Avoiding amputation: how surgeon Yurii Lazarenko is saving Ukrainian soldiers' arms with titanium implants
Dr Yurii Lazarenko can recall many of the operations he has performed on wounded soldiers in his more than 22 years of medical practice. But he particularly remembers the case of a fighter from the 72nd Brigade whom he operated on in early 2024.
The surgeons fitted him with a shoulder joint implant to save his arm from amputation. The surgery was exceptionally complex, but it was a success, and Lazarenko and his colleagues had gone to get some rest.
But just an hour later, a new call came in about the same patient – cardiac arrest.
"Heart problems are common among soldiers because they endure severe stress over long periods of time. We did everything we had to do to save him," the doctor recalls. "Luckily he survived."
The patient had been admitted to the hospital with a wounded arm a few days before. During combat, the soldier's shoulder had been almost shattered by mortar shrapnel. Skin and tendons were all that connected his arm to his body.
A year after the operation, that same soldier sent the doctor a video to show him how his rehabilitation was going. With the implant, his arm was now a fully functioning part of his body – so much so that he could lift objects with it and even do press-ups from the floor.
"Well, that's a bit much – be careful," the doctor told him regarding the press-ups. But in his heart, Lazarenko felt jubilant: "The most precious thing is seeing that your work has changed someone's life for the better."
Dr Yurii Lazarenko was born and raised in Volyn. He served in Kyiv and Dnipro before settling in Vinnytsia. Now he's a lieutenant colonel in the Medical Forces of the Armed Forces of Ukraine, a senior lecturer, Honoured Doctor of Ukraine, and head of the traumatology department at the Military Medical Clinical Centre of the Central Region in Vinnytsia.
The hospital has a constant stream of patients coming in from the battlefield.
"War is an epidemic of injuries," Lazarenko says sadly. "I once compared the figures. Before the [full-scale] invasion we used to have up to 20 surgical interventions per week. Now we have 25-30 surgical interventions per day."
To ensure I had properly understood the medical term "surgical intervention", I asked Lazarenko what he meant. Are wound care and dressing considered surgical interventions? The doctor explains that dressing doesn't belong to this category: a surgical intervention is a complex case that requires anaesthesia.
Lazarenko's usual working day begins at 07:30 and ends around 19:00. The morning starts with what they call the "morning huddle". As head of the department, Lazarenko gets the doctors together to discuss how each patient is doing. Then he starts work according to the day's tasks. But the working day ends at 19:00 only in theory.
"Work continues until the job is done, not until a specific time," he explains.
Lazarenko hasn't always had this sort of routine. In 2022-2023 he worked with a group of surgeons at the front and in frontline hospitals.
"Most days we got three or four hours' sleep. The rest of the time it was back-to-back emergency calls, either for surgery or for consultations," he recalls. "There was a severe shortage of doctors back then, so we each had to do the work of two or three people."
But even that routine was easier than the frontline duty he did during the ATO (the Anti-Terrorist Operation, 2014-2018), when he also served in the military after enlisting as a volunteer.
"Back then there were periods when we might not sleep for two or three days in a row," he recalls.
Having experienced the battlefield, Lazarenko now believes that a baptism of fire is essential for all the doctors under his command.
"In our department, everyone undergoes rotation for six months or a year, providing care at stabilisation points or mobile field hospitals. And they come back completely different people."
The phrase "different people" sounds rather too abstract. What does he mean? How do doctors change after they experience the battlefield?
"Any anxiety or fussiness disappears," Lazarenko answers. "You become very calm and self-confident. After all, at the front you're constantly having to make a lot of important decisions, to take responsibility without hesitating in dozens, in fact hundreds, of cases. That sort of experience makes you a top-notch professional."
Titanium arms
Lazarenko once calculated that nearly 17% of all the soldiers' injuries he treats are wounds to the shoulder and shoulder joint.
"It can happen that the shoulder itself and the humerus are significantly damaged, but the rest of the arm – the elbow, the hand – are intact and healthy," he says. "The arm is alive, the blood and nerve endings are reaching it, but it's non-functional."
Ordinary prostheses can't help in cases like this, so Lazarenko has developed a new protocol. First the doctors perform a computer tomography (CT) scan, which is used to create a 3D model of the humerus implant. Next, based on this model, they order a titanium implant – these are manufactured by a Ukrainian company, Velta Medical.
At this stage, volunteers get involved. The Tykho Charitable Foundation is constantly raising money to buy these prostheses (the project is named ReBone) and has already funded many titanium implants.
In total, Lazarenko has performed 60 operations specifically on shoulders and shoulder joints since 2023.
"Of those 60, in how many cases can you say that you managed to save the person's arm from amputation?" I ask him.
"Overall, 20%. The rest were situations where the patient had an arm that was not going to be amputated, but it was also non-functional."
Lazarenko gives a few more examples of shoulder implants from his practice.
"A soldier came to us after receiving treatment in Germany. He had a complication – tissue necrosis around the prosthesis. We had to replace the German prosthesis with an implant made by the Ukrainian company Velta Medical. The process, including rehabilitation, took around six months. As a result, the man can move his arm and ride a motorbike, even though he's over 50 and has had numerous operations on his arm. We've warned him not to put too much strain on the arm, but he still wants to ride his sports bike.
A guy from the 3rd Separate Assault Brigade was injured by an enemy FPV drone. The drone hit him as he was evacuating an injured comrade-in-arms. He came to us in the spring of 2025. He had a wound to his back and his shoulder blade was shattered. We ordered an implant for part of the shoulder blade because we needed to restore the anatomical alignment. His treatment and rehabilitation also took around six months. Now he can move his arm and has returned to normal life – and I've heard he recently got married."
Between scepticism and the need to act
Lazarenko documents all these cases as a researcher and regularly shares his experience with colleagues at forums and academic conferences.
Patients are sometimes overly optimistic. Having seen videos about bionic prostheses, some of them put too much faith in the doctors' omnipotence and think the operation is going to be like something out of Terminator or RoboCop, Lazarenko worries.
An implant is not a spare part, like in a car. It changes a person's life forever: patients must follow all the doctors' instructions and take good care of the limb in which it is fitted.
The reaction from the medical community is completely different.
"Unfortunately, our approach still meets with a lot of scepticism. And many doctors in Ukraine still don't realise that our method makes it possible to save limbs from amputation," Lazarenko says regretfully. "Once a surgeon from another city called me to ask for advice on a complex case involving a shoulder wound. I was upset because this very doctor had attended the most recent academic conference where I gave a presentation specifically about such cases. He referred the patient to me, and we operated on him and fitted a titanium shoulder joint implant."
Lazarenko has shared his experience with doctors abroad on several occasions.
"I've spoken about our operations and shared our experience in Wisconsin in the US, and in Munich in Germany. Doctors in other countries are constrained by protocols and the requirements of insurance companies. They tend to be quite cautious about new methods that they didn't study at medical school. And a lot of them can be quite condescending about Ukrainian healthcare, as if they see us as people from a less developed country.
They showed me some equipment that we use in Vinnytsia too and were very surprised when I said we had the same equipment. I explained that we custom-make implants for each new patient."
His colleagues' scepticism towards the new method is not unfounded, Lazarenko admits, as it is a relatively new approach in reconstructive surgery.
"In peacetime, you have to do research first and then try to introduce new methods into practice very carefully and gradually," he says. "But because of the lack of time and the large number of patients, we have to improvise. That's why I had discussions with fellow surgeons in the US and Germany.
But let's recall the history of medicine. When were the breakthrough periods in the development of medical treatment in general and surgery in particular? In wartime. Cynical as it may sound, it was wars that gave the world prominent surgeons, crucial experience and research. Take [Nikolai] Pirogov, who performed thousands of operations during the Crimean War in the 19th century, or [Valentin] Voyno-Yasenetsky, who operated during World War II.
Some of my sceptical colleagues say that fitting titanium implants is risky. After all, the part might be rejected, or an infection or other complications could develop. But every surgery carries a risk. And we stay in touch with all our patients – they are under our continuous supervision and we can see how their rehabilitation is progressing."
Doctor and patient vs disease
"The art [of medicine] consists in three things – the disease, the patient, and the physician. The physician is the servant of the art, and the patient must combat the disease along with the physician," Hippocrates said back in the 4th century BC.
Recovery depends to a large extent on the patient's mindset – everyone knows that. But how can a doctor influence that mindset?
"It was Yurii Viktorovych who taught me how to communicate properly with patients so that they follow all instructions, trust the doctor, and genuinely strive for recovery themselves," recalls Lieutenant Colonel Anton Rodionov.
From 2015 to 2018, Rodionov treated service members alongside Lazarenko at the Military Medical Centre of the Central Region in Dnipro. Rodionov was a resident, while Lazarenko was head of the traumatology department.
"He's a person with strong leadership qualities who restructured the work of the entire department and led by example with his work ethic. He always used to say: 'You have to be as hungry as wolves for work, then everything will be fine.'"
Lazarenko's phone contacts show how his students have grown professionally. Dmytro Buchyk, a resident in the traumatology department, was originally saved as "Dmytro student", then "Dmytro intern", and later "Dmytro Vasylovych, doctor" [now with his patronymic as a sign of respect – ed.].
"Yes, I update everything in my phone's address book according to their status," Lazarenko explains. It might seem like a small thing, but for a young doctor it represents important recognition: his mentor now sees him as an independent colleague.
A grandfather's prediction
Hundreds of operations, decades of practice and service, the rank of lieutenant colonel, the title of Honoured Doctor of Ukraine, years of surgery performed at the front and in the rear.
Where did it all begin? What did little Yura Lazarenko want to be when he grew up?
The doctor doesn't remember his childhood dreams, but one episode is etched in his memory. Seven-year-old Yura is on holiday in sunny Tashkent with his grandad – who incidentally was also a military man. Yura is playing doctor with some dolls, bandaging them up. His grandad photographed him doing this and later put the pictures into a photo album for his grandson. The caption he wrote was: "Professor Yurii Viktorovych Lazarenko, Colonel in the Medical Service."
Lazarenko is now a lieutenant colonel – only one step away from becoming a colonel. Becoming a professor, though, is going to need a lot more work. That's his plan for the future – to defend a new postdoctoral thesis, become a professor and teach students.
"We have a vast amount of research material," Lazarenko says. "I would like to pass this experience on to the next generation of doctors."
Vladyslav Holovin, for UP
Translated by Anatolii Tereshchenkov and Solomiia Shvak
Edited by Teresa Pearce