In-vehicle extremity injuries from improvised explosive devices: current and future foci

Abstract

The conflicts in Iraq and Afghanistan have been epitomized by the insurgents' use of the improvised explosive device against vehicle-borne security forces. These weapons, capable of causing multiple severely injured casualties in a single incident, pose the most prevalent single threat to Coalition troops operating in the region. Improvements in personal protection and medical care have resulted in increasing numbers of casualties surviving with complex lower limb injuries, often leading to long-term disability. Thus, there exists an urgent requirement to investigate and mitigate against the mechanism of extremity injury caused by these devices. This will necessitate an ontological approach, linking molecular, cellular and tissue interaction to physiological dysfunction. This can only be achieved via a collaborative approach between clinicians, natural scientists and engineers, combining physical and numerical modelling tools with clinical data from the battlefield. In this article, we compile existing knowledge on the effects of explosions on skeletal injury, review and critique relevant experimental and computational research related to lower limb injury and damage and propose research foci required to drive the development of future mitigation technologies.

Numerical Analysis of the Risk of Neck Injuries Caused By IED Explosion under the Vehicle in Military Environments

“…Doing so may prevent other traumatic mechanisms than only compression. It is important to study both displacements caused by the explosion and displacement transmitted through seats on the individual segments of the bodies of soldiers (Ramasamy et al, 2011). Three-dimensional analysis of the trajectory movement of each of the soldiers enables the probable dysfunction of the cervical spine caused by extortion as an IED explosion to be specified.…”

“…2. During this incident the soldiers are mostly at risk of injury (Sławiński et al, 2013, Ramasamy et al, 2011, Heider et al, 2010, Krzystała et al, 2011a). Fig.…”

Prospects for studying how high-intensity compression waves cause damage in human blast injuries

“…Using these experimental systems we are expanding our capabilities to analyze the material properties of biological materials (e.g., fracture patterns and transmission of high compression waves) and the cellular effects and molecular interactions affecting damage and repair in these injuries. Our multidisciplinary approach [12], schematically summarized in Fig. 1, is based on the need to integrate knowledge and expertise in engineering, clinical and the physical and life science to enable systematic and physiologically relevant studies in blast injury to be undertaken.…”

“…Our approach to studying lower limb blast injuries involves the development of new and/or novel experimental facilities that are capable of capturing data that describes material, biomechanical, cellular and molecular properties of bones, soft tissues, cells and molecules affected by high compression waves [12]. Key elements we are developing include experimental systems capable of creating physiologically relevant blast or high compression waves; specifically designed apparatus for "mounting" samples (from cadaveric limbs to live cell cultures); and customized systems for capturing relevant experimental data (wave forms and magnitudes, fracture patterns, image capture and analysis).…”

Evaluation of trauma patterns in blast injuries using multiple correspondence analysis

“…However, the location of the explosion to a victim does influence fracture variation. Other variables, such as whether the person is an open or enclosed environment can also influence the pattern of trauma [14][15][16][17]. For example, terrorist bombing events (occurring in both enclosed and open areas) typically result in a high prevalence of extremity injuries, particularly to the head and lower limbs [18][19][20].…”