Primary surgical treatment of war injuries of major joints of the limbs

We present the results of primary surgical treatment of war injuries of maj or joints in 339 patients, wounded in the territory of the former Yugoslavi a in the period June 1991-October 1995. The total number of surgically trea ted joints was 358. The injuries were inflicted by the fragments of explosi ve devices in 176 (51.9%) patients and by bullets in 125 (36.9%) patients. A single wound was present in 160 (47.2%) and several wounds in 176 (51.9%) patients; 276 (77.1%) patients had injuries of articular bone. The most fr equently injured joints were knee joint 167 (46.6%) and elbow joint 72 (20. 1%). Associated neurovascular injuries were present in 68 (18.9%) patients. Postoperative bone fragment stabilization was required in 254 (70.9%) join ts. Stabilization was by plaster of Paris in 148 (58.2%) and external fixat ion in 85 (33.4%) patients. Postoperative course was uneventful in 262 (77. 3%) while postoperative complications occurred in 77 (22.7%) patients. Ampu tations were performed in 15 (4.4%) patients. After the primary surgical tr eatment 254 (74.9%) patients were discharged and directed to rehabilitation or home care and 81 (23.9%) patients required additional reconstructive su rgery for bone and soft tissue defects. (C) 1999 Elsevier Science Ltd. All rights reserved.