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Blast Injuries and Landmines

C. GiannouHat Yai

July 2012

Explosive blast injuries

Travelling positive pressure wave

Negative phase

Blast injury: types

Primary: direct pressure effectstympanum, blast lung, intestine

Secondary: missile woundsbomb casing or contentssecondary missiles: stones, bricks, glass

Tertiary: blast windtotal body disintegrationtraumatic amputation, eviscerationblunt injury

Quaternary: miscellaneousburns, asphyxia, dust or gas inhalation

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Different types of mines

ATM

Different types of mines

Anti-tank minesblast effect: blast injuryfragments: penetrating injuryfire: burnsblunt injury

Antipersonnel minesblast typefragmentation type

Lethal remnants of warUXOcluster munitions

Patterns of APM Injury

Pattern 1Blast mine amputation

Pattern 2Fragmentation mine

Pattern 3Manipulation of mine

Blast mine

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Blast mine Blast mine on the ground

Blast effect on foot:Small amount of explosive; pattern 1 injury

Blast effect on foot:Small amount of explosive

Blast effect on foot:Small amount of explosive

Blast effect on foot:Small amount of explosive

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Blast effect on foot:Small amount of explosive

Blast effect on leg:blast wave thrombosis

Blast effect on leg:blast wave thrombosis

Blast effect on leg:blast wave thrombosis

Blast effect on leg:blast wave thrombosis

Blast effect on leg:Larger amount of explosive; pattern 1 injury

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Blast effect on leg:pattern 1 injury

Blast effect on leg:pattern 1 injury

Blast effect on leg:pattern 1 injury

Blast effect on leg:pattern 1 injury

Blast effect on leg:pattern 1 injury

Blast effect:Pattern 1 injury; notice wounds of other limb and genitalia

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Blast effect:Pattern 1 injury …. and of contralateral arm

Blast effect:Small body, big amount of explosive

Directional fragmentation mine Fragmentation mine

Bounding fragmentation mine Fragmentation mine:pattern 2 injury; at a short distance

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Fragmentation mine:pattern 2 injury; at a great distance

Complex injury:Blast, fragments and burn

Complex injury:Blast, fragments and burn

Complex injury:Blast, fragments and burn

PFM mine PFM mine: pattern 3 injuryManipulation of mine

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PFM mine: pattern 3 injuryManipulation of mine Amputations: few basic rules

Function ….. function ….. function

Upper limb: as long as possible

Lower limb: support body weightgood muscle cover of stump: vastus medialis, medial gastrocnemiusnon-adherent non-painful scar: bevelled tibiaproper length for stability: cut fibula 2 cm shorter than tibianeuroma: prevent

Anti-tank Mines

Blunt injury

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Penetration of the armour The victims:if you are lucky …

someone will give you a prosthesis. The victims:learning …

… together … to play …

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unless you prefer volleyball. Rehabilitation and Reintegration