Reconstructive surgery for gunshot injuries of the knee: experience from the Russo-Ukranian War 2022-2024.

IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Bmj Military Health Pub Date : 2024-10-01 DOI:10.1136/military-2024-002799
Yurii Klapchuk, D Los, O Buryanov, Y Yarmoliuk, M Bazarov, I Bets, V Lyanskorunsky, B Vashkevych, A Ramasamy
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Abstract

The invasion of Ukraine by the Russian Federation in February 2022 has witnessed the first peer-on-peer full-scale European conflict since World War 2. We have noted that the vast majority of injuries affect the extremities. Within that group, injuries to the joints pose a huge clinical challenge. Specifically, 17.1% of all gunshot injuries (GSWs) involved the joints, which represents 22.3% of all limb injuries. 55.6% of all GSW to the joints involved the knee; 10% had a concomitant vascular injury and 15%-20% had a nerve injury.The surgical management of ballistic knee injuries includes initial damage control surgery with debridement of non-vitalised tissue, vascular reconstruction and fasciotomies where necessary, with stabilisation of bone injury with a spanning external fixator. Following repatriation to Role 4 facilities, staged reconstruction is performed with cement spacers followed by autograft, endoprosthesis or arthrodesis. Where reconstruction is not possible, above-knee amputation remains an option.In this paper, based on the analysis of 33 cases, we describe the Ukrainian early experience of the management of gunshot wounds to the knee joint with three clinical case studies as representative examples.

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膝关节枪伤的整形手术:2022-2024 年俄乌战争的经验。
2022 年 2 月俄罗斯联邦入侵乌克兰,见证了自第二次世界大战以来欧洲第一次同级别的全面冲突。我们注意到,绝大多数伤害都影响到四肢。其中,关节损伤构成了巨大的临床挑战。具体来说,17.1% 的枪伤(GSW)涉及关节,占所有肢体损伤的 22.3%。弹道膝关节损伤的手术治疗包括最初的损伤控制手术,必要时清创非存活组织、血管重建和筋膜切开术,并使用跨骨外固定器稳定骨损伤。在送回 "角色 4 "设施后,将使用骨水泥垫片进行分阶段重建,然后再进行自体移植、内假体或关节固定术。在本文中,我们根据对 33 个病例的分析,以三个临床病例研究为代表,介绍了乌克兰早期处理膝关节枪伤的经验。
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Bmj Military Health
Bmj Military Health MEDICINE, GENERAL & INTERNAL-
CiteScore
3.10
自引率
20.00%
发文量
116
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