Particularities of the therapeutic procedures and success in treatment of combat-related lower extremities injuries
Background/Aim. In a combat environment the extremities continue to be the most common sites of injury with associated high rates of infectious complications due to initial contamination. The aim of this observational study was to determine therapeutic procedures effective in a combat en...
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| Main Author: | |
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| Format: | Article |
| Language: | English |
| Published: |
Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2014-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2014/0042-84501403239S.pdf |
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| Summary: | Background/Aim. In a combat environment the extremities continue to be the
most common sites of injury with associated high rates of infectious
complications due to initial contamination. The aim of this observational
study was to determine therapeutic procedures effective in a combat
environment and to assess functional outcomes of definitive care. Methods. A
total of 44 casualties with combat-related lower extremities fractures
sustained during combat operations in former Yugoslavia in a 2-year period
(1993-1994) were enrolled. Initial management of these injuries was performed
at battlefield (echelon I), surgical treatment was provided in the hospital
in Trebinje (echelon II) and definitive care was provided in the Orthopedic
Ward of General Hospital in Nikšić (echelon III). Results. All combat
casualties received surgical treatment within 6-48 hours. Antibiotics were
administered during hospitalization in 37 (84%) of all the patients. In all
the cases fractures healed, while 15 (38.59%) of them developed complications
(most notably osteomyelitis in 3 of the cases, dysfunction in adjacent joints
in 3 of the cases and infection of the soft tissue around pins in 3 of the
cases). Follow-up period was a little bit over 2 years and reliable
conclusions regarding the therapy and the outcomes could be made. Good
functional outcomes were prevalent (63.63%), satisfactory were present in one
fifth and inadequate in 13.63% of all the cases. There were no amputations or
fatalities. Internal fixation was shown to be the method of definitive
surgical care of combat-related lower extremity fractures. Conclusion. The
management of combat- related lower extremity fractures is complex,
multidisciplinary approach through echelons is necessary and internal
fixation as the method of definitive surgical care is essential. |
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| ISSN: | 0042-8450 |