Circumstances of Injury:

On May 10, 2024, during a battle near Kharkiv, Dmytro sustained a severe machine gun injury. Despite the challenging circumstances, he remained grateful to have survived. His resilience and inner strength helped him endure this difficult moment.

Diagnosis:

• Multiple Explosive Trauma (May 10, 2024):
  • High-energy injury affecting both soft tissues and bones, often associated with significant blood loss and infection risk.
• Gunshot Shrapnel Injury to the Right Thigh:
  • Soft tissue damage and penetration of shrapnel or bullets affecting the femur.
  • Often involves vascular or nerve damage.
• Comminuted Fracture of the Middle-Lower Third of the Femur:
  • The femur is broken into multiple fragments with displacement, requiring complex surgical intervention.
• External Fixation Apparatus (May 10, 2024):
  • Temporary stabilization of the femoral fracture to prevent further injury and allow access for wound care.

Clinical Decision:

1. Closure of Soft Tissue Defects:

• Surgical intervention to close the wound and protect it from infection:
  • Primary Suturing: If sufficient healthy tissue is available.
  • Plastic Reconstruction: Using local or transferred flaps to cover the defect.
  • Skin Grafting: For large defects, skin autografts may be utilized to ensure proper wound closure.

2. Transition to Traction Device for Right Lower Limb:

• Application of a traction system to:
  • Maintain proper alignment of bone fragments.
  • Reduce strain on damaged structures.
  • Prepare the injury site for further surgical interventions or final treatment.