The Vietnam and Algerian wars have demonstrated that the overwhelming conventional military superiority of major powers is no guarantee against their defeat in wars against small nations. For external powers such wars are necessarily “limited,” which constrains escalation above certain levels. With no direct survival interest at stake, fighting the war does not take automatic priority over the pursuit of other social, political, and economic objectives. Prosecuting the war consumes resources—economic, human, and political—which are thus not available for the pursuit of these other objectives. In the absence of a quick victory this creates the potential for those political divisions which historically have shifted the balance of forces in the metropolis in favor of withdrawal. For the insurgents, the fact of invasion and occupation generates cohesion, minimizes constraints on mobilization, and maximizes the willingness to incur costs. Precisely the opposite effects tend to characterize the war effort of the external power. A conceptual framework for the analysis of the evolution and outcome of such conflicts is presented and its applications and limitations discussed.

Type III open tibia fractures from combat unite in 80.3% of cases at an average of 9.2 months. We recorded a 27% deep infection rate and a 22% amputation rate. The G/A type is associated with development of deep infection, need for amputation, and time to union. Positive surveillance cultures are associated with development of deep infection, osteomyelitis, and ultimate need for amputation. Surveillance cultures were not predictive of the infecting organism if a deep infection subsequently develops.