Clinical observation of a victim with an open comminuted III B (Gustilo – Anderson) fracture of the bones of the left forearm and extensive skin undermining of the left shoulder, forearm and hand

The OBJECTIVE was to demonstrate the result of surgical treatment of a victim with an occupational trauma, which included an open comminuted fracture of the bones of the left forearm with partial skin loss and skin undermining from the hand to the upper third of the shoulder. The patient suffered a high-energy occupational trauma as a result of the left upper extremity getting into a machine tool. At the prehospital stage, the ambulance team applied a tourni quet on the upper third of the shoulder and aseptic dressing. When the patient was admitted to the shock room, the patient was examined by the multidisciplinary team. The left upper extremity was assessed by visual examination and additional study methods (radiography, soft tissue ultrasound and ultrasonic dopplerography of vessels). Based on the results of the examination and studies, the decision was made to carry out treatment in several stages.