The role of the orthopaedic surgeon in United Nations Peacekeeping Operations.

Covey, Dana C.

doi:10.2106/00004623-199504000-00001

Cited by 9 publications

(8 citation statements)

References 11 publications

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“…This reflects similar statistics from other conflicts (64,65,68,69). Whilst some require immediate hospitalisation in UK, a significant number could be managed in theatre or via early appropriate referral to the DMRC or a Regional Rehabilitation Unit (RRU) on return to UK or BFG.The care pathways are illustrated in Figure 1.…”

Section: Operational Medical Rehabilitationsupporting

confidence: 54%

“…The incidence of musculoskeletal injury during all phases of military operations is substantial (64)(65)(66)(67).The provision for assessment, treatment and rehabilitation particularly in theatre has previously been ad hoc. The need is for early assessment, diagnosis, compilation of an effective clinical plan and provision for co-ordinated rehabilitation either in theatre or on return to the UK or BFG.…”

Section: Operational Medical Rehabilitationmentioning

confidence: 99%

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Rheumatology, Rehabilitation Medicine and Sports and Exercise Medicine

et al. 2006

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Section: Operational Medical Rehabilitationsupporting

confidence: 54%

Section: Operational Medical Rehabilitationmentioning

confidence: 99%

Rheumatology, Rehabilitation Medicine and Sports and Exercise Medicine

et al. 2006

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“…Due to the sudden, unexpected, and disproportionate increase in the number of trauma patients as well as limited surgical and anesthetic support, often early definite orthopaedic management is usually not possible. The role of orthopaedic surgeons during rescue missions in such situations is, therefore, important [ 3 ]. We report the injury pattern and profile of musculoskeletal injuries managed by our team soon after the 2015 Nepal earthquake, within a short span of three days.…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Musculoskeletal Injuries after 2015 Nepal Earthquake: Our Experience

Vaishya¹,

Agarwal²,

Vijay³

et al. 2015

Cureus

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We report our experience of handling 80 major musculoskeletal injuries in a brief span of three days immediately after the major earthquake of Nepal in April 2015. Planning, proper utilization of resources, and prioritizing the patients for surgical intervention is highlighted. The value of damage control by orthopaedics in these disasters is discussed. Timely and appropriate surgical treatment by a skilled orthopaedic team not only can save these injured limbs but also the lives of the victims of a major disaster.

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“…In the second Lebanon war, 44% of the injuries were in the limbs [58] and about the same in Oferet Yezuka at Gaza strip at 2009 [59] an equal or higher number than reported in other earlier combats. The reasons for that are the better torso armor (such as Ceramic vests) and head helmet (Kevlar made) that relatively protect the torso [60][61][62][63], a fact that can be learned by comparison of the injuries pattern in the Iraq Freedom war between the protected US soldiers and the unprotected Iraqi soldiers (relatively higher extremities/torso injuries ratio in the American soldiers comparing to the Iraqi population) [64][65][66]. Another reason is the better survival rate of the severely wounded, due to better treatment and quicker evacuation and hence more patients who suffer extremities injuries successfully arrive to treatment so more extremities injuries are treated.…”

Section: Blast Mechanisms and Tissue Damagementioning

confidence: 99%

Wound Ballistics and Tissue Damage

Rozen

Dudkiewicz

2011

Armed Conflict Injuries to the Extremities

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With globally increasing war, conflicts and terrorism acts, blast or bullet limb injuries are seen more often and present a surgical challenge.The amount of tissue damage and the injury severity of gunshot injuries are due to the energy transmitted by the bullets or projectiles, depending mainly on their velocity. Therefore, the injuries are not divided any more, as in the past, to "high-and low-velocity injury" but to "a high-or low-energy injury."Blast injuries are also energy related and mainly dependent upon the distance from the blast, the energy released from the bombing device, the media (air or water) and the environment in which the blast takes place (close or open). Although the injury may look superficial, it might be much worse and the external wound is sometimes only the tip of the iceberg. Bullet and Projectile BallisticsProjectile or bullet injuries may be classified as "lowenergy" or "high-energy," which describe the amount of damage to the tissues. The factor that most affects the injury severity is the amount and the efficiency of energy transfer [1][2][3][4][5], which is mostly related to kinetic energy that is presented by the equation2 ] (M -mass; V -velocity)" in a bullet that does not "waste" energy on deforming. Other suggested theories are the momentum theory expressed as "Mass × Velocity" and the power theory related to "Mass × Velocity 3 " [6]. Ballistic wounds can be classified, according to the amount of energy causing them, into: high energy (>1,000 J); medium energy (250-1,000 J); low energy (<250 J) [7]. For example, this is the basic principle of successful open fracture classification system as described by GustiloAnderson [8,9].The energy importance is represented by most shot wound classifications, such as the Red Cross classification for war injury [10] that emphasizes wound severity in terms of tissue damage and injuries to specific anatomic structures. The injury is rated according to the size of the entry and exit wounds. It also categorizes the presence of a cavity, a fracture, or an injured vital structure and the presence or absence of metallic bodies [10]. The modified Red Cross classification for civilian injuries, [11] which incorporates the ballistic and clinical aspects of gunshot injuries in civilians, is based on energy dissipation, vital structures injured, type of wound created, severity of bony injury, degree of contamination, and the modified Gustilo-Anderson open fracture classification system in which lowvelocity gunshot wounds are designated as Grade I or Grade II, based on the size of the skin wound and highvelocity gunshot injuries are designated as Grade III injuries, regardless of wound size [12].The cascade of a shot starts with pulling the trigger. This leads to the quick expansion of gas that may reach a temperature of over 2,800°C. This produces

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The role of the orthopaedic surgeon in United Nations Peacekeeping Operations.

Cited by 9 publications

References 11 publications

Rheumatology, Rehabilitation Medicine and Sports and Exercise Medicine

Rheumatology, Rehabilitation Medicine and Sports and Exercise Medicine

Surgical Management of Musculoskeletal Injuries after 2015 Nepal Earthquake: Our Experience

Wound Ballistics and Tissue Damage

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