Circumstances of Injury:

During a combat mission, while Oleg was stationed at his position, the enemy launched a mortar attack. One of the explosions caused severe injuries to Oleg. His comrades immediately came to his aid, carried him out of the danger zone, and arranged for his evacuation to medical personnel.

Diagnosis:

• Multiple Fragmentation Trauma (MFT) sustained on 20.08.2023:
  • Combined fragment wounds of the chest, spine, and limbs.
  • Delayed-union comminuted fracture of both bones of the left shin:
    • Fragment displacement and bone tissue defect.
  • Penetrating through-and-through chest wound.
  • Blind penetrating spinal wound at the T11-T12 vertebrae:
    • Marginal fracture of the posterior-inferior body of the T11 vertebra on the right.
    • Spinal cord injury with an intracanally located metal fragment at the level of the left arch root of the T12 vertebra.
    • Perforated fracture of the T12 vertebral body.
    • Severe lower paraplegia with impaired motor and sensory function of the lower limbs.
    • Dysfunction of pelvic organs (central type).

Clinical Plan:

1. Osteotomy of the Malunion of Both Left Tibial Bones:
   • Surgical resection of incorrectly healed bone to restore anatomical alignment.
   • Prepares the site for proper fixation and healing.
2. Bone Defect Replacement with Two Portions of Bioglass:
   • Bioglass:
     • Bioactive material promoting bone tissue regeneration.
     • Mechanically integrates with existing bone for stability.
     • Stimulates new bone growth to accelerate healing.
3. Ankle Joint Arthrodesis with Zimmer Rod:
   • Arthrodesis:
     • Surgical fusion of joint surfaces to restore limb stability and functionality.
     • Essential for cases with severe damage or instability of the joint.
   • Zimmer Rod:
     • Provides robust fixation for long-term structural support.
     • Ensures stability for weight-bearing and walking after rehabilitation.