Keywords
elbow joint
distal metaepiphysis of the humerus
soft tissue defect
gunshot fracture
reconstructive surgery
soft tissue reconstruction
How to Cite
Abstract
Summary. Combat-related surgical injuries of the elbow joint are a significant issue in modern warfare, as they involve damage to bone structures, nerves, and soft tissues, complicating their treatment and rehabilitation. This study presents a retrospective analysis of 30 patients with gunshot injuries to the elbow joint who were treated at the Severe Polystructural Trauma Department between 2022 and 2025. The mean age of the patients was 35.0 ± 9.1 years. Upon admission, 20 patients (69.0%) already had an external fixation device applied to the humerus and forearm. Bony defects of the distal epiphysis of the humerus were diagnosed in all 30 patients, including 12 (40.0%) – with a lateral condyle defect, 11 (36.7%) – with a medial condyle defect, and 7 (23.3%) – with massive condylar defects. Soft tissue defects requiring flap closure were found in 13 patients (44.83%). Neural structure damage was identified in 18 patients (62.07%), including 12 cases (41.38%) of ulnar nerve injury, 8 (27.59%) – of radial nerve injury, 4 (13.79%) – with combined ulnar and radial nerve injury, and 5 (17.24%) – with injury to all three nerves. Restoration of anatomical structures and function of the elbow joint was performed through soft tissue defect closure using flaps, humeral condyle reconstruction with autografts from the iliac crest, and subsequent rehabilitation according to international protocols. The Liverpool Elbow Score was used to assess elbow joint function and treatment effectiveness both before surgery and two months after reconstruction, allowing for evaluation of the degree of functional recovery.
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