Analysis of the practical application of surgical treatment technologies in victims with long bone defects depending on the size of the defect

Background. The most common injuries resulting from high-energy trauma are limb injuries, which are often accompanied by both large defects of both soft tissues and long bone defects. The purpose was to study and evaluate the use of surgical treatment technologies for victims with long bone defects depending on the size of the defect. Materials and methods. The study included 115 cases of long bone defects in patients who were injured as a result of modern hostilities on the territory of Ukraine from 2022 to 2024. Calculations were carried out in accordance with the criteria and requirements of evidence-based medicine. The research was conducted in compliance with the requirements of the Declaration of Helsinki, approved by the Bioethics Commission of the State Educational Institution “Ukrainian Scientific and Practical Center of Emergency Medical Care and Disaster Medicine of MHU”. Results. It was found that in the general mass of victims, defects with sizes of 5–9.99 and 10.0–14.99 cm prevail (41.31 and 26.09 %, respectively), the smallest proportion is made up of bone defects larger than 20 cm (2.17 %). Also, the largest proportion is accounted for by such technologies of surgical treatment of bone defects as bone transport (antegrade, retrograde) — 51.09 % and Masquelet technique — 27.17 %. The choice of surgical method probably depends on the size of the bone defect. Masquelet technique was more widely used for defects of long bones up to 10 cm, and bone transport technologies are the method of choice for larger defects. Conclusions. 1. The choice of specific surgical treatment technology for victims with long bone defects due to combat trauma obviously depends on the size of the defect. 2. The Masquelet surgical treatment technique is the method of choice for long bone defects up of to 5 cm and the relative method of choice for those with a size of 5–10 cm. Bone transport and length correction are the method of choice for defects larger than 10 cm. 3. Effective treatment of victims with long bone defects requires an organic combination of classical and modern surgical treatment technologies. At the same time, there is an urgent need to develop modern surgical technologies for large long bone defects.