Long bone defects in victims with modern combat trauma. Risk-based determination of the need for soft tissue plastic surgery depending on the size and location of the bone defect, Дефекти довгих кісток у постраждалих із сучасною бойовою травмою. Ризикорієнтовне визначення потреби в пластиці м’яких тканин залежно від розміру та локалізації кісткового дефекту

<jats:p>Background. Modern combat trauma of the extremities is characterized by a significant amount of damage to both bones and soft tissues. Bone defects are one of the most severe and common complications of modern combat trauma of the extremities. Such injuries are accompanied by significant soft tissue defects. The purpose was to evaluate the necessity and feasibility of soft tissue plastic surgery in victims with long bone defects due to modern combat trauma. Materials and methods. This retrospective cohort research is based on the study and analysis of 141 cases of limb injuries due to modern combat trauma with the presence of long bone defects. The inclusion criterion was the presence of combat damage to the limbs with defects of long bones and soft tissues. Results. The study found that the vast majority of victims (68.09 %) with long bone defects caused by combat trauma require surgical interventions for soft tissue plastic surgery. It was revealed that the soft tissue plastic surgery was mostly required in victims with long bone defects measuring 5–9.99 cm (42.71 % of victims by the specific weight in this group), and the least soft tissue plastic surgery was required by patients with long bone defects of up to 5 cm (5.21 %). A trend towards increasing need for soft tissue plastic surgery with increasing bone defect size has been established. Starting from a bone defect size of more than 5 cm, the risk of the need for soft tissue plastic surgery is catastrophic in terms of qualitative characteristics, and up to 5.0 cm, it is significant. It was also found that the greatest need for surgical interventions for the purpose of soft tissue plastic surgery was in victims with defects in the tibia (83.87 %) and forearm (75.00 %) bones, and the least need was in victims with defects in the femur bone caused by combat trauma (12.00 %). It has been proven that the size and location of the bone defect are risk factors in terms of the need for surgical interventions for soft tissue plastic surgery. Conclusions. 1. The size and location of the bone defect are risk factors for the need for soft tissue plastic surgery in victims with long bone defects as a result of modern hostilities. 2. The clinical outcome risk of the need for soft tissue plastic surgery in victims with long bone defects resulting from modern warfare is significant for sizes up to 5 cm and catastrophic for sizes over 5 cm, which determines the relative or absolute indications for soft tissue plastic surgery, respectively. 3. The clinical outcome risk of the need for soft tissue reconstruction is catastrophic for defects of the shoulder, forearm, and lower leg and is insignificant for defects of the hip. This also determines the absolute or relative indications for soft tissue reconstruction.</jats:p>