Abstract
BACKGROUND: The ongoing Russo-Ukrainian war has resulted in significant gunshot injuries, particularly to the bones, necessitating innovative surgical approaches to address severe bone defects. The aim of the study was to investigate and evaluate the effectiveness of using individual 3D-printed titanium grids for the treatment of patients with gunshot fractures associated with the formation of large bone defects received on the battlefield of the Russo-Ukrainian war. METHODS: This study investigates the efficacy of individualized 3D-printed titanium grid scaffolds for treating segmental bone defects in 13 male patients, all of whom sustained injuries on the battlefield between 2022 and 2023. Radiological evaluations, including X-rays and computed tomography scans, facilitated precise measurement of bone defects and guided surgical planning. RESULTS: Clinical observations indicated that gunshot injuries predominantly affected the upper and lower extremities, presenting with complex bone defects exceeding 5 cm. The results revealed that 3D-printed titanium scaffolds not only provided structural support but also enhanced bone regeneration in cases of significant defects. Complications such as joint contractures were observed, emphasizing the need for tailored rehabilitation strategies. The application of 3D technology in this context highlights its potential to improve patient outcomes in war-related orthopedic trauma, especially when traditional methods may be inadequate. CONCLUSIONS: This study underscores the importance of adopting advanced technologies in military medicine, reflecting a shift towards patient-centered care and innovative surgical solutions in challenging combat environments. Severe defects of the long bones are frequent in warfare. 3D printed titanium grid scaffolds might be considered for bone reconstruction in selected patients without severe osteomyelitis or other severe infection in the gunshot wound area. The application of 3D titanium grid scaffolds is associated with accurate preoperative planning, good replacement of large bone defects, and improved rehabilitation process.