A Military Case Review Method to Determine and Record the Mechanism of Injury (BioTab) from In-Theater Attacks.

A recent study of all mounted vehicle underbody blast attacks found that 21% of Abbreviated Injury Scale Severity 2+ injuries in the Joint Trauma Analysis and Prevention of Injury in Combat network were injuries to the leg and ankle. To develop effective countermeasure systems for these attacks, the epidemiology and mechanisms of injury from this loading environment need to be quantified. The goal of this study was to develop a military correlate of an existing civilian case review framework, the Crash Injury Research and Engineering Network (CIREN), to consider the differences in military event types and the amount of available vehicle/attack information. Additional data fields were added to the CIREN process to cover military-specific data and "certainty" definitions in the proposed injury hypothesis were modified. To date, six group reviews have been conducted analyzing 253 injuries to the foot/ankle, tibia, femur, pelvis, and lumbar spine from 52 occupants. The familiar format and unclassified nature of the presentations allowed for the involvement of biomechanics experts from multiple disciplines.

Comparison of ATD to PMHS Response in the Under-Body Blast Environment.

A blast buck (Accelerative Loading Fixture, or ALF) was developed for studying underbody blast events in a laboratory-like setting. It was designed to provide a high-magnitude, high-rate, vertical loading environment for cadaver and dummy testing. It consists of a platform with a reinforcing cage that supports adjustable-height rigid seats for two crew positions. The platform has a heavy frame with a deformable floor insert. Fourteen tests were conducted using fourteen PMHS (post mortem human surrogates) and the Hybrid III ATD (Anthropomorphic Test Device). Tests were conducted at two charge levels: enhanced and mild. The surrogates were tested with and without PPE (Personal Protective Equipment), and in two different postures: nominal (knee angle of 90°) and obtuse (knee angle of 120°). The ALF reproduces damage in the PMHS commensurate with injuries experienced in theater, with the most common damage being to the pelvis and ankle. Load is transmitted through the surrogates in a caudal-to-cranial sequential fashion. Damage to the PMHS lower extremities begins within 2 ms after the initiation of foot/floor motion. The Hybrid III cannot assume the posture of the PMHS in rigid seats and exhibits a stiffer overall response compared to the PMHS. The ATD does not mimic the kinematic response of the PMHS lower extremities. Further, the Hybrid III does not have the capability to predict the potential for injury in the high-rate, vertical loading environment. A new ATD dedicated to under-body blast is needed to assist in the effort to mitigate injuries sustained by the mounted soldier.