Application of damage control orthopedics to combat-related hand injuries

Vigouroux, Florence; Choufani, Camille; Grosset, Antoine; Barbier, Olivier; Rigal, Sylvain; Laurent, Michel

doi:10.1016/j.hansur.2018.09.002

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…Blast may cause damage to the human body by the direct effect of overpressure, penetration by highly energised fragments and blunt trauma by violent displacements of the body 2 3. Despite the biophysics and the fact that various effects of blast trauma have been well described in the modern medical literature, few papers have focused on combat-related blast injury of the hand 4–8…”

Section: Introductionmentioning

confidence: 99%

“…Their severity depends on the explosive charge and the position of the hand at the time of the explosion, with various classifications described 9–11. In contrast, war hand blast has been less studied 4 5 7. No military classification has been described because weapons of war often cause heterogenous multidigital amputations combined with life-threating injuries 4 7.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, war hand blast has been less studied 4 5 7. No military classification has been described because weapons of war often cause heterogenous multidigital amputations combined with life-threating injuries 4 7. Due to the severity and multiplicity of the lesions and the limited resources available in forward surgical units, damage control surgery always apply with three priorities: saving life, saving the limb and preserving function 6 7.…”

Section: Introductionmentioning

confidence: 99%

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Blast injury of the hand related to warfare explosive devices: experience from the French Military Health Service

et al. 2020

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IntroductionThe objective was to report on the experience of the French Army Health Service in the management of blast injury of the hands related to warfare explosive devices.MethodsA retrospective study was conducted in the Percy Military Hospital (role 4 medical treatment facility) among French soldiers who presented with a combat-related blast injury of the hand between 2002 and 2018. The functional result was assessed by the disabilities of the arm, shoulder and hand (DASH) and the Orthotics and Prosthetics User Survey (OPUS, upper extremity functional status) scores. Proximal amputations (PAs) and distal amputations (DAs) were distinguished for the analysis.ResultsFifteen patients with a mean age of 31±8 years were included. They totalised 20 blasted hands. There were 16 traumatic amputations: 8 in each of the PA and DA groups. Twelve patients had additional injuries, four of which were polytraumatic. Skin closure time and flap use were higher in the DA group. Only one thumb reconstruction was performed. At a mean follow-up of 6.5±4 years, the number of amputees wearing a prosthesis was higher in the PA group. The mean DASH and OPUS scores were 35.5%±24.0% and 64.0%±19.0%, respectively, with no difference between the two groups.ConclusionThe severity of hand blasts related to warfare explosive devices requires the systematic application of damage control surgery. PAs are frequent and secondary reconstruction options are limited. The functional result is poor and similar between proximal and distal amputees.

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Section: Introductionmentioning

confidence: 99%