THE RESULTS OF EARLY SURGICAL INTERVENTION IN FRACTURES OF THE TUBULAR BONE OF THE LOWER EXTREMITY AFTER GUNSHOT INJURIES

Abstract

In the article, on the eve of the Second Karabakh War, wound healing, bone healing period, and complications after early surgical intervention in open fractures of long tubular bones of the lower extremity caused by gunshot injuries in hospitals close to the front line were investigated, and the advantages of timely interventions were evaluated. On the eve of the Second Karabakh Homeland War, on September 28–November 14, 2020, 66 patients with an average age of 24.8 (from 19 to 42 years) underwent surgical intervention due to open fractures of the femur and tibia bones caused by gunshot wounds in front-line hospital No. N (out of 78 fractures, 40 femoral and 38 tibial bones) were examined retrospectively after surgery. After repeated debridement of the wound site on the operating table, fracture fragments were repositioned, taking into account the axis of the same limb. An osteosynthesis operation was performed with a unilateral external fixator (13 units) and Ilizarov external fixator apparatus (65 units). In 38 patients (48.7%) with sufficient consolidation in the fracture line or complete union, the fixators were removed by the 6th month after surgery. In 31 patients (39.7%), a delay in fracture line union was observed and external fixators were removed within 7-12 months. In total, 88.5% of all patients had a complete union within 12 months and a high result was achieved. Complications resulting in amputation in 2 patients and chronic osteomyelitis in 1 patient were recorded. Our research proved the achievement of a high recovery rate, a minimal number of amputations, and a low infection rate.