The portrayal of injuries to the extremities and their reconstruction in times of conflict (Khartoum, Sudan): a cross-sectional.

Introduction: Military weapons primarily damage the upper and lower limbs of the body, causing significant structural disruption in these injuries. The goal of limb reconstruction is to keep the extremity's sensorimotor functions, skeletal stability, and adorable aesthetic result. Materials and methods: This is a descriptive prospective cross-sectional hospital-based study performed to assess presentation of extremities injuries due to war weapon in Khartoum, Sudan, during conflict period July-December 2023. All patients with lower and upper extremities wounds due to combat injury and who underwent reconstructive surgery were included. Patients with concomitant injuries to trunk and head and neck regions were excluded. Results: Among 200 patients, 82% were male, while 18% were female. The majority of patients, accounting for 28.5%, were between 20 and 30 years old. The lower limb was the most commonly involved extremity (56%), while in 54.9% of cases, the upper limb is dominant. In most cases, all components were injured except for neural and vascular elements. The ratio of fasciocutaneous to muscle flap was 73-27%. Complications were not experienced by more than half of the patients, with infection being the most common complication encountered in 60% of complicated cases. Conclusion: War-related trauma to the extremities leads to complex wounds with various structural complications, often contaminated, posing a significant challenge during the reconstruction phase. In resource-limited settings, a customized reconstructive ladder may be implemented if free flaps are not an option, utilizing pedicled flaps to achieve satisfactory outcomes.