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Neglected war injuries: Reconstruction versus amputation.

Gamal Ahmed Hosny¹, Abdel-Salam Abdel-Aleem Ahmed¹

¹Benha University, Faculty of Medicine, Egypt.

|October 8, 2023

Summary

This summary is machine-generated.

This study demonstrates that a single-stage limb reconstruction approach can successfully treat neglected war injuries, avoiding amputation. The innovative technique achieved good bone and functional results in all patients, highlighting its potential for complex trauma cases.

Keywords:

Amputation Circular external fixator Neglected fractures Open tibial fractures War injuries

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Area of Science:

Orthopedic Surgery
Trauma Surgery
Reconstructive Surgery

Background:

War injuries present unique challenges including severe contamination and delayed management.
Neglected war injuries often lead to complex fractures with a high likelihood of amputation.
This study focuses on limb reconstruction for war injuries where amputation was previously considered.

Purpose of the Study:

To evaluate the outcomes of limb reconstruction in patients with neglected war injuries.
To assess the efficacy of a single-stage reconstruction technique in avoiding amputation.
To report the functional and bone healing results in a cohort of war injury patients.

Main Methods:

A cohort of 54 male patients with neglected war injuries requiring limb reconstruction was studied.
The treatment involved a single-stage procedure combining bone and soft tissue reconstruction.
Techniques included bifocal, trifocal, and mono-focal management with gradual distraction.

Main Results:

All 54 patients achieved successful fracture healing with a mean follow-up of 45.1 months.
The majority of cases (79.6%) presented with infection; 17 had single-vessel limbs.
Good bone and functional results (ASAMI criteria) were achieved in all cases, avoiding amputation.

Conclusions:

A one-stage limb reconstruction approach is a viable strategy for neglected war injuries.
The technique, involving corticotomy-first, debridement, osteoplasty, and gradual distraction, effectively addresses complex trauma.
This method offers a successful alternative to amputation in challenging war-related limb trauma cases.