Pattern and Mechanism of Traumatic Amputation by Explosive Blast

Hull, J.B.; Cooper, G. J.

doi:10.1097/00005373-199603001-00044

Cited by 108 publications

(65 citation statements)

References 3 publications

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“…Five were military personnel (83%) and one was a civilian. Median Injury Severity Score (ISS) for survivors was 5 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14), and the ISS for the deceased was 63 (38-73), with a significant difference between groups, p<0.001.…”

Section: Mortalitymentioning

confidence: 99%

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Initial treatment of combat related limb injuries in Colombia

Martinez-Rondanelli

Arango

Persico

et al. 2016

revsal

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Manejo inicial de lesiones en extremidades asociadas al conflicto armado en ColombiaAlfredo Martínez-Rondanelli ABSTRACT Introduction:Injuries caused by high-energy war weapons are frequent in Colombia. This type of weaponry produces highly complex injuries to the musculoskeletal system that is challenging for health professionals. Objectives: To describe various combat related injuries in Colombia and treatment. Methodology: This is a series of cases from a retrospective cohort including Colombian civilians, police and army personnel wounded in combat areas between January 2012 and March 2013. Demographic variables, injury characteristics, treatment, length of hospital stay, morbidity and mortality were all analysed. Results: 219 patients were admitted, 92% males (n=202). Average age was 26 ± 12 years. Mechanisms of trauma included explosive devices (44%), gunshot wounds (36%) and anti-personnel mines (16%). Limb injuries were identified in 72% (n=159). There were 120 soft tissue lesions, 82 limb fractures of which 14 fractures occurred in the spine and pelvis. 34 patients sustained injuries caused by anti-personnel mines, 35% of whom required limb amputation. Overall 73% patients were treated at Intensive Care Units (ICU). Mortality rate was 2.7%. Conclusion: Orthopaedic injuries due to war weapons are complex, require a comprehensive approach, and one or multiple surgical interventions. In our series, mortality rate was low but the severity of the injuries produced permanent disabilities such as limb amputation.

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Section: Mortalitymentioning

confidence: 99%

“…All of these injuries can compromise the musculoskeletal system. Hull, et al studied the mechanism of limb amputations after explosive blasts 5 . Of 100 cases with lethal injuries reviewed, 34 had limb amputation.…”

Section: Introductionmentioning

confidence: 99%

Initial treatment of combat related limb injuries in Colombia

Martinez-Rondanelli

Arango

Persico

et al. 2016

revsal

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“…This results in soft tissue injury and bone micro-fractures. Hull (1995) demonstrated that a goat limb, 1 shielded from the effects of the detonation products and fragments, could be fractured by the blast wave alone when placed in close proximity to the seat of the explosion. Using a finite element modelling technique, he predicted that the blast wave will have reached the limb prior to any displacement of the limb from the detonation products.…”

Section: Primary Orthopaedic Blast Injurymentioning

confidence: 99%

“…Due to the bone geometry and the differential movement allowed by the knee and ankle joint, the bending forces exerted on the tibia by the blast wave, results in an area of stress concentration. The peak hoop and axial stresses within this area exceeds the tensile failure stress of bone, resulting in fracture; adapted from Hull (1995). (b) A traumatic amputation of the femur.…”

Section: Secondary Orthopaedic Blast Injurymentioning

confidence: 99%

The effects of explosion on the musculoskeletal system

Ramasamy

Hughes

Carter

et al. 2013

Trauma

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Explosions remain the leading cause of death and injury to combatants in conflict. The current 'Global War on Terror' has resulted in a shift of explosive-related injuries from the battlefield into civilian centres. Despite musculoskeletal injuries being the most common injury witnessed in blast, there remains little research into the effects of blast on this system. In order to develop new treatment regimens and mitigation systems, there is a requirement to have a better understanding of skeletal trauma in this unique environment. The aim of this review article is to deconstruct the complex injury mechanisms witnessed in blast and relate them to its effects on the musculoskeletal system.

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“…Primary blast injury is the result of blast wave overpressure and affects the air or fluid filled organs. Experimental work links primary blast injury with skeletal trauma to the ribs and traumatic amputations [8,11,12]. Secondary blast injury represents injuries caused by the fragmentation of munitions and the impact of these fragments on the human body.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of trauma patterns in blast injuries using multiple correspondence analysis

Dussault

Smith

Hanson

2016

Forensic Science International

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A B S T R A C TAnthropology features little in published literature about blast injuries. Contributions through case studies and experimental research are beginning to expand our understanding of the effect these injuries have on the human skeleton. This study examines blast injury and gunshot related fractures through multiple correspondence analysis (MCA) with the aim of establishing injury patterns between the two types of trauma. Using a sample of 491 individuals from Bosnia, MCA is employed to identify which body regions differentiate between blast or gunshot related fractures. Cranial fractures were more closely associated with gunshot related cases. Post-cranial fractures were associated with blast-related cases. A differentiation in post-cranial and cranial fractures between gunshot and blast related cases was revealed in the samples. The high prevalence of extremity trauma in blast is similar to previous work, but the smaller amount of cranial blast-related fractures differs from previous studies and from what is found in gunshot-related cases. Differentiation of blast and gunshot wound injuries can be made on the human skeleton and can be used to possibly interpret injury mechanism in large skeletal assemblages as well as single cases.

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Pattern and Mechanism of Traumatic Amputation by Explosive Blast

Cited by 108 publications

References 3 publications

Initial treatment of combat related limb injuries in Colombia

Initial treatment of combat related limb injuries in Colombia

The effects of explosion on the musculoskeletal system

Evaluation of trauma patterns in blast injuries using multiple correspondence analysis

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