Upper Extremity War Injuries: Syrian Patients

Abstract

Damage control orthopedics (DCO) has evolved as an approach to minimize the impact of primary surgery, and it should be regarded as part of resuscitation. The impact of fracture stabilization is minimized.

Primary and major procedures of greater than 6 h duration at days 2–4 should be avoided (Hildebrond et al., Injury 35, 2004).

DCO appears to provide a major reduction of operation time and blood loss in the primary treatment period in severely injured patients.

DCO is not associated with an increased rate of procedure-related complications (George, J Trauma Injury Infect Crit Care 59, 2005).

Several surgical procedures are required to provide soft tissue coverage and maximum possible recovery.

Staged reconstruction usually gives fair to good results.

After nerve injuries, spontaneous recovery of inactive nerves in continuity is expected in 70% of gunshot wounds within 3–9 months and 85% of fracture dislocation within 1–4 months.

Successful epineural suture has less encouraging results rated 44% of laceration and 25% of gunshot wounds.

Nerve suture is most successful when patient is less than 20 years old [3].