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Restricting Lower Limb Flail is Key to Preventing Fatal Pelvic Blast Injury.
Annals of Biomedical Engineering ( IF 3.8 ) Pub Date : 2019-05-31 , DOI: 10.1007/s10439-019-02296-z
Iain A Rankin 1 , Thuy-Tien Nguyen 1 , Diagarajen Carpanen 1 , Jonathan C Clasper 1 , Spyros D Masouros 1
Affiliation  

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.

中文翻译:

限制下肢连Fla是预防致命的骨盆爆炸伤害的关键。

爆炸伤亡中的盆腔血管损伤是死亡率增加的主要危险因素。伤害机制以前尚未在物理模型中进行过研究。在这项研究中,利用了小动物的盆底冲击波与冲击管介导的冲击波模型,结果表明,下肢连ail对于不稳定的骨盆骨折伴血管损伤的发生是必要的。173只尸体小鼠接受了冲击波管爆炸测试和随后的损伤分析。随着下肢连increasing的增加,骨盆骨折移位增加,骨盆血管损伤的发生率增加。血管损伤的50%风险是下肢从中线跳动66°(95%置信区间59°-75°)。髋部或膝部手术前的截肢术表明,大腿对于导致骨盆移位至关重要,而大腿则没有。这些发现得到临床数据的证实,使我们对爆炸损伤机理的理解发生了范式转变。通过个人防护设备限制人的下肢连ail具有减轻骨盆爆炸伤害的潜力。
更新日期:2019-05-30
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