{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T10:58:46Z","timestamp":1773658726865,"version":"3.50.1"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,10,22]],"date-time":"2023-10-22T00:00:00Z","timestamp":1697932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The care of tibial traumatic fractures brought on by shelling injuries is extremely difficult, as these fractures are frequently comminuted, leading to a bone defect, extensive soft tissue damage, and an increased risk of bacterial contamination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A 13-year-old male presented with trauma to the right leg following a shelling injury. He had a Gustilo IIIa open fracture with soft tissue destruction and a 7.5 cm bone loss in the distal region of the tibial shaft. Neurovascular exams were unremarkable. Primary treatment by external fixation, wound debridement, and simple suture closure was achieved. After the external fixator was removed, distraction osteogenesis was performed to deal with the bone loss. The surgical technique chosen was transport over a flexible intramedullary nail. By the end of both distraction and consolidation phases, the patient was healed with no complications, deformities, or length discrepancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>The objective of treating tibial shelling wounds is to restore functionality and save the patient's life and limb. Neurovascular evaluation, early bone fixation, and wound care are the basic treatment. Many techniques of distraction osteogenesis can be used to restore bone loss. With lower external fixation time and complications, transport over a nail is an important one. However, using a rigid intramedullary nail in children is contraindicated, so a flexible one was used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this case report, we highlight the value of proper management of open leg fractures and the importance of restoring bone loss to improve the quality of life for war victims, particularly children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2023.108990","type":"journal-article","created":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T20:31:01Z","timestamp":1698352261000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Transport over a flexible nail to treat a tibial defect caused by shelling injury"],"prefix":"10.1097","volume":"112","author":[{"given":"Maher","family":"Badawi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulrazak","family":"Anadani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya","family":"Sabboh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad Tawfeek","family":"Banna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hani","family":"Alloush","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-78-20260316","doi-asserted-by":"crossref","first-page":"2661","DOI":"10.1007\/s00264-019-04314-0","article-title":"External fixation for primary and definitive management of open long bone fractures: the Syrian war experience","volume":"43","author":"Alhammoud,","year":"2019","journal-title":"Int. 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Ilizarov to bone reconstruction: historical achievements and state of the art","volume":"11","author":"Gubin,","year":"2016","journal-title":"Strategies Trauma Limb Reconstr"},{"key":"R5-78-20260316","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1097\/BTO.0b013e3181c2cedd","article-title":"Tibial Lengthening Over an Intramedullary Nail","volume":"24","author":"L\u0129nh","year":"2009","journal-title":"Techniques in Orthopaedics"},{"key":"R6-78-20260316","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.2106\/00004623-199710000-00003","article-title":"Femoral lengthening over an intramedullary nail. A matched-case comparison with Ilizarov femoral lengthening","volume":"79","author":"Paley,","year":"1997","journal-title":"J. Bone Joint Surg. Am"},{"key":"R7-78-20260316","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.ijsu.2020.10.034","article-title":"The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport [SCARE] guidelines","volume":"84","author":"Agha,","year":"2020","journal-title":"Int. J. Surg"},{"key":"R9-78-20260316","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s11751-012-0144-5","article-title":"Does the use of an intramedullary nail alter the duration of external fixation and rate of consolidation in tibial lengthening procedures? A systematic review","volume":"7","author":"Jain,","year":"2012","journal-title":"Strategies Trauma Limb Reconstr"},{"key":"R11-78-20260316","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1080\/17434440.2017.1367284","article-title":"The use of flexible intramedullary nails in limb lengthening","volume":"14","author":"Popkov,","year":"2017","journal-title":"Expert Rev. Med. Devices"},{"key":"R12-78-20260316","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1097\/BPO.0b013e3181f0eaf9","article-title":"Flexible intramedullary nail use in limb lengthening","volume":"30","author":"Popkov,","year":"2010","journal-title":"J. Pediatr. Orthop"},{"key":"R13-78-20260316","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.otsr.2012.01.001","article-title":"Traumatic diaphyseal bone defects in children","volume":"98","author":"Sales de Gauzy,","year":"2012","journal-title":"Orthop. Traumatol. Surg. Res"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261223011197?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261223011197?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2023.108990","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T10:01:07Z","timestamp":1773655267000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2023.108990"}},"subtitle":["A case report of a 13-year-old child Bone transport over a flexible nail"],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":10,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2023.108990","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2023,11]]}}}