S. Ramez et al., PRIMARY-TREATMENT OF GUNSHOT AND EXPLOSIO N INJURIES OF THE EXTREMITIES USING THE ILISAROW TECHNIQUE, Der Unfallchirurg, 96(8), 1993, pp. 438-442
High-energy missile and explosion injuries of the upper and lower extr
emities are complex and require treatment over a long time. Following
classic strategies of surgical therapy, bone defects can be reconstruc
ted only after the injured soft tissue has healed. The callus distract
ion technique now permits the beginning of bony reconstruction at the
same time as the initial surgical debridement. During the period 1 Jul
y 1987 ot 30 June 1990, 25 grade III open fractures in 24 patients wer
e primarily treated with the Ilisarow technique at Wazir Akbar Khan Ho
spital, Kabul, Afghanistan. Twelve months after the removal of the fix
ation devices the patients were examined and the following results wer
e demonstrated: no amputations; bony, aseptic healing in 22.cases (88%
); 3 non-unions, including 2 infected non-unions; 2 axial deviations >
10-degrees. The primary initiation of bony reconstruction by callus d
istraction offers numerous advantages in the treatment of gunshot and
explosion injuries.