Circumstances of Injury:

“I stayed conscious — and focused on one thing: surviving.”

On August 7, 2024, during a combat mission, I came under heavy fire.
I was holding my position when a combined attack began — FPV drones and artillery at the same time. One of the blasts sent shrapnel into my shoulder. I knew right away the bone was shattered.

Even with the injury, I stayed alert. I pulled myself to a safer spot, and a fellow soldier helped pack the wound. I barely felt the pain — probably thanks to the adrenaline.

Later, I was evacuated to a stabilization point.

I never thought I’d lose the arm. I just kept repeating one thing to myself: survive, endure, come back.

Diagnosis:

As a result of a blast injury sustained on August 7, 2024, the soldier suffered a complex gunshot wound to the right shoulder. Shrapnel shattered the upper part of his humerus (upper arm bone), causing a large bone defect — part of the bone was destroyed.

Despite treatment, a serious complication developed: chronic post-traumatic osteomyelitis — a deep, infected inflammation of the bone. The infection progressed to an active draining stage, forming channels (called fistulas) through which pus exits the body. This condition is dangerous and requires multiple complex surgeries and long-term treatment.

To control the infection, doctors implanted a temporary cement spacer — a medical device filled with antibiotics that replaces the missing bone segment and helps preserve the structure of the joint during the healing process.

Additionally, he developed a joint contracture — limited mobility of the shoulder due to scar tissue, muscle damage, and adhesions. His arm can no longer fully extend or lift.

Clinical Decision:

The patient requires a multi-stage reconstructive surgery, as the injury resulted in significant bone loss, infection, and damage to the surrounding soft tissues.

Stage One includes:

• Removing damaged scarred tissue from the shoulder area — where the skin and deltoid muscle have hardened and lost function due to the trauma. Surgeons will replace it with a free thoracodorsal muscle flap — a healthy piece of muscle and skin taken from the patient’s back. This helps restore soft tissue and improves the chances of proper healing.

• Implanting a cement spacer — a temporary device that replaces the destroyed head of the humerus (upper arm bone). The spacer holds the shape of the joint, contains antibiotics, and plays a key role in controlling infection until permanent reconstruction can be done.