Periarticular blast wounds without fracture a prospective case series.
J Orthop Surg Res
; 19(1): 126, 2024 Feb 06.
Article
in En
| MEDLINE
| ID: mdl-38321483
ABSTRACT
BACKGROUND:
During the wars in Afghanistan and Iraq most injuries to service members involved the musculoskeletal system. These wounds often occurred around joints, and in some cases result in traumatic arthrotomy-a diagnosis that is not always clear, especially when there is no concomitant articular fracture. The aim of the present study is to evaluate the diagnosis and treatment of peri-articular blast injuries without fracture.METHODS:
The study cohort included 12 consecutive patients (12 involved extremities) who sustained peri-articular blast wounds of the extremities without fractures. The diagnosis of penetrating articular injury was based on clinical examination, radiographic findings, or aspiration. A peri-articular wound was defined as any wound, or radio-opaque blast fragment, within 5 cm of a joint. The New Injury Severity Score (NISS) was calculated for each patient. Four patients had upper, and 8 patients had lower extremity injuries. Nine of 12 patients had joint capsular penetration and underwent joint irrigation and debridement.RESULTS:
Two patients had retained intra-articular metal fragments. One patient had soft tissue blast wounds within 5 cm of a joint but did not have joint capsule penetration. There were no significant differences (p = 0.23) between the distribution of wounds to upper versus lower extremities. However, there were a significantly greater number of blast injuries attributed to Improvised Explosive Devices (IEDs) than from other blast mechanisms (p = 0.01).CONCLUSION:
Extremity blast injuries in the vicinity of joints involving only soft tissues present a unique challenge in surgical management. A high index of suspicion should be maintained for joint capsular penetration so that intra-articular injuries may be appropriately treated.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Wounds, Gunshot
/
Wounds, Penetrating
/
Blast Injuries
/
Soft Tissue Injuries
/
Fractures, Bone
/
Military Personnel
Limits:
Humans
Language:
En
Journal:
J Orthop Surg Res
Year:
2024
Document type:
Article
Affiliation country:
United States