Circumstances of the Injury:

During a combat mission, Mykhailo sustained a gunshot wound. In the initial moments after falling, he had a single thought: this is the end.

When he regained consciousness, a new fear emerged — the fear of losing his arm.

Diagnosis:

• Gunshot shrapnel wound to the right shoulder with a gunshot fracture of the proximal third of the right humerus, vascular and nerve bundle damage, and a soft tissue defect.

Key Details:

1. Bone:
   • The upper portion of the humerus is fractured into multiple fragments.
   • The bone fragments are displaced from their natural position.
2. Vascular Damage:
   • Major blood vessels in the affected area are damaged, compromising blood supply to the arm.
   • This could result in poor circulation and potential tissue death in the affected limb.
3. Nerve Damage:
   • Nerves running through the shoulder that control sensation and movement in the arm have been injured.
   • This may lead to weakness, reduced control, or even partial loss of function in the arm.
4. Soft Tissue:
   • Muscles, skin, and subcutaneous tissues are damaged, with some tissue loss creating a defect that requires reconstruction.

Clinical Plan:

Metal Osteosynthesis (MOS) of the Shoulder with Bone Defect Reconstruction Using Bioactive Glass.           

Treatment Steps:

1. Metal Osteosynthesis (MOS):
   • Surgical stabilization of the fractured humerus using metal implants (e.g., plates, screws, or intramedullary rods).
   • Ensures proper alignment of bone fragments and promotes healing.
2. Bioactive Glass Reconstruction:
   • Bioactive glass is used to fill the bone defect, providing structural support and encouraging natural bone regeneration.
   • This advanced material integrates with existing bone tissue, gradually stimulating the formation of new bone while maintaining mechanical stability.