PRIMARY-TREATMENT OF GUNSHOT AND EXPLOSIO N INJURIES OF THE EXTREMITIES USING THE ILISAROW TECHNIQUE

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.