relating to 16 century there is a miniature representing production of iron fastening on the «derevyanitsa» applied for And. legs at a change.

In 1806 in E. O. Mukhin's book «The first beginnings of kostopravny science» it is mentioned about And. by means of bags with sand, trenches and popular prints. N. I. Pirogov applied a plaster bandage during the transportation of wounded with fractures of bones of extremities. During World War I need for standardization and mass production of tires for a transport immobilization came to light. In the subsequent devices for And. were continuously improved.

Philosophy And. — immobilization next to the damaged segment of joints. So, at a fracture of a forearm the tire or a plaster bandage is applied so that to eliminate the movements in radiocarpal and elbow joints. This principle is proved by the fact that muscles are, as a rule, attached outside the damaged segment, i.e. to the next bones. Fixing of the joints, next to a change, excludes reduction of these muscles and creates fuller immobilization of a zone of damage.

And. it is accepted to divide on transport and medical. The first is carried out by means of standard (released by the industry) or non-standard (the helpers improvised) tires (see. Sheena, splintage ). For short-term And., generally at slight injuries of soft tissues, apply various strengthening soft bandages (see. Desmurgy ).

Treatment And. it is carried out by conservative methods (a plaster bandage, skeletal traction and so forth), or operational (an osteosynthesis intramedullary, Extra focal etc. — see. Extension , Plaster equipment , Distraktsionno-kompressionnye devices , Osteosynthesis ).

For providing transport And. use the standard tires which are available on supply in special sets. Tires plywood, cardboard, tires wire and Diterikhs's tires intended for are included in the special packages And. fractures of a hip. Wire (ladder) tires are most convenient: they are easily modelled therefore with their help it is possible to make And. top and bottom extremities.

For transport And. a backbone and a basin use rigid linings (boards, boards). For the same purpose the vacuum mattress filled with plastic balls is offered. After pumping out by means of the small pump of air from a mattress it becomes firm, is well modelled on a body at any position of the patient and the long time keeps the form given it. There are tires plastic which are softened at immersion in hot water, are well modelled and after cooling become rigid.

Transport And. is of great importance in field conditions. It shall be carried out at fractures of bones of extremities, at spinal fractures and a basin and at wounds without injury of a bone, but with big destruction of soft tissues. In the battlefield for And. use make-shifts (boards, bunches of rods, etc.). Sometimes apply a so-called autoimmobilization, fixing the injured lower extremity to healthy or a hand to a breast by means of a kerchief or a zone belt. These improvised devices are replaced with standard tires as soon as possible.

For And. also air splints representing similarity of the stocking or a boot having two walls are issued. Such tire is put on an extremity and in space between walls on the tubule which is available on the tire air is forced (it is blown by a mouth). The tire becomes elastic and quite steadily fixes area of a change. Air splints have small weight and in folded form take not enough place. At And. fire changes conditions for treatment of a wound shall be provided. Fenestrated or bridge-like plaster bandages or the Extra focal osteosynthesis are applied to this purpose.

Bibliography: Velikoretsky A. I. Bandages, M., 1956; To the Pipe of HIV of G. A. Desmurgiya, M., 1968; L of e in and M. I N. Transport immobilization, M., 1957; A. B Hares. Transport immobilization, M., 1975; T to and the p e of N to about S. S. The principles of stage treatment of the bones which were injured with a fire change, Voyen. - medical zhurn., No. 2, page 23, 1972.

A. N. Berkutov.