{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:34:28Z","timestamp":1787776468948,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"\n Background:<\/jats:title>\n The insurgence of banditry, kidnapping and farmer-herdsmen clashes has presented a unique etiological factor of complex long bone (fracture) and soft tissue gunshot injuries to orthopaedic Surgeons in North West Nigeria. These complex fractures and soft tissues injuries are of very challenging and with high risks of bone loss being open fracture, infected gap nonunion and soft tissue defects which are individually and\/or collectively difficult situation to manage to salvage the affected limbs. The management include but not limited to resuscitation using Advanced Trauma Life Support Protocols, often staged management of the injury which entails: wound debridement with external fixation, soft tissue cover or grafting, bone grafting including vascularized bone grafting and bone transport.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n The objective of this retrospective study is to share our experience of the outcome of Linear Rail System (LRS) in salvaging long bone complex fractures from gunshot injuries.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n Twenty-seven patients who had limb salvage procedures with LRS on account of complex fractures from gunshot injuries between January 1, 2019 and December 30, 2022 and were recruited into this retrospective study. The clinical details of the patients were retrieved from the medical record department and analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n The study involved 27 patients (male-female ratio of 5.75:1) aged 22\u201349 years with a mean age of 30.5 years. All patients suffered Gustilo type III injuries associated with varying bone loss resulting from debridement of devitalized bone or bone loss at the scene of the injury. There were 17 cases of tibia, 7 femurs, and 3 humerus. All patients presented at the accident and emergency room. The surgical treatment included debridement, docking, corticotomy at an appropriate level and distraction\/compression by LRS respectively. All cases had antibiotics, achieved union and limb length equalization\/bone transport. Primary docking was done in 59% with subsequent limb lengthening while 41% had bone transport from the osteotomy sites. The average bone gap regenerated was 8.92 cm (range 3.23\u201316.90 cm) over a period of 19 months (ranging between 7 and 19 months). At the end of fracture union, 78% of the patients had normal range of motion in nearby joints and with satisfactory limb function in 93% of the cases according to patients\u2019 report.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The uniqueness of complex long bone fractures by gunshot injuries with extensive soft tissue and fractures especially with cases of bone loss due to the injury or from the debridement required a faster, simpler and more acceptable device that will achieve the desired result. The use of LRS in this study was a good option to achieve soft tissue care, infection control, fracture union, restore limb length and rehabilitation to restore function with satisfactory outcome. However, appropriate patients counselling and education about the device and the likely outcome are imperative parts of the keys to the success.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/aam.aam_143_23","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T12:00:11Z","timestamp":1748606411000},"page":"562-566","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Management of Unique Complex Long Bone Fractures by Gunshot Injuries with Linear Rail System"],"prefix":"10.4103","volume":"24","author":[{"given":"Lukman Olalekan","family":"Ajiboye","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullahi Bello","family":"Galadima","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulkadir Muhammad","family":"Usman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olanrewaju Olatunji","family":"Sulaimon","sequence":"additional","affiliation":[{"name":"Trauma Division, Department of Hospital Services, Federal Ministray of Health, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chukwuebuka Kingsley","family":"Okezie","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"R1-20260422","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1038\/s41536-021-00127-1","article-title":"Firearms-related skeletal muscle trauma: Pathophysiology and novel approaches for regeneration","volume":"6","author":"Moriscot","year":"2021","journal-title":"NPJ Regen Med"},{"key":"R2-20260422","doi-asserted-by":"crossref","first-page":"21","DOI":"10.5435\/00124635-200001000-00003","article-title":"Ballistics and gunshot wounds: Effects on musculoskeletal tissues","volume":"8","author":"Bartlett","year":"2000","journal-title":"J Am Acad Orthop Surg"},{"key":"R3-20260422","first-page":"546","article-title":"Treating civilian gunshot wounds to the extremities in a level 1 trauma center: Our experience and recommendations","volume":"11","author":"Burg","year":"2009","journal-title":"Isr Med Assoc J"},{"key":"R4-20260422","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1007\/s00264-010-1023-7","article-title":"Role of early Ilizarov ring fixator in the definitive management of type II, IIIA and IIIB open tibial shaft fractures","volume":"35","author":"Wani","year":"2011","journal-title":"Int Orthop"},{"key":"R5-20260422","first-page":"4","article-title":"Ilizarov fixation","volume":"3","author":"Pemberton","year":"1993","journal-title":"Br J Theatre Nurs"},{"key":"R6-20260422","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/1471-2474-14-30","article-title":"Treatment of distal tibial fractures with the Ilizarov external fixator \u2013 A prospective observational study in 39 consecutive patients","volume":"14","author":"Ramos","year":"2013","journal-title":"BMC Musculoskelet Disord"},{"key":"R7-20260422","doi-asserted-by":"crossref","first-page":"71","DOI":"10.5812\/atr.11300","article-title":"Clinical outcomes of the Ilizarov method after an infected tibial non union","volume":"2","author":"Shahid","year":"2013","journal-title":"Arch Trauma Res"},{"key":"R8-20260422","first-page":"811","article-title":"Management of massive posttraumatic bone defects in the lower limb with the Ilizarov technique","volume":"76","author":"Chaddha","year":"2010","journal-title":"Acta Orthop Belg"},{"key":"R9-20260422","doi-asserted-by":"crossref","first-page":"171","DOI":"10.4103\/1118-8561.196352","article-title":"Management of traumatic segmental bone loss using linear rail system, our experience at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria","volume":"19","author":"Dabkana","year":"2016","journal-title":"Sahel Med J"},{"key":"R10-20260422","first-page":"249","article-title":"Callotasis lengthening: A review of some technical aspects","volume":"54","author":"Maffulli","year":"1996","journal-title":"Bull Hosp Jt Dis"},{"key":"R11-20260422","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/00003086-199404000-00013","article-title":"Mechanical forces as predictors of healing during tibial lengthening by distraction osteogenesis","volume":"301","author":"Aronson","year":"1994","journal-title":"Clin Orthop Relat Res"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_143_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:10:46Z","timestamp":1787775046000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_143_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/aam.aam_143_23","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,30]]},"assertion":[{"value":"2023-08-26","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-10","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}