CONVERSION OSTEOSYNTHESIS TECHNIQUE FOR LIMB COMBAT INJURIES

To achieve optimal treatment outcomes in complex cases involving severe mine-explosive injuries, a staged approach has been developed worldwide. This approach involves external fixation for initial stabilization followed by definitive reconstruction using internal fixators. The purpose of this study was to evaluate the effectiveness of conversion osteosynthesis in providing medical care to victims of modern warfare. The study analyzed 174 cases of long bone injuries sustained during the full-scale invasion of Russia between 2022 and 2024. The treatment outcomes in the main group demonstrated an increase in the average consolidation time, characteristic of closed fractures, but a lower incidence of nonunion and malunion with segmental deformities. The frequency of delayed fusion of fragments was 7.7% less compared to the victims of the control group. Fusion of bone fragments with deformation in patients of the main group was 8.6% of cases, and in the control group in 13.8% of cases. False bone joints in the victims of the main group developed 4.8% less often than in the wounded of the control group. Infectious complications occurred in 5.4% of patients in the main group, with superficial infections accounting for 80.0% of these cases. Deep infections with osteomyelitis were observed in one patient, representing 1.1% of the main group. The study confirmed the effectiveness of conversion osteosynthesis in treating combat-related limb injuries. Transitioning from external fixation to internal osteosynthesis significantly reduced inpatient treatment time for patients with long bone fractures and improved treatment outcomes. However, the specific indications, methods, and timing for implementing conversion osteosynthesis in such cases require further development.