Treatment of mangled extremities following terrorist blast injury: The Royal London experience

Abstract

The radiographic propagation of the spiral fractures was consistent and followed six simple principles. There was a statistically significant difference in the numbers of correctly diagnosed radiographs, before and after the explanation of our findings, by these doctors ( 2 = 14.06, d.f. = 1, p = 0.002).The direction of the torsional force producing spiral fractures can be determined from characteristic features on routine anterior-posterior and lateral radiographs. Determining the direction of the torsional force on radiographs does not seem to be intuitive.These derived six principles will be a useful aid to physicians who manage paediatric spiral fractures where non-accidental injury is being considered.