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Table 2 Summary of the interventions performed and outcomes achieved

From: The Libyan civil conflict: selected case series of orthopaedic trauma managed in Malta in 2014

Case Bone injuries Primary fixation Secondary fixation Outcome
1 Left subtrochanteric femoral fracture, Right open ankle fracture, missing calcaneum Left femoral external fixator, right tibio-metatarsal external fixator Left Intramedullary femoral nail, right below knee amputation Transferred to rehabilitation hospital
2 Right open elbow fracture, left comminuted mid-shaft humeral fracture Right humero-ulnar external fixator and multiple Kirsches wire fixation, left non-spanning humeral external fixator Repeated soft tissue debridements and necrectomies, removal of infected metalwork Inpatient mortality due to sepsis
3 Left comminuted proximal femur fracture, right open tibia/fibular fracture, right superior and inferior pubic rami fracture, T12 vertebral body fracture Left femoral external fixator, right tibio-calcaneal external fixator Left Intramedullary femoral nail, right conversion to ring external fixator Transferred to rehabilitation hospital
4 Right comminuted open distal femur and tibial fracture Right femoro-tibial external fixator Repeated soft tissue debridements and necrectomies, Planned knee fusion Discharge against medical advise
5 T5 metal foreign body, Right scapular and rib fracture Nil Observations, Acute rehabilitation Transferred to rehabilitation hospital
6 Traumatic amputation of lateral four metatarsals of right foot Right tibio-metatarsal external fixator Repeated soft tissue debridements then eventual right below knee amputation as foot deemed unsalvageable Transferred to rehabilitation hospital
  1. The primary fixation was performed in Libya, and secondary fixation carried out in Malta