创伤与治疗杂志

Treatment of Bone Defects in War Wounds Retrospective Study

Abstract

Predrag Grubor, Milan Grubor and Luigi Meccariello

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 fractures of 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 autotransplatation of bones, transplants of the fibula and Ilizarov distraction osteogenesis. The results of compensation of bone defect less than 4 cm and conducted by an early corticospongioplastics 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 abovementioned 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. War wounds caused by firearms; characterize the extensive destruction of tissues, organs and the primary contamination polymorphic bacterial flora. Upon receipt of the injured we have not been in position to take from contributory a swab from the wounds of war, to identify the primary causes of infection and prescribe targeted, obtained by the antibiotic, antibiotic therapy. This is due to the material and technical conditions. We are a small country, where there is no industry for the production of medical equipment, disposable medical supplies, antibiotics. We were dependent on the humanitarian organizations and the not specially organized industry, we organized the production of external fixator because it was easiest.