Circumstances of the Injury:

On September 17, 2023, during a combat mission, Oleksandr was involved in an assault when intense mortar shelling began. A nearby explosion scattered shrapnel, severely injuring his limbs, abdomen, neck, and face. Upon regaining consciousness, Oleksandr realized he was unable to help himself. Despite his critical condition, he managed to call for assistance via radio. His comrades quickly provided first aid and evacuated him to safety.

The pain became excruciating during the evacuation, and it became evident that one of his limbs had suffered significant damage, with a severe injury to his knee from the explosion.

Diagnosis:

Multiple Blast Injuries (MBI):

• Infected soft tissue defect on the anteromedial surface of the upper third of the shin.
  • A large open wound with infection, involving skin, subcutaneous tissue, and muscle, complicates the healing process.
• Fracture of the proximal tibia with extensive bone tissue loss.
  • Significant destruction of the bone in the upper third of the shin, including partial bone loss, making regeneration more challenging.
• Post-compartment syndrome condition.
  • A complication where increased pressure within muscle compartments disrupts blood flow and nerve function, requiring emergency surgical intervention to prevent tissue necrosis.

Clinical Plan:

Surgical Treatment Performed:

• Metal Osteosynthesis (MOS): Stabilization of the tibial fracture with a metal plate.
• Bone Defect Management: The area of missing bone tissue was filled with a cement spacer.

Future Plan:

• Replacement of the cement spacer with bone grafting to restore structural integrity and support the healing process.