The Medical and Social Consequences of Land Mines in Cambodia

Stover, Eric; Keller, Adrienne; Cobey, James C.; Sopheap, Sam

doi:10.1001/jama.1994.03520050011003

Cited by 40 publications

(31 citation statements)

References 15 publications

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“…Landmine injuries are special because of the ravaging wounds that they frequently inflict not only through the blast effect but also by propelling dirt, bacteria, clothing, and casing fragments into soft tissue and bone, often causing secondary infection [1,11,15]. Because of the rarity of these injuries the treatment options available are not well defined.…”

Section: Discussionmentioning

confidence: 99%

Calcanisation of tibia using Ilizarov fixator in crush injuries of hindfoot: a new method

Wardak¹,

Wardak

Goel

2007

International Orthopaedics (SICO

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Crush injuries of the foot are one of the most difficult and challenging tasks for a trauma surgeon to manage in terms of limb salvage and provision of a painless functional foot. Injuries to the foot, especially the hindfoot, account for almost 24.6% of all the warfare injuries in Afghanistan, of which more than 70% end in amputation for various reasons. We devised a method using the principles of Ilizarov's distraction osteosynthesis to salvage limbs with bony defects in the hindfoot which otherwise were candidates for amputation. The procedure is done in two stages. Initially, the ring fixator is applied for the soft tissue reconstruction and infection control, and the next stage consists of percutaneous "inverted L"-shaped osteotomy in the posterior half of the lower tibia. The study included 32 patients with hindfoot crush injuries involving talus, calcaneum, a combination of both, or even involving the adjacent tarsal bones. All these crush injuries were classified using the Gustilo and Anderson classification. The postoperative functional assessment of the feet was done using the Maryland Foot Score system with a minimum follow-up of four years. We had good results in 53%, fair in 34% and failure in 13% of our cases. The complications of this procedure were the same as with the use of the ring fixator elsewhere in the body. This method provides a technique to salvage the foot and produce a painless, stable, fused foot in one of the most difficult settings of a hindfoot crush injury.Résumé Le traitement des écrasements du pied est une des thérapeutiques les plus difficiles pour les chirurgiens traumatiques notamment si l'on veut conserver le membre. Ces lésions, notamment celles de l'arrière pied ont représenté 24.6% des blessures de guerre en Afghanistan, 70% d'entre-elles conduisant à une amputation pour diverses raisons. Nous avons utilisé une méthode selon les principes de l'ostéosynthèse en distraction d'Ilizarov chez des patients qui étaient candidats à l'amputation. Le traitement a été réalisé en deux temps. Initialement le fixateur circulaire est utilisé pour la reconstruction des tissus mous et pour permettre le contrôle des problèmes infectieux, secondairement est réalisée une ostéotomie inversée en L au niveau de la partie postérieure basse du tibia. Ce travail a permis d'analyser 32 patients présentant de telles lésions. Ces lésions ont été classées selon Gustilo et Anderson. Le devenir fonctionnel des pieds opérés a été évalué selon le score de Maryland (MFS) sur un suivi minimum de 4 ans. Nous avons obtenu 53% de bons résultats, 34% de résultats moyens et 13% d'échecs. Cette technique permet d'améliorer la conservation du membre ainsi que la stabilité et l'indolence du pied.

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Section: Discussionmentioning

confidence: 99%

Calcanisation of tibia using Ilizarov fixator in crush injuries of hindfoot: a new method

Wardak¹,

Wardak

Goel

2007

International Orthopaedics (SICO

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“…4 Of five studies conducted in Cambodia, four relied on hospital-based data and were thus subject to access bias. [5][6][7][8] The remaining study, a district-level, retrospective cross-sectional survey (n = 6090), showed that 7% (n = 432) of the local households had been affected by landmine injuries. These had been fatal in 31% (n = 136) of the cases.…”

Section: Published Literaturementioning

confidence: 99%

“…4,5,[7][8][9] Patients who are seriously injured by landmines or ERW typically remain in the hospital longer, require more blood transfusions and undergo more operations than those who suffer injuries from other causes. 9 Survivors often experience chronic pain, social exclusion and high levels of psychological distress, all of which are risk factors for poor mental health and increased drinking and smoking and can heighten susceptibility to non-communicable diseases.…”

Section: Mine Action Information Management Systemsmentioning

confidence: 99%

The underreporting of landmine and explosive remnants of war injuries in Cambodia, the Lao People's Democratic Republic and Viet Nam

Durham

Hill

Hoy

2012

Bull. World Health Organ.

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“…Landmine injuries have a higher amputation rate and a higher mortality than other war injuries (12,13). Mass movement of populations also results in an increase in mine casualties; the number of landmine victims presenting to the Red Cross hospitals in Afghanistan and Pakistan during the first 9 months of 1992 rose by 250% as 1 million refugees returned to their homes from camps in Pakistan and Iran (14,15).…”

Section: Global Proliferationmentioning

confidence: 99%

“…There will also be collateral damage to the other leg and/or perineum, depending on the size of the charge. Bilateral amputations are required in 5-10% (20,21) and orchidectomy in 1-2% (13).…”

Section: Patterns Of Injurymentioning

confidence: 99%