Mapping the Risk of Fracture of the Tibia From Penetrating Fragments

Abstract

Penetrating injuries are commonly inflicted in attacks with explosive devices. The extremities, and especially the leg, are the most commonly affected body areas, presenting high risk of infection, slow recovery, and threat of amputation. The aim of this study was to quantify the risk of fracture to the anteromedial, posterior, and lateral aspects of the tibia from a metal fragment-simulating projectile (FSP). A gas gun system and a 0.78-g cylindrical FSP were employed to perform tests on an ovine tibia model. The results from the animal study were subsequently scaled to obtain fracturerisk curves for the human tibia using the cortical thickness ratio. The thickness of the surrounding soft tissue was also taken into account when assessing fracture risk. The lateral cortex of the tibia was found to be most susceptible to fracture, whose impact velocity at 50% risk of EF1+, EF2+, EF3+, and EF4+ fracture types-according to the modified Winquist-Hansen classification-were 174, 190, 212, and 282 m/s, respectively. The findings of this study will be used to increase the fidelity of predictive models of projectile penetration.

Sensitivity of the amide I band to matrix manipulation in bone: a Raman micro-spectroscopy and spatially offset Raman spectroscopy study

“…The tibia mid-shaft (shin) could be also another region, which typically has a tissue thickness of 4 mm or less. 50 The clinical application of our current SORS instrument would be the assessment at the peripheral site. Our data suggest that amide I sub-peak analysis may not be doable clinically speaking when the overlying tissue is greater than 2 mm without advanced spectral processing techniques.…”

Lower Leg Injury Mechanism Investigation During an IED Blast Under a Vehicle Using an Anatomic Leg Model

“…Both in vivo and in vitro lower limb injuries resulting from the explosion of mines or IEDs are quite well documented in the literature ( Kuppa et al, 2001 ; Nelson et al, 2008 ; Nguyen et al, 2020 ; Radonic et al, 2004 ; Ramasay et al, 2013 ). These injuries are dislocations and sprains of the ankle (AIS1), patella injuries and ligament injuries in the knee joint (AIS 2), fractures of the foot bones, in particular the talus and calcaneus (AIS2), fibula and tibia fractures, including the fracture of the proximal tibia (AIS2+), the fracture of the femur (AIS2+), and pelvic fractures (AIS2+).…”

Table1.docx

“…Both in vivo and in vitro lower limb injuries resulting from the explosion of mines or IEDs are quite well documented in the literature (Kuppa et al, 2001;Nelson et al, 2008;Nguyen et al, 2020;Radonic et al, 2004;Ramasay et al, 2013). These injuries are dislocations and sprains of the ankle (AIS1), patella injuries and ligament injuries in the knee joint (AIS 2), fractures of the foot bones, in particular the talus and calcaneus (AIS2), fibula and tibia fractures, including the fracture of the proximal tibia (AIS2+), the fracture of the femur (AIS2+), and pelvic fractures (AIS2+).…”