Surgical treatment of a 7-year-old child with mine-blast trauma to the left shoulder and left gluteal region accompanied by penetrating abdominal injury

Treating children with gunshot-related polytrauma poses a significant challenge, both in the acute phase due to combined injuries and during reconstructive surgical treatment. The success of treatment depends on the correct management strategy—from first aid to specialized surgical rehabilitation at a Level III hospital. 

 This clinical case presents the management of a 7-year-old girl with combined mine-blast trauma to the left shoulder and left gluteal region, along with a penetrating abdominal injury. The injury occurred due to an explosion near the child. She was initially admitted to a primary hospital in Krasny Liman with the following diagnoses: mine-blast trauma, open comminuted displaced fracture of the distal third of the left humerus, penetrating shrapnel wound of the distal left shoulder, and a blind shrapnel wound in the right gluteal region. Primary surgical debridement of the left shoulder wound was performed with primary sutures and immobilization using a plaster splint. After stabilization, the child was transferred to Svatovo Central District Hospital, where the right gluteal wound was revised and packed with gauze. On the same day, she was transferred to Lugansk Regional Children’s Hospital, where the left shoulder wound underwent surgical debridement with removal of primary sutures and external fixation of the open humeral fracture using a pin-rod external fixator. For further treatment, she was airlifted to the Research Institute of Emergency Pediatric Surgery and Traumatology in Moscow, where an individualized multistage surgical treatment plan was developed. 

The correctly chosen treatment strategy not only saved the child’s life but also restored the function of the affected organs and limb segments.

The use of modern adjunctive wound treatment methods (e.g., plasma therapy, vacuum-assisted closure) allowed for rapid wound preparation for closure without infectious complications.