Medical and surgical management of lower extremity war-related injuries. Experience of the French Military Health Service (FMHS)

Baus, A.; Bich, C.-S.; Grosset, Antoine; Rousiers, Arnaud de; Duhoux, A.; Brachet, M.; Duhamel, P.; Thomas, Marie; Rogez, D.; Laurent, Michel; Bey, E.

doi:10.1016/j.anplas.2020.05.008

Cited by 9 publications

(5 citation statements)

References 45 publications

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“…1). In this context of care, the IMT matches perfectly with such consecutive reconstructive procedures [5,11].…”

Section: Introductionmentioning

confidence: 73%

“…The reconstruction of segmental bone defects remains a challenge for military orthopedic surgeons, especially in cases of missile or blast injuries characterized by a high proportion of multi-tissue and infected defects [1][2][3][4][5]. Treatment modalities include techniques such as autologous bone graft (ABG), bone transport, vascularized bone transfer, and the two-stage Masquelet induced membrane (IM) technique (IMT; Table 1) [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…The IMT presents strong advantages because it requires no sophisticated equipment or microsurgical skills to perform and has a healing time almost independent of the defect length [3]. This simplicity makes it particularly adapted to bone reconstruction in military practice, especially in current high-intensity warfare where patients cannot be evacuated from the combat zone or present with multiple associated injuries [2,3,5,10].…”

Section: Introductionmentioning

confidence: 99%

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Masquelet technique in military practice: specificities and future directions for combat-related bone defect reconstruction

Mathieu

Mourtialon

Durand³

et al. 2022

Military Med Res

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Because of its simplicity, reliability, and replicability, the Masquelet induced membrane technique (IMT) has become one of the preferred methods for critical bone defect reconstruction in extremities. Although it is now used worldwide, few studies have been published about IMT in military practice. Bone reconstruction is particularly challenging in this context of care due to extensive soft-tissue injury, early wound infection, and even delayed management in austere conditions. Based on our clinical expertise, recent research, and a literature analysis, this narrative review provides an overview of the IMT application to combat-related bone defects. It presents technical specificities and future developments aiming to optimize IMT outcomes, including for the management of massive multi-tissue defects or bone reconstruction performed in the field with limited resources.

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“…1). In this context of care, the IMT matches perfectly with such consecutive reconstructive procedures [5,11].…”

Section: Introductionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Masquelet technique in military practice: specificities and future directions for combat-related bone defect reconstruction

Mathieu

Mourtialon

Durand³

et al. 2022

Military Med Res

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“…Морфологія переломів кісток є також атиповою та нехарактерною для цивільної травми й не може класифікуватися стандартно. Ця унікальність ушкоджень значно ускладнює реалізацію плану порятунку кінцівки, вимагаючи ретельного передопераційного планування [2]. Рання, агресивна обробка рани й іригація є наріжним каменем в лікуванні важких відкритих переломів [3].…”

Section: вступunclassified

“…Найпоширенішим під час лікування пацієнтів із бойовою травмою є етапний підхід. Так, згідно з концепцією служби військової медицини Франції, у разі бойової травми нижньої кінцівки необхідно дотримуватися принципу збереження («три З») -життя, кінцівка, функції [2]. Доктрина реконструкції базується на правилі 6/7/8/9, відповідно до якого розроблені стратегії відновлення м'яких тканин і втраченої кістки: санація вогнища впродовж 6 год., відновлення м'яких тканини та/або покриття кістки протягом 7 днів, остеосинтез та/або реконструкція пустот у кістці через 8 тижнів, задля досягнення функціонального відновлення через 9 міс.…”

Section: результати та їх обговоренняunclassified

Experience of the Segmental Bone Defects' Treatment for Patients With Combat Trauma Using the Method of Distraction Osteogenesis

Hariyan,

Tsybulskyi,

Makhovskyi

et al. 2024

OTP

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Upper and lower limb injuries resulting from battlefield trauma is a complex multidisciplinary problem. Efficacy of the treatment of segmental bone defects in patients with combat trauma is a subject of analysis for improving its results. Purpose. An analysis of the modern treatment strategies of the segmental bone defects in patients with battlefield trauma under conditions of distraction osteogenesis (based on data available in the literature and own clinical experience). Methods. Analytical review of scientific works and analysis of treatment results of 39 patients with segmental bone defects associated with battlefield trauma and treated using distraction osteogenesis were conducted. Results. Patients with segmental limbs defects require special attention of a multidisciplinary team of specialists to identify reconstructive opportunities to save the limb. Distraction osteogenesis — is an effective method of treating of segmental fractures and shortening of the limbs, infectious complications that led to bone defect formation. Bone transport with ring external fixator (ExFix) is considered as a classical method. Authors analyzed and illustrated with three clinical cases their own results of application of different distraction osteogenesis technique. Conclusions. Different types of ExFix can be applied independently or in combination with internal fixators. The use of an intramedullar nail along which distraction osteogenesis is carried out allows to provide better control of the axis of the limb and transported fragment, reduce the residence time in the ExFix, and, moreover, external fixation devices with a simpler configuration can be used. Transport along the plate allows to maintain proper axial relationships in the presence of short periarticular fragments and improve the quality of fixation but it also increases the risks of FRI and re-operations.

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Challenges and solutions for reconstruction of combat extremity injuries encountered during high-intensity warfare

Mathieu,

Durand,

de L’escalopier

et al. 2024

Eur J Trauma Emerg Surg

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Medical and surgical management of lower extremity war-related injuries. Experience of the French Military Health Service (FMHS)

Cited by 9 publications

References 45 publications

Masquelet technique in military practice: specificities and future directions for combat-related bone defect reconstruction

Masquelet technique in military practice: specificities and future directions for combat-related bone defect reconstruction

Experience of the Segmental Bone Defects' Treatment for Patients With Combat Trauma Using the Method of Distraction Osteogenesis

Challenges and solutions for reconstruction of combat extremity injuries encountered during high-intensity warfare

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