doiSerbia

Treatment of multiple fractures in a patient wounded by aircraft bombing

Golubović Zoran (Ortopedsko-traumatološka klinika, Klinički centar, Niš)
Stojiljković Predrag (Ortopedsko-traumatološka klinika, Klinički centar, Niš)
Mitković Milorad (Ortopedsko-traumatološka klinika, Klinički centar, Niš)
Trenkić Srbobran (Ortopedsko-traumatološka klinika, Klinički centar, Niš)
Vukašinović Zoran (Institut za ortopedsko-hirurške bolesti 'Banjica', Beograd)
Lešić Aleksandar (Klinika za ortopedsku hirurgiju i traumatologiju, Klinički centar Srbije, Beograd)
Košutić Milomir (Klinika za traumatologiju i ortopediju, Vojnomedicinska akademija, Beograd)
Milić Dragan (Ortopedsko-traumatološka klinika, Klinički centar, Niš)
Najman Stevo (Medicinski fakultet, Niš)
Golubović Ivan (Ortopedsko-traumatološka klinika, Klinički centar, Niš)
Višnjić Aleksandar (Medicinski fakultet, Niš)

Introduction Aircraft cluster bombs can cause severe fractures characterized by extensive destruction of affected tissues and organs. Case Outline We present the methods and results of treatment of multiple fractures (left supracondilar humeral fracture, comminuted fracture of the distal right tibia, fracture of right trochanter major without dislocation and fracture of the right second metacarpal bone) in a 24-year old soldier after multiple wounding by a cluster bomb. After short pre-operative preparation a surgical debridement of all wounds was done in general anesthesia and the fractures of the humerus and tibia were stabilized with the Mitkovic-type external fixator after adequate reposition. For the reconstruction of bone defect of the tibia we used the method of bone transport using the Ilizarov external fixator. Conclusion Radical wound debridement, abundant rinsing, leaving the wound open, administration of antibiotics and antitetanus immunization, external fixation and early reconstruction of soft tissue and bone defects are the basic elements of the treatment of serious fractures caused by war injuries and aimed at saving the extremities. .

Keywords: aircraft bomb, multiple fractures, bone defect, externalskeletal fixation, bone transport