Early management of proximal traumatic lower extremity amputation and pelvic injury caused by improvised explosive devices (IEDs)

摘要

Military conflicts are often characterised by specific injuries, or patterns of wounding.1 In Afghanistan, improvised explosive devices (IEDs) have become the insurgents' weapon of choice, and were responsible for 60% of coalition forces' fatalities in 2009 and 2010 (Table 1 ).2 The past 2 years have also seen an increase in the number of casualties with very proximal traumatic lower extremity amputations, or injuries so severe as to require subsequent high surgical amputation, and associated pelvic trauma (Fig. I). United States military casualty statistics record 209 major limb amputations for operations in Afghanistan between 2001 and September 2010 (and a further 804 for operations in Iraq), and British records show 163 amputations and 32 significant multiple amputations (survivors only), and an increasing incidence rate, between 2006 and September 2010 (Table 2).