title: Nature and results of treatment of war wounds caused by cluster bombs.
abstract: The aim of this study is to describe the nature of war wounds with fracture caused by cluster bombs and to suggest treatment options for such injuries. The nature of wounds caused by cluster bombs differs from those caused by conventional arms (they are more severe). The sides of the wounds are represented by conquasated soft tissues (such as fat and muscle) with thick dead tissues, ordinarily with a thickness of 0.5-4.5 cm. Another main characteristic of such injuries is the high percentage of amputations needed due to the high rate of neurovascular damage. This paper investigates the cases of 81 patients who sustained a total of 99 war wounds with fractures. The average age of the patients was 32.7 years while the youngest was 20 and the oldest, 77. According to The International Committee of the Red Cross (ICRC) classification of war wounds, 14 patients had grade I injuries, 48 patients grade II, and 29 patients, grade III. Mitkovic external fixation system, known also as the "War Fixator" was used for all fractures fixation. One protocol, which was a modification of the ICRC's protocol adapted to our specific conditions, was used throughout the study. For solving soft tissue defects, a rotator fasciocutan flap was the most frequently used. For solving of bones defect Mitkovic reconstructive external fixation device was used. All fractures we treated healed. We concluded that shortening the procedural time and being a very simple, immediate using of Mitkovic versatile external fixator ("War Fixator") is, leads to desirable results.
authors.affiliation: Orthopaedic and Traumatology Clinic, Clinical center, University of Nis, Serbia.
authors.forename: Milorad
authors.initials: M
authors.lastname: Mitković
authors.forename: Marko
authors.initials: M
authors.lastname: Bumbasirević
authors.forename: Predrag
authors.initials: P
authors.lastname: Grubor
authors.forename: Sasa
authors.initials: S
authors.lastname: Milenković
authors.forename: Ivan
authors.initials: I
authors.lastname: Micić
authors.forename: Predrag
authors.initials: P
authors.lastname: Stojiljković
authors.forename: Igor
authors.initials: I
authors.lastname: Kostić
authors.forename: Sasa
authors.initials: S
authors.lastname: Karaleić
authors.forename: Sonja
authors.initials: S
authors.lastname: Stamenić
authors.forename: Predrag
authors.initials: P
authors.lastname: Pavlović
authors.forename: Milos
authors.initials: M
authors.lastname: Stanojlović
authors.forename: Vladimir
authors.initials: V
authors.lastname: Jovanović
authors.forename: Zoran
authors.initials: Z
authors.lastname: Radovanović
authors.forename: Tamara
authors.initials: T
authors.lastname: Cirić
authors.forename: Katarina
authors.initials: K
authors.lastname: Kutlesić-Stojanović
authors.forename: Milan
authors.initials: M
authors.lastname: Mitković
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D001753:Blast Injuries / Q000601:surgery*; D054042:Bombs; D003646:Debridement; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D050723:Fractures, Bone / Q000601:surgery*; D005597:Fractures, Open / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000601:surgery*; D055771:Serbia; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps; D015599:Trauma Severity Indices; D014857:Warfare; D055815:Young Adult