Citation

Brown KV, Roberts DC, Wordsworth M, Duraku LS, Jose RM, Power DM, Stapley SA. J. Hand Surg. Eur. Vol. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, SAGE Publishing)

DOI

10.1177/17531934221098916

PMID

35579217

Abstract

Upper limb injuries are common in conflict zones. The functions of the upper limb are impossible to replicate with prosthetic replacement and wherever possible attempts should be made to preserve the limb with further secondary reconstruction aimed at restoration of function. Casualty assessment, haemorrhage control and resuscitation are simultaneously undertaken at the receiving medical facility. Primary surgical management involves decontamination and debridement, skeletal stabilization, restoration of vascularity, compartment fasciotomy where indicated and wound temporization with dressings. Operative findings and interventions should be documented and if evacuation of the casualty is possible, copies should be provided in the medical records to facilitate communication in the chain of care. Secondary procedures are required for further assessment and debridement prior to planning reconstruction and definitive fracture stabilization, nerve repair, wound cover or closure.

Language: en

Keywords

assessment; blast; Conflict injuries; gunshot; military; stabilization; upper limb