Circumstances of the Injury:

During an assault on enemy positions, the area came under intense fire from artillery, mortars, and FPV drones. In the chaos, I sustained a through-and-through gunshot shrapnel wound to my right shoulder, resulting in a comminuted fracture of the mid-third of the right humerus with bone tissue loss. I remained conscious, and a comrade applied a tourniquet.

Diagnosis:

• Gunshot and shrapnel injury to the right shoulder with a comminuted fracture of the right humerus and bone tissue defect.

Details of the Injury:

1. Gunshot and shrapnel wound:
   • A complex injury caused by the impact of a projectile or shrapnel, damaging the bone, surrounding muscles, blood vessels, and potentially nerves.
2. Comminuted fracture of the humerus:
   • The bone is broken into multiple fragments with significant misalignment and loss of structural integrity.
3. Bone tissue defect:
   • Partial bone loss due to the trauma, complicating natural healing and requiring surgical intervention to restore the bone.

Clinical Plan:

Internal Fixation with a Locking Intramedullary Nail:

1. Metal osteosynthesis:
   • A surgical procedure to stabilize bone fragments using internal fixation methods, ensuring proper alignment and stability for healing.
2. Intramedullary technique:
   • A specialized nail is inserted into the bone’s medullary canal to provide internal support.
   • This method minimizes additional damage to surrounding tissues and allows for more natural healing dynamics.
3. Locking osteosynthesis:
   • The nail is secured with locking screws at both ends, enhancing stability and preventing further displacement of bone fragments.
   • This approach is particularly effective for fractures with significant bone loss, as it supports weight-bearing and facilitates functional recovery.