0
Current Concepts Review   |    
Blast and Fragment Injuries of the Musculoskeletal System
Dana C. Covey, Captain, Medical Corps, United States Navy
View Disclosures and Other Information
Investigation performed at the Department of Orthopaedic Surgery, United States Naval Hospital Okinawa, Japan, and the Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland

Captain Dana C. Covey, Medical Corps, United States Navy Department of Orthopaedic Surgery, United States Naval Hospital Okinawa, PSC 482, Box 2563, FPO AP 96362-2563. E-mail address: coveydc@oki10.med.navy.mil. Please address requests for reprints to D.C. Covey.

In support of the research or preparation of this manuscript, the author received grants or outside funding from the Chairman of the Joint Chiefs of Staff Award for Excellence in Military Medicine and from the Zachary and Elizabeth Fisher Foundation. The author did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the author is affiliated or associated.

The views expressed in this paper are those of the author and do not reflect the official policy or position of the Department of the Navy, the Department of Defense, or the United States Government.

J Bone Joint Surg Am, 2002 Jul 01;84(7):1221-1234
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Abstract

Blast and fragment injuries of the musculoskeletal system are the most frequently encountered wounds in modern warfare.

Most injuries to the musculoskeletal system involve so-called secondary blast injuries in which casing fragments and other debris become flying projectiles.

Nonoperative treatment of selected wounds caused by small-fragment debris has been successful but remains controversial.

Successful surgical treatment depends on meticulous wound d�bridement, with excision of nonviable tissue and foreign material likely to cause infection; adequate drainage; and delayed closure.

Advanced internal fixation techniques used in modern trauma centers to treat predominantly blunt trauma may not be appropriate for care of orthopaedic war wounds in a field setting.

Figures in this Article
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    04/02/2014
    Illinois - Hinsdale Orthopaedics
    02/05/2014
    Oregon - The Center - Orthopedic and Neurosurgical Care and Research
    03/05/2014
    OK - The University of Oklahoma