Mains de « blast » : stratégie thérapeutique

Coulet, Bertrand; Lacombe, F.; Daussin, Paul-André; Chammas, Michel

doi:10.1016/j.main.2004.08.009

Cited by 13 publications

(3 citation statements)

References 13 publications

(23 reference statements)

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“…The poor functional results are obviously due to the seriousness of the injuries caused by warfare devices, which have an explosive power far superior to that of firecrackers encountered in civil practice. In the civil series of Coulet et al ,11 the mean DASH score was indeed 21%, compared with 35% here. Only mortar-type firecrackers can cause injuries like those generated by the accidental explosion of a large-calibre firearm munition.…”

Section: Discussionmentioning

confidence: 41%

“…This has been reduced to a percentage: 0% corresponding to a complete absence of discomfort, and 100% corresponding to a complete disability 13. This score was chosen to compare our series to the one of Coulet et al ,11 who used the DASH score to analyse management of firework hand injuries in civilian practice. For amputee patients, the functional result was assessed by the Orthotics and Prosthetics User Survey (OPUS, upper extremity functional status) since this score is commonly used to assess prosthesis functionality 14 15.…”

Section: Methodsmentioning

confidence: 99%

“…Blast injuries to the hand are well studied in civilian practice and are mostly caused by firecrackers or mortars resulting in thumb column injuries and first web space injuries. 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.…”

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: Discussionmentioning

confidence: 41%