Algorithm for the treatment of patients with gunshot wounds to the elbow joint

Résumé fourni par la source

Introduction. The treatment of patients with gunshot wounds to the elbow joint (GWEJ) is a complex clinical task due to the anatomical features of this area. The elbow joint (EJ), as a complex anatomical structure, combines three articulations, which determines its high functional significance. The superficial localization of the EJ predetermines a high probability of complex damage in gunshot wounds, including the involvement of bone, muscle-tendon complexes, as well as critically important vascular-nerve structures. The lack of a unified classification of post-gunshot bone defects that form the EJ and regulated clinical algorithms creates significant difficulties in providing specialized care. Objectives. Based on the analysis of the medium-term results of treatment in patients with GWEJ and available radiographs, to present a classification of gunshot bone defects and an algorithm for treating patients with this pathology. Material and methods. The study included treatment results of 135 patients with GWEJ, and analyzed radiographs of 140 patients treated at the Traumatology and Orthopedics Center of the N.N. Burdenko Main Military Clinical Hospital of the Ministry of Defense of the Russian Federation in the period from 2022 to 2025. Results. In order to standardize and determine indications for various treatment methods, a classification of post-gunshot bone defects forming the EJ and an algorithm for treating patients with GWEJ were developed. Conclusions. The obtained mid-term treatment results demonstrate sufficient clinical significance of the specified algorithm, enabling rational choice of surgical tactics based on the initial objective data. It should be emphasized that the proposed classification and treatment algorithm are open-ended and can be subject to modernization in parallel with the development of reconstructive surgery technologies.

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