How the Injury Occurred:

On July 1, 2024, during a combat mission to advance toward enemy positions, Vasyl came under heavy mortar fire. One of the shrapnel fragments struck his limbs, causing a severe injury. Despite the fear for his health and the risk of losing his leg, Vasyl remained determined and active until he received first aid.

Diagnosis:

• Gunshot shrapnel injury (GSI) to the right tibia with a comminuted fracture of the midshaft (middle third).

Gunshot Shrapnel Injury (GSI):

• Caused by firearms or explosive devices, resulting in damage to both soft tissues and bone structures.
• Open wounds from such injuries carry a high risk of infection, requiring urgent medical intervention.

Comminuted Fracture:

• The bone is fractured into multiple fragments, complicating treatment and recovery.
• Accompanied by displacement of bone fragments, disrupting the leg’s natural alignment and weight-bearing function.

Location:

• The injury is localized in the middle third of the tibia, the main weight-bearing bone of the lower leg.

Clinical Solution:

Closed Reduction and Biological Osteosynthesis (BIOS) of the Comminuted Tibial Fracture:

1. Closed Reduction:
   • Non-surgical realignment of bone fragments without cutting through soft tissue.
   • Manual or mechanical techniques are used to restore the natural anatomical position of the fragments.
2. Biological Osteosynthesis (BIOS):
   • A modern surgical approach that minimizes disruption to soft tissues and the blood supply around the bone.
   • Fracture stabilization using specialized implants, such as:
     • Intramedullary nails (rods) inserted into the bone canal.
     • Plates and screws to secure the bone fragments externally.
   • BIOS promotes natural bone healing by maintaining biological integrity and reducing surgical trauma.