Читать книгу Synopsis of Orthopaedic Trauma Management - Brian H. Mullis - Страница 21

A. Blunt injuries

1. These are the results of a direct blow leading to a focal area of injury (▶Fig. 2.1).

2. This is the most common mechanism for open fractures.

B. Ballistic injuries

1. Determine between low- (i.e., handguns) and high- (i.e., military and hunting rifles) velocity injuries and high-mass injuries (close-range shotgun).

a. Low-velocity ballistic fractures often can be treated as closed fractures. Weak evidence for antibiotic prophylaxis in these injuries.

b. High-energy (high-velocity or high-mass) ballistic injuries are associated with significant soft tissue compromise and require surgical debridement.

Fig. 2.1 An example of an open tibia fracture sustained after a blunt injury mechanism.

C. Blast injuries

1. These are divided into three different types of injuries:

a. Primary: initial blast wave energy dissipated onto the body.

b. Secondary: fragments emitted from the explosive device lodge into the body.

c. Tertiary: resulting injury from victim being projected against ground or solid objects.