Ukrainian Orthopedic Trauma Experience in Managing Wartime Injuries of the Upper Extremity

Warfare injuries of the upper extremity constitute approximately 45% of all injuries to the extremities. We review a warfare treatment algorithm for injuries to the shoulder, elbow, soft tissue, and peripheral nerves of the upper extremity. A very challenging problem is reconstruction of the elbow joint after gunshot injuries, with defects of distal humerus and proximal forearm. Warfare injuries of the peripheral nerves are part of a polystructural injury, with bone fractures and soft tissue defects. They are combined nerve injury patterns with the best results when treatment occurs between 3 weeks and 3 months from the time of injury.