Circumstances of the Injury:

“I thought it was my buddy’s leg lying on my face — but it turned out to be mine, twisted beyond recognition,” recalls Mykola Baranenko, a Ukrainian defender who survived a devastating tank strike on his position.

He was injured during an enemy assault that began with mortar fire. Then a drone arrived, and soon after, a tank zeroed in on the coordinates. Mykola had just stepped into the dugout from the trench when the shell hit. A fellow soldier was sitting right next to him, their legs touching. Mykola’s right leg was torn open by shrapnel above the knee. His comrade wasn’t as fortunate — his left leg was completely severed. He bled out before medics could evacuate him.

“There was a massive explosion, dust and smoke everywhere. My friend was screaming, ‘My leg!’ I looked down and saw a leg lying on my face. I was in shock, so I just pushed it off, thinking it was his. But it wasn’t — it was mine. That’s how badly it had been twisted. A large piece of shrapnel had shattered the bone and torn through the muscle, and smaller fragments had shredded the tissue all the way up near my hip. It looked completely destroyed. I couldn’t imagine it could ever be saved.”

In the chaos, he managed to apply a tourniquet himself, but it wasn’t tight enough and started to fall apart. Leaning on his rifle for support, he began to crawl out of the dugout — choking on smoke, gasping for air. Eventually, his fellow soldiers reached him and applied a proper tourniquet.

“It was December 2022. I was wearing two pairs of pants, rain gear, and boots — everything was wet and muddy. But even through all that, you could see the blood soaking through, and the broken bone sticking right out.”

Evacuation happened quickly, despite the danger. The pickup point was nearly 3.5 kilometers away, but a brave young driver raced through shellfire in a van, pulling up directly to their position. As the vehicle arrived, the shelling intensified.

“That place turned into hell,” Mykola says. “There were nine of us that morning. By evening, only three were still alive. One was killed instantly. The rest of us were wounded, some badly. I barely lost consciousness — maybe for a second or two — but I remember almost everything. I remember the drive, being thrown around in the back of the vehicle as it sped over rough terrain, hitting the floor and ceiling.”

In those first minutes, the shock dulled the pain. But once he reached medical care, the pain became overwhelming. At the stabilization point — a small hut without electricity — medics gave him painkillers and cleaned the wound as best they could, using only a flashlight for light.

His first surgery took place at the hospital. The anesthesia only numbed him from the waist down, so although he couldn’t feel the pain in his leg, he could hear everything — the whirring of the drill, the clinking of metal. That’s when they installed the external fixator to hold the shattered leg in place.

Since then, Mykola has undergone over 20 surgeries.

“At first, the doctors focused on treating the soft tissue. Only later could they start working on the bone. Honestly, some hospitals just gave up. They told me there was nothing they could do, that they didn’t have the right equipment. They couldn’t even recommend another place — they just left me alone with this injury.”

Thankfully, he eventually met Dr. Dmytro Haievskyi — a specialist who refused to give up. The doctor told Mykola that if they didn’t act quickly, his leg would have to be amputated. That was when he was introduced to the Ukrainian People’s Health Foundation, and became a participant in the national #SaveALimb program.

The medical team began by battling the infection deep in the wound. Now, Mykola is waiting for a critical bone graft — the missing part of his femur needs to be replaced with bioglass.

“I’m really hoping for this surgery,” he says. “It’s my chance to walk again without crutches. I dream about living a normal life again — raising my children, who have been with me and supporting me every step of the way.”

Diagnosis:

Multiple blind shrapnel wounds to the right lower limb, including a gunshot-induced fracture of the lower third of the right femur with displaced bone fragments.
Blind shrapnel wound to the soft tissues of the left foot.
Chronic post-traumatic osteomyelitis of the right femur with a segmental bone defect.

These are blind shrapnel wounds, meaning the fragments entered the body but did not exit — they remain lodged deep inside the tissues.

Main Injuries:

Fracture of the Right Femur:
The lower third of the femur — the large bone in the upper leg — was fractured by a piece of shrapnel. The break caused displacement, meaning the bone fragments are no longer aligned.
This significantly complicates treatment, as doctors not only have to heal the bone but also realign and stabilize the pieces.

Shrapnel Wound to the Left Foot:
Soft tissues — muscles, skin, and subcutaneous tissue — in the left foot were damaged by shrapnel.
This is also a blind injury, with fragments either embedded inside or passing deeply through the tissues.

Chronic Osteomyelitis of the Right Femur:
A serious long-term complication has developed: inflammation and infection in the bone tissue of the right thigh. This condition, known as osteomyelitis, often includes pain, swelling, and drainage of pus from the wound.
Additionally, part of the femur has been destroyed or lost, leaving a bone defect that requires reconstruction — typically with bone grafting or synthetic materials such as bioglass.

Clinical Plan and Surgical Treatment:

The patient underwent surgical debridement and infection control at the Center for Antiseptic Surgery. This included the cleaning of the infected bone site (called debridement) and a procedure known as BIOS — biological cleaning and stabilization of the femur.

To temporarily fill the bone defect, surgeons implanted a PMMA spacer (polymethylmethacrylate), a special type of medical cement mixed with vancomycin, a powerful antibiotic.
This spacer not only maintains the shape and structure of the damaged bone but also helps fight infection by slowly releasing the antibiotic directly into the surrounding tissues.

Next Steps:

The next phase of treatment is a bone reconstruction surgery, also known as bone grafting. This will involve filling the bone gap with Bonalive granules, a modern bioactive glass material designed to:

• Stimulate new bone growth

• Suppress bacterial infection

• Bond effectively with the patient’s natural bone

This is a critical step toward restoring the integrity and strength of the femur — and ultimately, helping the patient walk again.