Initial treatment of combat related limb injuries in Colombia

Abstract

Manejo inicial de lesiones en extremidades asociadas al conflicto armado en ColombiaAlfredo Martínez-Rondanelli ABSTRACT Introduction:Injuries caused by high-energy war weapons are frequent in Colombia. This type of weaponry produces highly complex injuries to the musculoskeletal system that is challenging for health professionals. Objectives: To describe various combat related injuries in Colombia and treatment. Methodology: This is a series of cases from a retrospective cohort including Colombian civilians, police and army personnel wounded in combat areas between January 2012 and March 2013. Demographic variables, injury characteristics, treatment, length of hospital stay, morbidity and mortality were all analysed. Results: 219 patients were admitted, 92% males (n=202). Average age was 26 ± 12 years. Mechanisms of trauma included explosive devices (44%), gunshot wounds (36%) and anti-personnel mines (16%). Limb injuries were identified in 72% (n=159). There were 120 soft tissue lesions, 82 limb fractures of which 14 fractures occurred in the spine and pelvis. 34 patients sustained injuries caused by anti-personnel mines, 35% of whom required limb amputation. Overall 73% patients were treated at Intensive Care Units (ICU). Mortality rate was 2.7%. Conclusion: Orthopaedic injuries due to war weapons are complex, require a comprehensive approach, and one or multiple surgical interventions. In our series, mortality rate was low but the severity of the injuries produced permanent disabilities such as limb amputation.

The prevalence and risk factors for phantom limb pain in people with amputations: A systematic review and meta-analysis

“…Another important consideration is that the prevalence estimates could have been influenced by the under-representation of only seven studies conducted in developing countries compared to 32 studies conducted in developed countries. Trauma or combat-related amputations are common in some regions in South America, Middle East, and West and Central Africa [ 57 – 59 ]. However, these regions are underrepresented in the body of studies identified by this review.…”