Вишеструки преломи костију екстремитета изазвани гелерима авионске бомбе – приказ болесника

Abstract

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 anaesthesia 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; external skeletal fixation; bone transport