Armed Conflict Injuries to the Extremities: A Treatment Manual

Description

Modern weapons and high-energy accidents inflict devastating damage to soft tissue and bone. As a result, both primary treatment and late limb reconstruction present a difficult surgical challenge. This book is designed to meet the continued need to re-learn the principles of treatment of complex war injuries to the extremities in order to minimize post-traumatic and post-treatment complications and to optimize functional recovery. Most of the chapters in the book are based on the unique experience gained in the treatment of military personnel who have suffered modern combat trauma and civilian victims of terror attacks at a single, large level 1 trauma center. The remaining chapters present the experience of leading international authorities in the field of trauma and reconstructive surgery. A staged treatment protocol is presented, ranging from primary damage control, including the use of external fracture stabilization, through to definitive functional limb reconstruction by means of various internal and external fracture fixation methods. The organization of medical aid, anesthesiology, diagnostic imaging, and infection prophylaxis also receive detailed attention. The management of potential complications such as delayed unions, non-unions, and osteomyelitis is reviewed, and controversies in limb salvage are considered. Primary and late limb amputations are fully discussed, andaspecial chapter is devoted to the challenging dilemma of limb salvage versus amputation in the treatment of limbs at risk. This well-illustrated book will be of value both to beginners and to experts in the field of trauma, including orthopedic surgeons, plastic surgeons, vascular surgeons, and military medical personnel. Front Matter....Pages i-xvi Organization of Urgent Medical Aid, Including Mass Casualty and Triage....Pages 1-20 Wound Ballistics and Tissue Damage....Pages 21-33 Damage Control Orthopaedics....Pages 35-49 Crush Injury of the Limbs and Acute Mechanical Muscle-Crush Compartment Syndrome....Pages 51-55 Anesthesia and Intensive Care of the Patient with Severe Extremity Trauma....Pages 57-80 Hemotransfusion in Combat Trauma....Pages 81-93 Diagnostic Imaging in Combat Trauma....Pages 95-114 Tissue Debridement....Pages 115-132 Primary External Fixation....Pages 133-162 Prevention of Infection and Antibiotic Use in the Management of Armed Conflict Injuries to the Extremities....Pages 163-171 Vascular Trauma to the Limbs....Pages 173-182 Peripheral Nerve Injury....Pages 183-194 Tissue Coverage After War Trauma....Pages 195-214 Definitive Bone Fixation and Reconstruction: Conversion from Temporary External Fixation to Internal Fixation Methods....Pages 215-231 Definitive Skeletal Reconstruction: Conversion to the Ilizarov Method....Pages 233-277 War Injuries of the Hand....Pages 279-293 Foot Surgery in War Trauma....Pages 295-317 Limb Salvage Versus Amputation: The Dilemma....Pages 319-333 Amputation in Combat Trauma....Pages 335-354 Delayed Union and Nonunions....Pages 355-373 Osteomyelitis....Pages 375-389 Chronic Pain Subsequent to Armed Conflict Injuries to the Extremities....Pages 391-406 Back Matter....Pages 407-415