Combat orthopedic trauma care: Challenges and innovations in Ukraine's wartime response.

Orthopedic trauma care in Ukraine, shaped by the ongoing conflict since the Donbas invasion in 2014 and further intensified by the 2022 Russian invasion, reflects the complexity of treating modern wartime injuries in the face of resource constraints and evacuation challenges. Ukrainian medical teams have to the greatest extent possible adhered to Western medical standards, using a tiered care system that spans from the point of injury, to forward surgical teams leading, finally to advanced procedures in tertiary facilities. However, resource shortages and delayed evacuations have led to significant complications, including tourniquet-related kidney injury and limb amputations. These realities compel the need for innovation in medical protocols and sustained international support to address the demands of conflict-zone care.