Successful Limb Salvage Using an Orthoplastic Approach of Type IIIB Open Injuries of the Shoulder: A Report of 3 Cases.

2021 
Case We report 3 adult men (aged 28, 34, and 71 years) with successfully salvaged mangled injuries around the shoulder with high threshold for amputation. Assessment by Mangled Extremity Severity Score, Ganga Hospital Open Injury Severity Score, and Orthopaedic Trauma Association-Open Fracture Classification open injury scores predicted amputation. However, extended salvage was performed by orthoplastic approach. Two of them had superior shoulder suspensory complex (SSSC) injury. The QuickDASH score was high in 2 patients with SSSC injury and a good score in the third patient who achieved good shoulder motion. Conclusion "Orthoplastic approach" achieves successful limb salvage in severely mangled shoulder injuries. Volume of muscle crush injury and double disruption of SSSC injury were the main determinants of outcome.
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