Wrist arthrodesis in blast-induced trauma: a case report from Gaza

Blast injuries pose significant challenges due to the combined damage they inflict on tissues, nerve and vascular structures, and bones from high-energy forces. Effective treatment necessitates a multidisciplinary team approach, often involving staged surgeries to address bone reconstruction, soft tissue repair, and functional restoration. In conflict zones such as Gaza, where healthcare systems are overwhelmed by mass casualties and severe resource constraints, timely and specialized care is often unattainable, leading to delayed interventions and suboptimal outcomes. This review presents the case of a 30-year-old male with a blast injury to his right forearm, initially stabilized with an external fixator for one year without addressing the associated soft tissue damage. The prolonged use of the external fixator, combined with delayed reconstructive surgery, resulted in significant functional impairments, increased surgical complexity and risks, and diminished overall outcomes. Definitive treatment involved extensive soft tissue release, wrist fusion with an iliac crest autograft, and tendon transfers, underscoring the challenges and strategies for managing such injuries in resource-limited settings.