• Shai Luria, Gurion Rivkin, Malka Avitzour, Meir Liebergall, Yoav Mintz, and Ram Mosheiff.
• Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. shail@hadassah.org.il
• Isr Med Assoc J. 2013 Mar 1;15(3):148-52.

BackgroundExplosion injuries to the upper extremity have specific clinical characteristics that differ from injuries due to other mechanisms.ObjectivesTo evaluate the upper extremity injury pattern of attacks on civilian targets, comparing bomb explosion injuries to gunshot injuries and their functional recovery using standard outcome measures.MethodsOf 157 patients admitted to the hospital between 2000 and 2004, 72 (46%) sustained explosion injuries and 85 (54%) gunshot injuries. The trauma registry files were reviewed and the patients completed the DASH Questionnaire (Disabilities of Arm, Shoulder and Hand) and SF-12 (Short Form-12) after a minimum period of 1 year.ResultsOf the 157 patients, 72 (46%) had blast injuries and 85 (54%) had shooting injuries. The blast casualties had higher Injury Severity Scores (47% vs. 22% with a score of > 16, P = 0.02) and higher percent of patients treated in intensive care units (47% vs. 28%, P = 0.02). Although the Abbreviated Injury Scale score of the upper extremity injury was similar in the two groups, the blast casualties were found to have more bilateral and complex soft tissue injuries and were treated surgically more often. No difference was found in the SF-12 or DASH scores between the groups at follow up.ConclusionsThe casualties with upper extremity blast injuries were more severely injured and sustained more bilateral and complex soft tissue injuries to the upper extremity. However, the rating of the local injury to the isolated limb is similar, as was the subjective functional recovery.

44 keywords...

hide…