Сase report of multimodal approach during reconstruction of gunshot defects the soft tissue of the forearm and wrist

Abstract

According to the literature, gunshot extremities wounds are most frequent among combat trauma and affect up to 62.2% of the patients. The total rate of gunshot upper extremities wounds is high too – near of 25.7% [1], in particular during local military conflicts. Provision of effective medical tactics allow to return the serviceman to service and expand the reserve of experienced personnel in Armed Forces. The forearm–hand area has a high functional value. It contains a large number of mobile anatomical elements, the complex structure of connective tissue, vascular and nervous structures. In this regard, the treatment of damage to this area is a significant clinical problem that requires a long and hard work. At the same time, active surgical tactics to accelerate the restoration of anatomical – functional integrity of the upper extremity [1–9] is necessary, as the complexity and fragility of the anatomical structure cause significant limitation of hand function even due to minor, at first glance, scarring.