Complex soft tissue injuries associated with portable charger detonation: four case reports from the war in Ukraine.

This article describes the characteristics and management of injuries associated with ricochet effects due to portable charger detonation. We present a case series of four military personnel who sustained complex soft tissue injuries when portable chargers detonated after being struck by projectiles during combat. All patients were treated by an advanced surgical team at the Military Medical Clinical Center of the Northern Region in Kharkiv, Ukraine, over a 9-month period in 2023. Patient history, physical examination findings, laboratory studies, radiographic imaging, treatment approaches, and early outcomes were examined. All patients were male, with a mean age of 33±0.3 years. Complex soft tissue injury patterns arose when a projectile (such as a bullet or shrapnel) struck the charger, causing ricochet effects while damaging the battery housing and triggering detonation. The anatomical region of injury corresponded to the charger's placement in the patients' pockets, namely the thigh or buttock. Characteristic findings included local chemical burns of the skin and subcutaneous tissue, with surrounding ecchymosis. Surgical teams identified three zones of damage associated with this injury pattern: (1) a central zone with the most pronounced burn related changes, covering the smallest area of the three zones; (2) an intermediate zone of soft tissue damage from thermochemical reactions extending beyond the charger's profile; and (3) an outer zone of ecchymosis. Risks associated with carrying portable chargers during combat have not been well documented. These findings may inform injury prevention strategies for military personnel.