Treatment of Bone Defects in War Wounds: Retrospective Study

Introduction: Results of the treatment of open fractures primarily depend on the treatment of connected soft tissue injuries. Objective: The aim was to present the experience and methods gained during the treatment of diaphyseal bone defects as a consequence of gunshot fracture soft war trauma. Patients and Methods: The study consisted of 116 patients with the diaphyseal bone defect who were treated with the usage of primary and delayed autotransplantation of bones, transplants of the fibula and Ilizarov distraction osteogenesis. Results: The results of compensation of bone defect less than 4 cm and conducted by an early cortico-spongioplastics were as follows: good in 8 respondents (45%), satisfactory in 6 (34%) and poor in 4 respondents (21%). In cases of delayed cortico-spongioplastics, the above mentioned results were: good in 36 (41%) respondents, satisfactory in 24 (34%) and poor in 16 (25%) respondents. The results of compensation of bone defect greater than 4 cm with the usage of fibular transplant were as follows: good in 3 (38%) respondents, satisfactory in 3 (38%) and poor in 2 (24%), and with the usage of using the Ilizarov method, the results were as follows: good in 8 (57%) respondents, satisfactory in 3 (21.5%) and poor in 3(21.5%) respondents. Conclusion: The results showed that, in cases of compensation of bone defects less than 4 cm, the advantage is given to the primary spongioplastics over the delayed one. In cases of compensation of bone defects greater than 4 cm, the advantage is given to the Ilizarov distraction osteogenesis when compared to the fibular transplant.

[1]  L. Meccariello,et al.  Treatment of Bone Defects in War Wounds Retrospective Study , 2016 .

[2]  G. Errico,et al.  The Damage Control Orthopedics and External Fixation in traffic accident after 20 Years in the Bosnian War : Our Experience and a Review of the Literature , 2014 .

[3]  P. Grubor,et al.  Comparison of stability of different types of external fixation. , 2011, Medicinski arhiv.

[4]  A. Ateşalp,et al.  Treatment of tibial bone defects with the Ilizarov circular external fixator in high-velocity gunshot wounds , 1998, International Orthopaedics.

[5]  T. Briggs,et al.  The role of reconstructive surgery in the management of war wounds. , 1991, Annals of the Royal College of Surgeons of England.

[6]  V. Konovalov,et al.  [The specialized treatment of the wounded with complications and unfavorable sequelae of gunshot wounds to the extremities]. , 1991, Voenno-meditsinskii zhurnal.

[7]  R. Coupland.  The role of reconstructive surgery in the management of war wounds. , 1991, Annals of the Royal College of Surgeons of England.

[8]  A. Barabash,et al.  [Experimental and clinical approval of a method of replacing extensive defects in the long bones]. , 1983, Ortopediia travmatologiia i protezirovanie.

[9]  V. Milivojevic,et al.  Experimental soft tissue wounds caused by standard military rifles. , 1979, Acta chirurgica Scandinavica. Supplementum.

[10]  G. I. Taylor,et al.  THE FREE VASCULARIZED BONE GRAFT: A Clinical Extension of Microvascular Techniques , 1975, Plastic and reconstructive surgery.

[11]  H. Iwasa.  [TREATMENT OF BONE DEFECTS]. , 1963, Rinsho geka. Journal of clinical surgery.

[12]  D. Phemister.  Treatment of ununited fractures by onlay bone grafts without screw or tie fixation and without breaking down of the fibrous union. , 1947, The Journal of bone and joint surgery. American volume.