Restricting lower limb flail is key to preventing fatal pelvic blast injury
File(s)
Author(s)
Rankin, Iain A
Thuy-Tien, Nguyen
Carpanen, Diagarajen
Clasper, Jonathan C
Masouros, Spyros D
Type
Journal Article
Abstract
Pelvic vascular injury in the casualty of an explosive insult is a principal risk factor for increased mortality. The mechanism of injury has not previously been investigated in a physical model. In this study, a small-animal model of pelvic blast injury with a shock-tube mediated blast wave was utilised and showed that lower limb flail is necessary for an unstable pelvic fracture with vascular injury to occur. One hundred and seventy-three cadaveric mice underwent shock-tube blast testing and subsequent injury analysis. Increasingly displaced pelvic fractures and an increase in the incidence of pelvic vascular injury were seen with increasing lower limb flail; the 50% risk of vascular injury was 66° of lower limb flail out from the midline (95% confidence intervals 59°–75°). Pre-blast surgical amputation at the hip or knee showed the thigh was essential to result in pelvic displacement whilst the leg was not. These findings, corroborated by clinical data, bring a paradigm shift in our understanding of the mechanism of blast injury. Restriction of lower limb flail in the human, through personal protective equipment, has the potential to mitigate the effects of pelvic blast injury.
Date Issued
2019-11
Date Acceptance
2019-05-23
Citation
Annals of Biomedical Engineering, 2019, 47 (11), pp.2232-2240
ISSN
0090-6964
Publisher
Springer
Start Page
2232
End Page
2240
Journal / Book Title
Annals of Biomedical Engineering
Volume
47
Issue
11
Copyright Statement
© 2019 The Author(s) Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
License URL
Identifier
https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000495102700010&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
Subjects
Biomechanics
Engineering
Engineering, Biomedical
Fracture
MECHANISM
MORTALITY
Pelvis
Science & Technology
SHARP-RISING OVERPRESSURES
SHOCK TUBE
Technology
Traumatic amputation
TRAUMATIC AMPUTATION
Vascular injury
Publication Status
Published
Date Publish Online
2019-05-30