Skip to main content
SpringerLink
Log in

Wound Ballistics and Tissue Damage

  • Chapter
  • First Online:
Armed Conflict Injuries to the Extremities

With globally increasing war, conflicts and terrorism acts, blast or bullet limb injuries are seen more often and present a surgical challenge. The amount of tissue damage and the injury severity of gunshot injuries are due to the energy transmitted by the bullets or projectiles, depending mainly on their velocity. Therefore, the injuries are not divided any more, as in the past, to “high- and low-velocity injury” but to “a high- or low-energy injury.”

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Janzon, B., Seeman, T.: Muscle devitalization in high-energy missile wounds, and its dependence on energy transfer. J. Trauma 25, 138–144 (1985)

    Article  PubMed  CAS  Google Scholar 

  2. Hoekstra, S.M., Bender, J.S., Levison, M.A.: The management of large soft-tissue defects following close-range shotgun injury. J. Trauma 30, 1489–1493 (1990)

    Article  PubMed  CAS  Google Scholar 

  3. Di Maio, V.J.M.: Gunshot Wounds: Practical Aspects of Firearms, Ballistics, and Forensic Techniques. CRC Press, Boca Raton (1993)

    Google Scholar 

  4. Swan, K.G., Swan, R.C.: Gunshot Wounds: Pathophysiology and Management, 2nd edn. Year Book Medical Publishers, Chicago (1989)

    Google Scholar 

  5. Cooper, G.J., Ryan, J.M.: Interaction of penetrating missiles with tissues: Some common misapprehensions and implications for wound management. Br. J. Surg. 77, 606–610 (1990)

    Article  PubMed  CAS  Google Scholar 

  6. Ordog, G.J.: Chapter 4: Wounds ballistic. In: Ordog, G.J. (ed.) Management of Gunshot Wounds, pp. 25–60. Elsevier, Amsterdam (1988)

    Google Scholar 

  7. Hill, P.F., Edwards, D.P., Bowyer, G.W.: Small fragment wounds: Biophysics, pathophysiology and principles of management. J. R. Army Med. Corps 147, 41–51 (2001)

    PubMed  CAS  Google Scholar 

  8. Gustilo, R.B.: Current concepts review: The management of open fractures. J. Bone Joint Surg. 72A, 299–304 (1990)

    Google Scholar 

  9. Gustilo, R.B., Anderson, J.T.: Prevention of infection in the treatment of one thousand and twenty-five open fractures of the long bones: Retrospective and prospective analysis. J. Bone Joint Surg. 58A, 453–458 (1976)

    Google Scholar 

  10. Coupland, R.M.: The Red Cross classification of war wounds: The E.X.C.F.V.M. scoring system. World J. Surg. 16, 910–917 (1992)

    Article  PubMed  CAS  Google Scholar 

  11. Zbigniew, G., Lindsey, R.W.: Classification of gunshot injuries in civilians. Clin. Orthop. 408, 65–81 (2003)

    Article  Google Scholar 

  12. Gustilo, R.B.: Management of open fractures and complications. Instr. Course Lect. 31, 64–75 (1982)

    PubMed  CAS  Google Scholar 

  13. Bartlett, C.S., Helfet, D.L., Hausman, M.R., Strauss, E.: Ballistics and gunshot wounds: Effects on musculoskeletal tissues. J. Am. Acad. Orthop. Surg. 8, 21–36 (2000)

    PubMed  CAS  Google Scholar 

  14. Hollerman, J.J., Fackler, M.L., Coldwell, D.M., Ben-Menachem, Y.: Gunshot wounds: 1: Bullets, ballistics, and mechanisms of injury. AJR 155, 685–690 (1990)

    PubMed  CAS  Google Scholar 

  15. Hopkinson, D.A.W., Marshall, T.K.: Firearm injuries. Br. J. Surg. 54, 344–353 (1967)

    Article  PubMed  CAS  Google Scholar 

  16. Fackler, M.L.: Wound ballistics and soft-tissue wound treatment. Tech. Orthop. 10, 163–170 (1995)

    Article  Google Scholar 

  17. Ordog, G.J., Wasserberger, J., Balasubramaniam, S.: Shotgun wound ballistics. J. Trauma 28, 624–631 (1988)

    Article  PubMed  CAS  Google Scholar 

  18. Deitch, E.A., Grimes, W.R.: Experience with 112 shotgun wounds of the extremities. J. Trauma 24, 600–603 (1984)

    Article  PubMed  CAS  Google Scholar 

  19. Burg, A., Nachum, G., Salai, M., Haviv, B., Heller, S., Velkes, S., Dudkiewicz, I.: Treating civilian gunshot wounds to the extremities in a level 1 trauma center: Our experience and recommendations. Isr. Med. Assoc. J. 11, 546–551 (2009)

    PubMed  Google Scholar 

  20. Clasper, J.: The interaction of projectiles with tissues and the management of ballistic fractures. J. R. Army Med. Corps 147, 52–61 (2001)

    PubMed  CAS  Google Scholar 

  21. Bellamy, R., Champion, H., Mahoney, P., Roberts, P.: Introduction and epidemiology. In: Rich, N. (ed.) Definitive Surgical Trauma Skills: Course Manual, pp. 1–5. The Royal College of Surgeons of England, London (1999)

    Google Scholar 

  22. Rose, S.C., Fujisaki, C.K., Moore, E.E.: Incomplete fractures associated with penetrating trauma: etiology, appearance and natural history. J. Trauma 28, 106–109 (1988)

    Article  PubMed  CAS  Google Scholar 

  23. Ragsdale, B.D., Josselson, A.: Experimental gunshot fractures. J. Trauma 28(Suppl 1), S109–115 (1988)

    Article  PubMed  CAS  Google Scholar 

  24. Clasper, J.C., Bowley, D.W.G.: Comminution and contamination after high-energy ballistic fractures of the tibia. J. Bone Joint Surg. Br. 82-B(Supp 1), 55 (2000)

    Google Scholar 

  25. DeMuth Jr., W.E.: The mechanism of shotgun wounds. J. Trauma 11, 219–229 (1971)

    Article  PubMed  Google Scholar 

  26. Amato, J.L., Billy, L.J., Lawson, N.S., Rich, N.M.: High velocity missile injury: An experimental study of the retentive forces of tissue. Am. J. Surg. 127, 454–459 (1974)

    Article  PubMed  CAS  Google Scholar 

  27. Holmström, A., Larsson, J., Lewis, D.H.: Microcirculatory and biochemical studies of skeletal muscle tissue after high energy missile trauma. Acta Chir. Scand. Suppl. 508, 257–259 (1982)

    PubMed  Google Scholar 

  28. Nichols, J.S., Lillehei, K.O.: Nerve injury associated with acute vascular trauma. Surg. Clin. North Am. 68, 837–852 (1988)

    PubMed  CAS  Google Scholar 

  29. Wigle, R.L.: The reaction of copper and other projectile metals in body tissues. J. Trauma 33, 14–18 (1992)

    Article  PubMed  CAS  Google Scholar 

  30. Sykes Jr., L.N., Champion, H.R., Fouty, W.J.: Dumdums, ­hollow-points, and Devastators: Techniques designed to increase wounding potential of bullets. J. Trauma 28, 618–623 (1988)

    Article  PubMed  Google Scholar 

  31. Fackler, M.L., Dougherty, P.J.: Theodor Kocher and the scientific foundation of wound ballistics. Surg. Gynecol. Obstet. 172, 153–160 (1991)

    PubMed  CAS  Google Scholar 

  32. Woloszyn, J.T., Uitvlugt, G.M., Castle, M.E.: Management of civilian gunshot fractures of the extremities. Clin. Orthop. 226, 247–251 (1988)

    PubMed  Google Scholar 

  33. Wang, Z.G., Feng, J.X., Liu, Y.Q.: Pathomorphological observations of gunshot wounds. Acta Chir. Scand. Suppl. 508, 185–195 (1982)

    PubMed  CAS  Google Scholar 

  34. Wright, D.G., Levin, J.S., Esterhai, J.L., Heppenstall, R.B.: Immediate internal fixation of low-velocity gunshot-related femoral fractures. J. Trauma 35, 678–682 (1993)

    Article  PubMed  CAS  Google Scholar 

  35. Barr, R.J., Mollan, R.A.B.: The orthopaedic consequences of civil disturbance in Northern Ireland. J. Bone Joint Surg. Br. 71, 739–744 (1989)

    PubMed  CAS  Google Scholar 

  36. Fasol, R., Irvine, S., Zilla, P.: Vascular injuries caused by anti-personnel mines. J. Cardiovasc. Surg. Torino 30, ­467–72 (1989)

    PubMed  CAS  Google Scholar 

  37. Dimond, F., Rich, N.M.: M-16 rifle wounds in Vietnam. J. Trauma 7, 619–625 (1967)

    Article  PubMed  Google Scholar 

  38. Mendelson, J.A.: The relationship between mechanisms of wounding and principles of treatment of missile wounds. J. Trauma 31, 1181–1202 (1991)

    Article  PubMed  CAS  Google Scholar 

  39. Fackler, M.L.: Ballistic injury. Ann. Emerg. Med. 15, 1451–1455 (1986)

    Article  PubMed  CAS  Google Scholar 

  40. Fackler, M.L.: Gunshot wound review. Ann. Emerg. Med. 28, 194–203 (1996)

    Article  PubMed  CAS  Google Scholar 

  41. Fackler, M.L., Bellamy, R.F., Malinowski, J.A.: The wound profile: Illustration of the missile-tissue interaction. J. Trauma 28(Suppl 1), S21–29 (1988)

    Article  PubMed  CAS  Google Scholar 

  42. Fackler, M.L., Malinowski, J.A.: The wound profile. A visual method for quantifying gunshot wound components. J. Trauma 25, 522–529 (1985)

    Article  PubMed  CAS  Google Scholar 

  43. Brettler, D., Sedlin, E.D., Mendes, D.G.: Conservative treatment of low velocity gunshot wounds. Clin. Orthop. 140, 26–31 (1979)

    PubMed  Google Scholar 

  44. DeMuth, W.E., Smith, J.M.: High-velocity bullet wounds of muscle and bone: The basis of rational early treatment. J. Trauma 6, 744–755 (1966)

    Article  PubMed  Google Scholar 

  45. Ryan, J.M., Cooper, G.J., Haywood, I.R., Milner, S.M.: Field surgery on a future conventional battlefield: Strategy and wound management. Ann. R. Coll. Surg. Engl. 73, 13–20 (1991)

    PubMed  CAS  Google Scholar 

  46. Tian, H.H., Deng, G.G., Huang, M.J., et al.: Quantitative bacteriological study of the wound track. J. Trauma 28(Suppl), S215–S216 (1988)

    Article  PubMed  CAS  Google Scholar 

  47. Simpson, B.M., Wilson, R.H., Grant, R.E.: Antibiotic therapy in gunshot wound injuries. Clin. Orthop. Relat. Res. (408), 82–85 (2003).

    Google Scholar 

  48. Ordog, G.J.: Chapter 28: Lead toxicity secondary to retained missiles. In: Ordog, G.J. (ed.) Management of Gunshot Wounds, pp. 405–411. Elsevier, Amsterdam (1988)

    Google Scholar 

  49. Frykberg, E.R., 3rd Tepas, J.J.: Terrorist bombings. Lessons learned from Belfast to Beirut. Ann. Surg. 208, 569–76 (1988)

    Article  PubMed  CAS  Google Scholar 

  50. Burkle, F.M.J.M., Newland, C., Meister, S.J., Blood, C.G.: Emergency medicine in the Persian Gulf War-Part 3: Battlefield casualties. Ann. Emerg. Med. 23, 755–60 (1994)

    Article  PubMed  Google Scholar 

  51. Bowyer, G.W.: Management of small fragment wounds: experience from the Afghan border. J. Trauma 40(3 Suppl), 170–2 (1996)

    Article  Google Scholar 

  52. Rukovansjki, M.: Spinal cord injuries caused by missile weapons in the Croatian War. J. Trauma 40(3 Suppl), 189–92 (1996)

    Article  Google Scholar 

  53. Wiedeman, J.E.: Rocket grenade injuries: Patient management in a field hospital setting. Mil. Med. 159, 77–9 (1994)

    PubMed  CAS  Google Scholar 

  54. Aboutanos, M.B., Baker, S.P.: Wartime civilian injuries: Epidemiology and intervention strategies. J. Trauma 43, 719–26 (1997)

    Article  PubMed  CAS  Google Scholar 

  55. Satava, R.M., Modesto, V.L.: A mass casualty while in garrison during Operation Desert Storm. Mil. Med. 157, 299–300 (1992)

    PubMed  CAS  Google Scholar 

  56. Kuzman, M., Tomic, B., Stevanovic, R., Ljubicic, M., Katalinic, D., Rodin, U.: Fatalities in the war in Croatia, 1991 and 1992. Underlying and external causes of death. JAMA 270, 626–8 (1993)

    Article  PubMed  CAS  Google Scholar 

  57. Coupland, R.M., Korver, A.J.: Injuries from antipersonnel mines: The experience of the International Committee of the Red Cross. Br. Med. J. 303, 1509–1512 (1991)

    Article  CAS  Google Scholar 

  58. Ofer, G., Aviram, W., Micky, D., Aviv, K., Michael, Y., Ofir, C., Ronene, G., Oren, F., Nahman, A., Yehezkel, L., Gil, H., Amir, B.: Injuries characteristics of IDF soldiers in second Lebanon war. JIMM 4, 3–6 (2007)

    Google Scholar 

  59. Yuval, R., Eran, H., Salah, D., Micha, K., Avraham, Y., Yana, Y., Yoni, C., Micky, D., Carmi, B.-T., Nahman, A., Gil, H.: Injuries characteristics of IDF soldiers in operation cast lead. JIMM 6, 95–98 (2009)

    Google Scholar 

  60. Bowyer, G.W., Cooper, G.J., Rice, P.: Management of small fragment wounds in war: Current research. Ann. R. Coll. Surg. Engl. 77, 131–4 (1995)

    PubMed  CAS  Google Scholar 

  61. Fackler, M.L.: Wound ballistics. A review of common misconceptions. JAMA 259, 2730–6 (1988)

    Article  PubMed  CAS  Google Scholar 

  62. Huang, J.Z., Yang, Z., Wang, Z., Leng, H.: Study on characteristics of blast-fragment combined injury in dogs. J. Trauma 40(3 Suppl), 63–7 (1996)

    Article  Google Scholar 

  63. Covey, D.C.: The role of the orthopaedic surgeon in United Nations Peacekeeping Operations. J. Bone Joint Surg. Am. 77, 495–9 (1995)

    PubMed  CAS  Google Scholar 

  64. Owens, B.D., et al.: Combat wounds in operation Iraqi freedom and operation enduring freedom. J. Trauma 64(2), 295–299 (2008)

    Article  PubMed  Google Scholar 

  65. Marshall Jr., T.J., et al.: Combat casualty care: The Alfa Surgical Company experience during Operation Iraqi Freedom. Mil. Med. 170(6), 469–472 (2005)

    PubMed  Google Scholar 

  66. Patel, T.H., et al.: A U.S. forward surgical team’s experience in Operation Iraqi Freedom. J Trauma 57(2), 201–207 (2004)

    Article  PubMed  Google Scholar 

  67. Hull, J.B., Cooper, G.J.: Pattern and mechanism of traumatic amputation by explosive blast. J. Trauma 40(Suppl), S198–S205 (1996)

    Article  PubMed  CAS  Google Scholar 

  68. Langworthy, M.J., Sabra, J., Gould, M.: Terrorism and blast phenomena: Lessons learned from the attack on the USS Cole (DDG67). Clin. Orthop. 422, 82–87 (2004)

    Article  PubMed  Google Scholar 

  69. Jaffe, D.H., Peleg, K., Israel Trauma Group: Terror explosive injuries: a comparison of children, adolescents, and adults. Ann. Surg. 251(1), 138–43 (2010)

    Article  PubMed  Google Scholar 

  70. Mellor, S.G., Cooper, G.J.: Analysis of 828 servicemen killed or injured by explosion in Northern Ireland 1970-84: the Hostile Action Casualty System. Br. J. Surg. 76, 1006–10 (1989)

    Article  PubMed  CAS  Google Scholar 

  71. Horrocks, C.L.: Blast injuries: Biophysics, pathophysiology and management principles. J. R. Army Med. Corps 147, 28–40 (2001)

    PubMed  CAS  Google Scholar 

  72. Stuhmiller, J.H., Phillips, Y.Y., Richmond, D.R.: The physics and mechanisms of primary blast injury. In: Bellamy, R.F., Zajthcuk, R. (eds.) Conventional Warfare: Ballistic, Blast and Burn Injuries, pp. 241–270. US Government Printing Office, Washington, DC (1991)

    Google Scholar 

  73. Stapczynski, J.S.: Blast injuries. Ann. Emerg. Med. 11, 687–94 (1982)

    Article  PubMed  CAS  Google Scholar 

  74. Mellor, S.G.: The pathogenesis of blast injury and its management. Br. J. Hosp. Med. 39, 536–9 (1988)

    PubMed  CAS  Google Scholar 

  75. Wightman, J.M., Gladish, S.L.: Explosions and blast injuries. Ann. Emerg. Med. 37, 664–78 (2001)

    Article  PubMed  CAS  Google Scholar 

  76. Stein, M., Hirshberg, A.: Medical consequences of terrorism. The conventional weapon threat. Surg. Clin. North Am. 79, 1537–52 (1999)

    Article  PubMed  CAS  Google Scholar 

  77. Katz, E., Ofek, B., Adler, J., Abramowitz, H.B., Krausz, M.M.: Primary blast injury after a bomb explosion in a civilian bus. Ann. Surg. 209, 484–488 (1989)

    Article  PubMed  CAS  Google Scholar 

  78. Leibovici, D., Gofrit, O.N., Stein, M., et al.: Blast injuries: Bus versus open-air bombings: A comparative study of injuries in survivors of open-air versus confined-space explosions. J. Trauma 41, 1030–1035 (1996)

    Article  PubMed  CAS  Google Scholar 

  79. Landsberg, P.G.: Originally published in “Trauma & Emergency Medicine” 17(2), (2000) (Edmonds 3, Lavonas 7).

    Google Scholar 

  80. Cripps, N.P., Cooper, G.J.: The influence of personal blast protection on the distribution and severity of primary blast gut injury. J. Trauma 40(Suppl), S206–S211 (1996)

    Article  PubMed  CAS  Google Scholar 

  81. Karmy-Jones, R., Kissinger, D., Golocovsky, M., Jordan, M., Champion, H.R.: Bomb-related injuries. Mil. Med. 159, 536–9 (1994)

    PubMed  CAS  Google Scholar 

  82. Bowen, I.G., Fletcher, E.R., Richmond, D.R., Hirsch, F.G., White, C.S.: Biophysical mechanisms and scaling procedures applicable in assessing responses of the thorax energized by air-blast overpressures or by nonpenetrating missiles. Ann. NY Acad. Sci. 152, 122–146 (1968)

    Article  PubMed  CAS  Google Scholar 

  83. Bowyer, G.W., Cooper, G.J., Rice, P.: Small fragment wounds: Biophysics and pathophysiology. J. Trauma 40(Suppl), S159–S164 (1996)

    Article  PubMed  CAS  Google Scholar 

  84. Cernak, I., Savis, J., Ignatovic, D., Jevtic, M.: Blast injury from explosive munitions. J. Trauma 47, 96–104 (1999)

    Article  PubMed  CAS  Google Scholar 

  85. Covey, D.C., Peterson, D.A.: Treatment of musculoskeletal blast wounds at a Navy field hospital during the Balkans War. Tech. Orthop. 10, 195–205 (1995)

    Article  Google Scholar 

  86. Spalding, T.J., Stewart, M.P., Tulloch, D.N., Stephens, K.M.: Penetrating missile injuries in the Gulf war 1991. Br. J. Surg. 78, 1102–4 (1991)

    Article  PubMed  CAS  Google Scholar 

  87. Brismar, B., Bergenwald, L.: The terrorist bomb explosion of Bologna, Italy, 1980: An analysis of the effects and injuries sustained. J. Trauma 22, 216–220 (1982)

    Article  PubMed  CAS  Google Scholar 

  88. Carley, S.D.: The casualty profile from the Manchester bombing 1996: A proposal for the construction and dissemination of casualty profiles from major incidents. J. Accid. Emerg. Med. 14, 76–80 (1997)

    Article  PubMed  CAS  Google Scholar 

  89. Hogan, D.E., Wackerle, J.F., Dire, D.J., Lillibridge, S.R.: Emergency department impact of the Oklahoma City terrorist bombing. Ann. Emerg. Med. 34, 160–167 (1999)

    Article  PubMed  CAS  Google Scholar 

  90. Mallonee, S., Shariat, S., Stennies, G., et al.: Physical injuries and fatalities resulting from the Oklahoma City bombing. JAMA 276, 382–387 (1996)

    Article  PubMed  CAS  Google Scholar 

  91. Hull, J.B.: Blast. Injury patterns and their recording. J. Audiov. Media Med. 15, 121–127 (1992)

    PubMed  CAS  Google Scholar 

  92. Clark, M.A.: The pathology of terrorism: Acts of violence directed against citizens of the United States while abroad. Clin. Lab. Med. 18, 99–114 (1998)

    PubMed  CAS  Google Scholar 

  93. Korver, A.J.: Injuries of the lower limb caused by antipersonnel mines; experience of the International Committee of the Red Cross. Injury 27(7), 477–9 (1996)

    Article  PubMed  CAS  Google Scholar 

  94. Trimble, K., Clasper, J.: Anti-personnel mine injury: Mechanism and medical management. J. R. Army Med. Corps 147, 73–79 (2001)

    PubMed  CAS  Google Scholar 

  95. Guy, R.J., Glover, M.A., Cripps, N.P.: Primary blast injury: pathophysiology and implications for treatment. Part III: injury to the central nervous system and limbs. J. R. Nav. Med. Serv. 86, 27–31 (2000)

    PubMed  CAS  Google Scholar 

  96. Hull, J.B.: Traumatic amputation by explosive blast: pattern of injury in survivors. Br. J. Surg. 79, 1303–6 (1992)

    Article  PubMed  CAS  Google Scholar 

  97. Korzinek, K.: War injuries of the extremities. Unfallchirurg 96, 242–7 (1993). German

    PubMed  CAS  Google Scholar 

  98. Bowen, T.E., Bellamy, R.F. (eds.): Emergency war surgery, p. 32. United States Department of Defense, United States Government Printing Office, Washington, DC (1988)

    Google Scholar 

  99. Amato, J.J., Billy, L.J., Gruber, R.P., Lawson, N.S., Rich, N.M.: Vascular injuries. An experimental study of high and low velocity missile wounds. Arch. Surg. 101, 167–74 (1970)

    Article  PubMed  CAS  Google Scholar 

  100. Coupland, R.M.: Technical aspects of war wound excision. Br. J. Surg. 76, 663–7 (1989)

    Article  PubMed  CAS  Google Scholar 

  101. Hartl, W., Klammer, H.L.: Gunshot and blast injuries to the extremities. Management of soft tissue wounds by a modified technique of delayed wound closure. Acta Chir. Scand. 154, 495–9 (1988)

    PubMed  CAS  Google Scholar 

  102. Johnston, G.W., Kennedy, T.L.: Limb and abdominal injuries: Principles of treatment. Br. J. Surg. 63, 738–41 (1976)

    Article  PubMed  CAS  Google Scholar 

  103. Weil, Y.A., Mosheiff, R., Liebergall, M.: Blast and penetrating fragment injuries to the extremities. J. Am. Acad. Orthop. Surg. 14, S136–S139 (2006)

    PubMed  Google Scholar 

  104. Atias-Nikolav, V., Saric, V., Kovac, T., Frankovic, E., Mrsic, V., Lukac, J., Mihaljevic, Z.: Organization and work of the war hospital in Sturba near the town of Livno, Bosnia and Herzegovina. Mil. Med. 160, 62–9 (1995)

    Google Scholar 

  105. Forsberg, J.A., Pepek, J.M., Wagner, S., Wilson, K., Flint, J., Andersen, R.C., Tadaki, D., Gage, F.A., Stojadinovic, A., Elster, E.A.: Heterotopic ossification in high-energy wartime extremity injuries: Prevalence and risk factors. J. Bone Joint Surg. Am. 91, 1084–1091 (2009)

    Article  PubMed  Google Scholar 

  106. Cernak, I., Savic, J., Ignjatovic, D., Jevtic, M.: Blast injury from explosive munitions. J. Trauma 47, 96–103 (1999)

    Article  PubMed  CAS  Google Scholar 

  107. Pape, H.C., Marsh, S., Morley, J.R., Krettek, C., Giannoudis, P.V.: Current concepts in the development of heterotopic ossification. J. Bone Joint Surg. Br. 86, 783–787 (2004)

    Article  PubMed  CAS  Google Scholar 

  108. Covey, D.C.: Combat orthopaedics: A view from the trenches Journal of the American Academy of Orthopaedic Surgeons. J. Am. Acad. Orthop. Surg. 14, S10–S17 (2006)

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Emek Medical Center, Afula, Israel

    Nimrod Rozen (Chief of Orthopaedic Surgery)

  2. Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel

    Nimrod Rozen (Chief of Orthopaedic Surgery)

  3. Department of Rehabilitation, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

    Israel Dudkiewicz (Head of Orthopaedic Rehabilitation Unit)

Authors
  1. Nimrod Rozen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Israel Dudkiewicz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nimrod Rozen .

Editor information

Editors and Affiliations

  1. Ziv Medical Center, Str. Rambam 1, Zefat, 13100, Israel

    Alexander Lerner

  2. Faculty of Medicine, Deptartment of Orthopaedic Surgery, Rambam Medical Center, Haaliyah Street 8, Haifa, 31096, Israel

    Michael Soudry

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Berlin Heidelberg

About this chapter

Cite this chapter

Rozen, N., Dudkiewicz, I. (2011). Wound Ballistics and Tissue Damage. In: Lerner, A., Soudry, M. (eds) Armed Conflict Injuries to the Extremities. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16155-1_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-16155-1_2

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-16154-4

  • Online ISBN: 978-3-642-16155-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation