Primary surgical treatment of war injuries of major joints of the limbs.

We present the results of primary surgical treatment of war injuries of major joints in 339 patients, wounded in the territory of the former Yugoslavia in the period June 1991-October 1995. The total number of surgically treated joints was 358. The injuries were inflicted by the fragments of explosive devices in 176 (51.9%) patients and by bullets in 125 (36.9%) patients. A single wound was present in 160 (47.2%) and several wounds in 176 (51.9%) patients; 276 (77.1%) patients had injuries of articular bone. The most frequently injured joints were knee joint 167 (46.6%) and elbow joint 72 (20.1%). Associated neurovascular injuries were present in 68 (18.9%) patients. Postoperative bone fragment stabilization was required in 254 (70.9%) joints. Stabilization was by plaster of Paris in 148 (58.2%) and external fixation in 85 (33.4%) patients. Postoperative course was uneventful in 262 (77.3%) while postoperative complications occurred in 77 (22.7%) patients. Amputations were performed in 15 (4.4%) patients. After the primary surgical treatment 254 (74.9%) patients were discharged and directed to rehabilitation or home care and 81 (23.9%) patients required additional reconstructive surgery for bone and soft tissue defects.