Definitive Treatment of Combat Casualties at Military Medical Centers

Andersen, Romney C.; Frisch, H; Farber, Gerald L.; Hayda, Roman A.

doi:10.5435/00124635-200600001-00006

Cited by 18 publications

(7 citation statements)

References 1 publication

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“…In the case of lower extremity periarticular fractures, a combination of internal and external fixation often is useful. Free flaps and rotational flaps are used to provide soft tissue coverage, along with the relatively new innovation of secondary-intention wound granulation through vacuum-assisted closure dressings and hemostatic bandages [3].…”

Section: Wounds and Wound Managementmentioning

confidence: 99%

Treatment of War Wounds: A Historical Review

Manring

Hawk

Calhoun

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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142

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The treatment of war wounds is an ancient art, constantly refined to reflect improvements in weapons technology, transportation, antiseptic practices, and surgical techniques. Throughout most of the history of warfare, more soldiers died from disease than combat wounds, and misconceptions regarding the best timing and mode of treatment for injuries often resulted in more harm than good. Since the 19th century, mortality from war wounds steadily decreased as surgeons on all sides of conflicts developed systems for rapidly moving the wounded from the battlefield to frontline hospitals where surgical care is delivered. We review the most important trends in US and Western military trauma management over two centuries, including the shift from primary to delayed closure in wound management, refinement of amputation techniques, advances in evacuation philosophy and technology, the development of antiseptic practices, and the use of antibiotics. We also discuss how the lessons of history are reflected in contemporary US practices in Iraq and Afghanistan.

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Section: Wounds and Wound Managementmentioning

confidence: 99%

Treatment of War Wounds: A Historical Review

Manring

Hawk

Calhoun

et al. 2009

Clinical Orthopaedics &Amp; Related Research

Self Cite

142

View full text Add to dashboard Cite

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“…5,6 In a substantial proportion of patients, surgical revision is indicated to excise the ectopic bone to facilitate stump healing and prosthetic fitting. 1,7,8 The increase in the prevalence of HO after extremity blast amputations in recent conflicts is thought to result from an increased use of improvised explosive devices, which cause a high-energy mechanism of injury and concurrent improvements in body armor, field care, and evacuation of the wounded, which collectively enhance survival of injured combatants. 5 This is compounded by aggressive limb-salvage techniques adopted by military trauma orthopaedic surgeons attempting to preserve as much residual limb and resulting function as possible.…”

Section: Introductionmentioning

confidence: 99%

Heterotopic Ossification After Extremity Blast Amputation in a Sprague-Dawley Rat Animal Model

Tannous

Griffith

O’Toole

et al. 2011

Journal of Orthopaedic Trauma

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“…Case histories were selected based on expert judgment of the treating physician, an approach that was informative in previous case descriptions of combat-limb injuries [12]. They were selected to illustrate the range of HO care issues encountered by the physician in recent years in military amputee clinics [5,9], particularly those relevant for optimizing prosthetic use by lower-limb amputees.…”

Section: Symptoms Radiographs and Case Historiesmentioning

confidence: 99%

“…These descriptions are important, given the unique injury profiles of recent combat amputees [9][10][11][12] and the high frequency of HO occurring in this population [1,2,13]. Patient histories can be instructive for both civilian and military prosthetists, surgeons, and physical rehabilitation specialists.…”

Section: Introductionmentioning

confidence: 99%

Heterotopic ossification in combat amputees from Afghanistan and Iraq wars: Five case histories and results from a small series of patients

Melcer

Belnap²,

Walker³

et al. 2011

JRRD

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Abstract-Heterotopic ossification (HO) is excess bone growth in soft tissues that frequently occurs in the residual limbs of combat amputees injured in Operation Iraqi Freedom and Operation Enduring Freedom, or Iraq and Afghanistan wars, respectively. HO can interfere with prosthetic use and walking and delay patient rehabilitation. This article describes symptomatic and/or radiographic evidence of HO in a patient series of combat amputees rehabilitating at a military amputee care clinic (27 patients/33 limbs). We conducted a retrospective review of patient records and physician interviews to document evidence of HO symptoms in these limbs (e.g., pain during prosthetic use, skin breakdown). Results showed HO-related symptoms in 10 of the 33 residual limbs. Radiographs were available for 25 of the 33 limbs, and a physician identified at least moderate HO in 15 of the radiographs. However, 5 of the 15 patients who showed at least moderate radiographic HO did not report adverse symptoms. Five individual patient histories described HO onset, symptoms, treatments, and outcomes. These case histories illustrated how HO location relative to pressure-sensitive/pressuretolerant areas of the residual limb may determine whether patients experienced symptoms. These histories revealed the uncommon but novel finding of potential benefits of HO for prosthetic suspension.

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Definitive Treatment of Combat Casualties at Military Medical Centers

Cited by 18 publications

References 1 publication

Treatment of War Wounds: A Historical Review

Treatment of War Wounds: A Historical Review

Heterotopic Ossification After Extremity Blast Amputation in a Sprague-Dawley Rat Animal Model

Heterotopic ossification in combat amputees from Afghanistan and Iraq wars: Five case histories and results from a small series of patients

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