SURGICAL TREATMENT OF BONE DEFECTS OF THE EXTREMITIES AFTER GUNSHOT INJURIES

According to various authors, in wartime, injuries to the limbs as a result of combat trauma account for 44 to 70 % of all musculoskeletal injuries. In approximately 80 % of wounded, gunshot bone fractures are characterised by the presence of a bone defect of varying size. Despite certain difficulties and complications in the treatment of bone defects, orthopedic surgeons have quite effective methods of treating this pathology. However, a promising area of treatment is the technology of manufacturing an individual implant using 3D-printing of the scaffolds of existing bone defects and double-plate osteosynthesis with autobone grafting. Objective. To present the possibilities of surgical treatment of wounded with bone defects of the limbs as a result of gunshot wounds. The preliminary results of surgical treatment of 2 wounded with diaphyseal bone defects due to gunshot wounds of the upper and lower extremities, who were treated in the trauma department of the Military Medical Clinical Centre of the Eastern Region in 2022–2024, were analysed. To improve the functional results of treatment, we proposed three stages of rehabilitation treatment and implemented appropriate rehabilitation measures. To replace bone defects, we used the «double-plating» method with autobone grafting and individual implants made by 3D-printing. The results of surgical treatment were evaluated by clinical, radiological and functional data. It was found that fixation with two plates in combination with autogenous bone grafting ensures stable fixation, which helps to consolidate the bone defect and restore the functional capacity of the limb, and the use of individual implants made by 3D-printing allows to replace the lost bone tissue, which leads to the restoration and preservation of the functional state of the damaged limb.