Experience of the treatment of combat injuries of the maxillofacial area with titanium implants in the conditions of modern war

Authors

DOI:

https://doi.org/10.14739/2310-1237.2022.2.260598

Keywords:

face, trauma, military, fracture, tracheostomy

Abstract

The aim. To research some features of a combat injury of the jaw-facial region and possible options of surgical treatment using titanium implants.

Materials and methods. We investigated clinical cases of the treatment of high-speed combat injuries of the maxillofacial area in the department of maxillofacial surgery with otolaryngological beds of Municipal Non-Commercial Enterprise “City Hospital of Emergency and Urgent Medical Care of the Zaporizhzhia City Council”.

Results. Postoperative follow-up of the patients affected by high-velocity projectile showed positive treatment outcomes in all observations.

The negative consequences of the trauma revealed in the postoperative period were persistent paralysis of facial muscles, lower jaw dysfunction with limited mouth opening, necrosis of the damaged tissues of the oral cavity, necrosis and suppuration of tissues around the wounds, formation of deforming scars and fistulas, sequestration. The most common functional disorders as a result of injury were paralysis of the facial muscles and mandibular dysfunction which were observed in 100 % of our cases.

Sequestration of the bone fragments was observed in only one case, only one patient showed all the above mentioned negative pathological consequences of high-speed trauma.

Conclusions. Our experience in the treatment of high-velocity gunshot wounds at the face leads to the conclusion that the results of the treatment and the choice of surgical tactics depend primarily on the severity of the wound and the degree of destruction of soft and bone tissues of the face. The great variety of the nature of injuries does not allow determining of a “golden standard” for final surgical treatment.

 

Author Biographies

D. V. Ivchenko, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor of the Department of Traumatology and Orthopedics

S. D. Varzhapetian, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor of the Department of Postgraduate Dentistry

O. M. Mishchenko, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Associate Professor, Head of the Department of Postgraduate Dentistry

O. V. Sydor, Zaporizhzhia State Medical University, Ukraine

Postgraduate student of the Department of Postgraduate Dentistry

Yu. M. Petrenko, Municipal Non-Commercial Enterprise “City Hospital of Emergency and Urgent Medical Care of the Zaporizhzhia City Council”, Ukraine

MD, Head of the Department of Intensive Care

Ye. V. Yatsun, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Assistant of the Department of Traumatology and Orthopedics

T. V. Strohanova, Zaporizhzhia State Medical University, Ukraine

PhD, Associate Professor of the Department of Medical Physics, Biophysics and Further Mathematics

References

Peled, M., Leiser, Y., Emodi, O., & Krausz, A. (2012). Treatment protocol for high velocity/high energy gunshot injuries to the face. Craniomaxillofacial trauma & reconstruction, 5(1), 31-40. https://doi.org/10.1055/s-0031-1293518

Jeyaraj, P., & Chakranarayan, A. (2018). Treatment Strategies in the Management of Maxillofacial Ballistic Injuries in Low-Intensity Conflict Scenarios. Journal of maxillofacial and oral surgery, 17(4), 466-481. https://doi.org/10.1007/s12663-018-1089-0

Oren, D., Dror, A. A., Zoabi, A., Kasem, A., Tzadok, L., Kablan, F., Morozov, N. G., Safory, E., Sela, E., & Srouji, S. (2021). The impact of delayed surgical intervention following high velocity maxillofacial injuries. Scientific reports, 11(1), 1379. https://doi.org/10.1038/s41598-021-80973-7

Cho, D. Y., Willborg, B. E., & Lu, G. N. (2021). Management of Traumatic Soft Tissue Injuries of the Face. Seminars in plastic surgery, 35(4), 229-237. https://doi.org/10.1055/s-0041-1735814

Bezrodnyi, B. G., Dykuha, S. O., & Kolosovich, I. V. (2020). Diagnosis and treatment of combat injuries of the heart and great vessels. Review. Medical Science of Ukraine (MSU), 16(2), 69-74. https://doi.org/10.32345/2664-4738.2.2020.12

Buryanov, O., Yarmolyuk, Y., Los, D., & Vakulych, M. (2022). Suchasni khirurhichni metody likuvannia postrazhdalykh z vohnepalnymy poranenniamy kintsivok [Modern methods of surgical treatment of victims with limb gunshot injuries]. Trauma, 18(2), 30-35. [in Ukrainian]. https://doi.org/10.22141/1608-1706.2.18.2017.102555

Moriscot, A., Miyabara, E. H., Langeani, B., Belli, A., Egginton, S., & Bowen, T. S. (2021). Firearms-related skeletal muscle trauma: pathophysiology and novel approaches for regeneration. NPJ Regenerative medicine, 6(1), 17. https://doi.org/10.1038/s41536-021-00127-1

Jeffery S. L. (2016). The Management of Combat Wounds: The British Military Experience. Advances in wound care, 5(10), 464-473. https://doi.org/10.1089/wound.2015.0653

Volk, A. S., Shokri, T., Sokoya, M., Ducic, Y., & Hollier, L. H., Jr (2019). Facial Gunshot Wounds. Facial plastic surgery : FPS, 35(6), 578-583. https://doi.org/10.1055/s-0039-1700879

Breeze, J., Gensheimer, W., & DuBose, J. J. (2020). Combat Facial Fractures Sustained During Operation Resolute Support and Operation Freedom's Sentinel in Afghanistan. Military medicine, 185(9-10), 414-416. https://doi.org/10.1093/milmed/usaa159

Mardassi, A., Turki, S., Mbarek, H., Hachicha, A., Chebbi, G., Benzarti, S., & Abouda, M. (2016). Management of combat-related facial injuries. La Tunisie medicale, 94(12), 856.

Published

2022-08-22

How to Cite

1.
Ivchenko DV, Varzhapetian SD, Mishchenko OM, Sydor OV, Petrenko YM, Yatsun YV, Strohanova TV. Experience of the treatment of combat injuries of the maxillofacial area with titanium implants in the conditions of modern war. Pathologia [Internet]. 2022Aug.22 [cited 2024Apr.20];19(2):154-9. Available from: http://pat.zsmu.edu.ua/article/view/260598

Issue

Section

Case Reports