Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지

Treatment of Combat-related Gunshot and Explosive Injuries to the Extremities

전투 상황에서 발생한 사지 총상 및 폭발창의 치료

  • Lee, Jung Eun (Department of Orthopedic Surgery, Seoul National University College of Medicine) ;
  • Lee, Young Ho (Department of Orthopedic Surgery, Seoul National University College of Medicine) ;
  • Baek, Goo Hyun (Department of Orthopedic Surgery, Seoul National University College of Medicine) ;
  • Lee, Kyung-Hag (Department of Orthopedic Surgery, Seoul National University College of Medicine) ;
  • Cho, Young Jae (Department of Orthopedic Surgery, Seoul National University College of Medicine) ;
  • Kim, Yeong Cheol (Trauma Center, Seoul National University Hospital) ;
  • Suh, Gil Joon (Trauma Center, Seoul National University Hospital)
  • 이정은 (서울대학교 의과대학 정형외과학교실) ;
  • 이영호 (서울대학교 의과대학 정형외과학교실) ;
  • 백구현 (서울대학교 의과대학 정형외과학교실) ;
  • 이경학 (서울대학교 의과대학 정형외과학교실) ;
  • 조영재 (서울대학교 의과대학 정형외과학교실) ;
  • 김영철 (서울대학교병원 외상센터) ;
  • 서길준 (서울대학교병원 외상센터)
  • Received : 2013.05.24
  • Accepted : 2013.08.28
  • Published : 2013.09.30
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Abstract

Purpose: We should prepare proper medical service for disaster control as South Korea is not free from terrorism and war, as we experienced through the two naval battles of the Yeonpyeong, one in 1999 and the other in 2002, the sinking of Cheonan in 2010, and the attack against the border island of Yeonpyeong in 2010. Moreover, North Korea's increasingly bellicose rhetoric and mounting military threats against the world demand instant action to address the issue. The aim of this article is to describe our experience with three patients with combat-related gunshot and explosive injuries to their extremities and to establish useful methods for the management of patients with combat-related injuries. Methods: Three personnel who had been injured by gunshot or explosion during either the second naval battle of the Yeonpyeong in 2002 or the attack against the border island of Yeonpyeong in 2010 were included in our retrospective analysis. There were one case of gunshot injury and two cases of explosive injuries to the extremities, and the injured regions were the left hand, the right foot, and the right humerus. In one case, the patient had accompanying abdominal injuries, and his vital signs were unstable. He recovered after early initial management and appropriate emergency surgery. Results: All patients underwent emergent surgical debridement and temporary fixation surgery in the same military hospital immediately after their evacuations from the combat area. After that, continuous administration of antibiotics and wound care were performed, and definite reconstructions were carried out in a delayed manner. In the two cases in which flap operations for soft tissue coverage were required, one operation was performed 5 weeks after the injury, and the other operation was performed 7 weeks after the injury. Definite procedures for osteosynthesis were performed at 3 months in all cases. Complete union and adequate functional recovery were achieved in all cases. Conclusion: The patient should be stabilized and any life-threatening injuries must first be evaluated and treated with damage control surgery. Staged treatment and strict adherence to traditional principles for open fractures are recommended for combat-related gunshot and explosive injuries to the extremities.

Keywords

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