Bomb blast: imaging findings, treatment and clinical course of extremity traumas.
Dublin Core
Title
Bomb blast: imaging findings, treatment and clinical course of extremity traumas.
Subject
Terror-related trauma, Blast injury, Improvised explosive device (IED), Gustilo-Anderson, Damage
control surgery (DCS)
control surgery (DCS)
Description
Background
To describe the severity and types of blast-related extremity injuries and the presence of accompanying vascular
injuries (VI) and amputation, and to identify the associated factors affecting the treatment management and
clinical course.
Methods
The study included 101 patients with extremity injuries caused by a bomb explosion. The radiographs and
computed tomography angiographies of the patients were evaluated in terms of injury patterns, presence of
penetrating fragments and fractures, and localization (upper or lower extremity) and type (open or closed) of
injury. The Gustilo-Anderson classification was used for open fractures. According to their severity, open
fractures classified as types 1 and 2 were included in Group 1 and those classified as type 3A, 3B and 3C in
Group 2.
Results
As a result of blast exposure, 101 (57.7%) patients had extremity injuries, of which 76 (75.2%) presented with at
least one fracture. Of the total of 103 fractures, nine (8.8%) were closed and 94 (91.2%) were open. Thirty-eight
(40.4%) of the open fractures were located in the upper extremities, and 56 (59.6%) in the lower extremities and
pelvis. Open fractures were most frequently localized in the femur (n = 20; 21.2%), followed by the tibia (n = 18;
19.1%). The majority of patients with open fractures were in Group 1 (71.4%). The duration of hospital stay was
longer in Group 2 (12.1 [+ or -] 5.8 vs. 6.3 [+ or -] 6.7 days, p < 0.0001, respectively). Mortality among patients in
Group 2 (45.0%) was significantly higher than in Group 1 (8.0%) (p < 0.0001). Similarly, the injury severity score
(ISS) was higher in Group 2 (median 20 vs. 9, p < 0.0001). VI was present in 13 (12.9%) of all patients, and
amputation in seven (7.9%).
Conclusion
The presence of severe open fractures, VI, and high ISS score can be considered as important factors that
increase morbidity and mortality. In extremity traumas, through the secondary blast mechanism, contaminatedfragmented tissue injuries occur. Therefore, we believe that it will be beneficial to apply damage control surgery
in places with low socioeconomic level and poor hygienic conditions.
To describe the severity and types of blast-related extremity injuries and the presence of accompanying vascular
injuries (VI) and amputation, and to identify the associated factors affecting the treatment management and
clinical course.
Methods
The study included 101 patients with extremity injuries caused by a bomb explosion. The radiographs and
computed tomography angiographies of the patients were evaluated in terms of injury patterns, presence of
penetrating fragments and fractures, and localization (upper or lower extremity) and type (open or closed) of
injury. The Gustilo-Anderson classification was used for open fractures. According to their severity, open
fractures classified as types 1 and 2 were included in Group 1 and those classified as type 3A, 3B and 3C in
Group 2.
Results
As a result of blast exposure, 101 (57.7%) patients had extremity injuries, of which 76 (75.2%) presented with at
least one fracture. Of the total of 103 fractures, nine (8.8%) were closed and 94 (91.2%) were open. Thirty-eight
(40.4%) of the open fractures were located in the upper extremities, and 56 (59.6%) in the lower extremities and
pelvis. Open fractures were most frequently localized in the femur (n = 20; 21.2%), followed by the tibia (n = 18;
19.1%). The majority of patients with open fractures were in Group 1 (71.4%). The duration of hospital stay was
longer in Group 2 (12.1 [+ or -] 5.8 vs. 6.3 [+ or -] 6.7 days, p < 0.0001, respectively). Mortality among patients in
Group 2 (45.0%) was significantly higher than in Group 1 (8.0%) (p < 0.0001). Similarly, the injury severity score
(ISS) was higher in Group 2 (median 20 vs. 9, p < 0.0001). VI was present in 13 (12.9%) of all patients, and
amputation in seven (7.9%).
Conclusion
The presence of severe open fractures, VI, and high ISS score can be considered as important factors that
increase morbidity and mortality. In extremity traumas, through the secondary blast mechanism, contaminatedfragmented tissue injuries occur. Therefore, we believe that it will be beneficial to apply damage control surgery
in places with low socioeconomic level and poor hygienic conditions.
Creator
Mehmet Tahtabasi, Sadettin Er, Recep Karasu and Erhan Renan Ucaroglu
Publisher
BMC Emergency Medicine
Date
Mar. 6, 2021
Contributor
Fajar bagus W
Format
PDF
Language
Indonesia
Type
Text
Files
Collection
Citation
Mehmet Tahtabasi, Sadettin Er, Recep Karasu and Erhan Renan Ucaroglu, “Bomb blast: imaging findings, treatment and clinical course of extremity traumas.,” Repository Horizon University Indonesia, accessed December 3, 2024, https://repository.horizon.ac.id/items/show/3770.