Circumstances of the Injury:

During a combat mission, Viktor and his comrade were hit by a dropped enemy explosive from a drone. Shrapnel caused severe injuries to both of them. Summoning his last strength, Viktor managed to crawl to a nearby treeline, hoping his comrades could reach him.

Despite the grave danger, his comrades risked their lives to reach Viktor and his comrade, providing first aid and evacuating them from the combat zone.

Diagnosis:

Combined blast injuries to the chest, lower back, and limbs (May 1, 2024):

• Penetrating shrapnel wound to the right shin:
  • Severe comminuted fracture of both tibia and fibula in the lower third of the shin with significant bone displacement.
• Injury to the left hand:
  • Fracture of the proximal phalanx of the fifth finger with bone displacement.
• Non-penetrating wounds to the right chest and lower back:
  • Retained foreign bodies (shrapnel or bone fragments) causing damage to the facet joint between the L4-L5 vertebrae.
• Shrapnel wounds to the pelvis and left thigh:
  • Retained metal fragment in the head of the left femur and surrounding soft tissues.
• Paralysis of the left foot:
  • Resulting from nerve damage, causing loss of movement and function in the foot.

Surgical Procedures Performed (May 2, 2024):

• Primary wound care and debridement.
• Surgical cleaning and treatment of shin wounds.
• Metal osteosynthesis (MOS) of the tibia and fibula with external fixation.

Details of the Injuries:

1. Right Shin:
   • Shrapnel caused a complete fracture of both bones in the lower leg, splitting them into multiple fragments with significant displacement, complicating natural healing.
2. Left Hand:
   • The fifth finger suffered a fracture at the base, with the bone displaced from its normal position.
3. Chest and Lower Back:
   • Non-penetrating wounds with retained shrapnel fragments. The injury caused damage to the L4-L5 facet joint, affecting stability and movement.
4. Pelvis and Left Thigh:
   • Shrapnel embedded in the femoral head and thigh tissue. These injuries could impair mobility and joint function.
5. Paralysis of the Left Foot:
   • Likely due to nerve damage in the lower leg or foot, resulting in a loss of motor function.

Clinical Plan:

Metal Osteosynthesis of the Tibia:
This procedure involves stabilizing the shattered tibia and fibula using metal implants, such as plates, screws, or rods.

Benefits of the Procedure:

1. Stability: Holds bone fragments in the correct position to ensure proper alignment.
2. Healing Support: Creates the optimal conditions for natural bone regeneration.
3. Function Restoration: Facilitates the return of normal weight-bearing and mobility in the leg.