title: [External fixation in the treatment of shooting proximal humeral fracture with bone defect: a case report].
abstract: BACKGROUND
  Shooting injuries of shoulder with destruction of proximal humerus are rare and severe orthopaedic injuries.
  
  
  METHODS
  A 74-year-old patient was wounded at close range by a shotgun. He was wounded in the left shoulder and suffered a massive defect of the proximal humerus and soft tissue. The neurocirculatory finding of the injury extremity was normal. After a short resuscitation, x-ray of the thorax and the left shoulder registered a complete destruction of humeral head. After the primary treatment of the wound under general endotracheal anesthesia, the shoulder was stabilized with an external fixator type Mitkovic, with convergent orientation of the pins, where two pins were placed in the neck of scapula and two in the humeral shaft, because the left scapular acromion was fractured by shotgun projectiles.
  
  
  CONCLUSIONS
  After radical wound debridement, external fixation is the method of choice for shoulder stabilisation in shooting injury of shoulder with bone defect. If this is not possible, pins of the left external skeletal fixator should be placed into the coracoid process and acromion. The pins can be also placed into the humeral shaft, as done in the presented case, and by which a good stability of the injured proximal humerus, easy approach to the wound for bandaging and reconstructive surgery can be achieved.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Golubović
authors.forename: Zoran
authors.initials: Z
authors.lastname: Vukašinović
authors.forename: Vojkan
authors.initials: V
authors.lastname: Stanić
authors.forename: Saša
authors.initials: S
authors.lastname: Stojanović
authors.forename: Predrag
authors.initials: P
authors.lastname: Stojiliković
authors.forename: Danilo
authors.initials: D
authors.lastname: Stojiliković
authors.forename: Ivan
authors.initials: I
authors.lastname: Golubović
authors.forename: Ivan
authors.initials: I
authors.lastname: Micić
authors.forename: Zoran
authors.initials: Z
authors.lastname: Radovanović
authors.forename: Igor
authors.initials: I
authors.lastname: Kostić
mesh_terms: D000368:Aged; D016267:External Fixators; D005592:Fracture Fixation; D018460:Fractures, Comminuted / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D012784:Shoulder Fractures / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D014948:Wounds, Gunshot / Q000150:complications / Q000473:pathology / Q000601:surgery*