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Nguyen TT, Breeze J, Masouros SD. Penetration of Energised Metal Fragments to Porcine Thoracic Tissues. J Biomech Eng 2021; 144:1129240. [PMID: 34897379 DOI: 10.1115/1.4053212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Indexed: 11/08/2022]
Abstract
Energised fragments from explosive devices have been the most common mechanism of injury to both military personnel and civilians in recent conflicts and terrorist attacks. Fragments that penetrate into the thoracic cavity are strongly associated with death due to the inherent vulnerability of the underlying structures. The aim of this study was to investigate the impact of fragment-simulating projectiles (FSPs) to tissues of the thorax in order to identify the thresholds of impact velocity for perforation through these tissues and the resultant residual velocity of the FSPs. A gas-gun system was used to launch 0.78-g cylindrical and 1.13-g spherical FSPs at intact porcine thoracic tissues from different impact locations. The sternum and rib bones were the most resistant to perforation, followed by the scapula and intercostal muscle. For both FSPs, residual velocity following perforation was linearly proportional to impact velocity. These findings can be used in the development of numerical tools for predicting the medical outcome of explosive events, which in turn can inform the design of public infrastructure, of personal protection, and of medical emergency response.
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Affiliation(s)
- Thuy-Tien Nguyen
- Department of Bioengineering, Imperial College London, UK; Imperial College London, London, W12 0BZ, United Kingdom
| | - John Breeze
- Department of Bioengineering, Imperial College London, UK; Imperial College London, London, W12 0BZ, United Kingdom
| | - Spyros D Masouros
- Department of Bioengineering, Imperial College London, UK; Imperial College London, London, W12 0BZ, United Kingdom
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2
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Vieira LP, Costa FP, Negrão P, Neves N, Monteiro EL, da Silva MR. "Bone-shot fracture" - An unusual iliac wing fracture caused by a projectile of autologous bone fragment. A case report. Trauma Case Rep 2021; 33:100456. [PMID: 33855153 PMCID: PMC8025054 DOI: 10.1016/j.tcr.2021.100456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2021] [Indexed: 11/28/2022] Open
Abstract
Case A young adult male sustained a high-energy crash suffering multiple injuries including a comminuted right femoral shaft fracture and an ipsilateral iliac wing fracture. The iliac fracture was caused by a femoral fragment which was projected and pierced the iliac wing. The patient underwent surgery with retrieval of the femoral fragment and fixation of the iliac and femoral fractures. The lesions healed uneventfully. Conclusion This is the first reported case of an iliac fracture caused by a projectile of autologous bone. High-energy trauma may present unusual or never seen injury patterns to the trauma surgeon.
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Affiliation(s)
- Luís Pedro Vieira
- CUF Porto Hospital, Porto, Portugal.,Orthopedics Department, Centro Hospitalar e Universitário de São João, Porto, Portugal.,Surgery and Physiology Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Francisca Pinho Costa
- CUF Porto Hospital, Porto, Portugal.,Orthopedics Department, Centro Hospitalar e Universitário de São João, Porto, Portugal.,Surgery and Physiology Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Pedro Negrão
- CUF Porto Hospital, Porto, Portugal.,Orthopedics Department, Centro Hospitalar e Universitário de São João, Porto, Portugal.,Surgery and Physiology Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Nuno Neves
- CUF Porto Hospital, Porto, Portugal.,Orthopedics Department, Centro Hospitalar e Universitário de São João, Porto, Portugal.,Surgery and Physiology Department, Faculty of Medicine, University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.,INEB - Instituto Nacional de Engenharia Biomédica, University of Porto, Porto, Portugal
| | - Eurico Lisboa Monteiro
- CUF Porto Hospital, Porto, Portugal.,Orthopaedic Department, Centro Hospitalar de Entre o Douro e Vouga, EPE, Santa Maria da Feira, Portugal
| | - Manuel Ribeiro da Silva
- CUF Porto Hospital, Porto, Portugal.,Orthopedics Department, Centro Hospitalar e Universitário de São João, Porto, Portugal.,Surgery and Physiology Department, Faculty of Medicine, University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.,INEB - Instituto Nacional de Engenharia Biomédica, University of Porto, Porto, Portugal
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Nguyen TTN, Meek G, Breeze J, Masouros SD. Gelatine Backing Affects the Performance of Single-Layer Ballistic-Resistant Materials Against Blast Fragments. Front Bioeng Biotechnol 2020; 8:744. [PMID: 32714916 PMCID: PMC7343711 DOI: 10.3389/fbioe.2020.00744] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 06/10/2020] [Indexed: 11/22/2022] Open
Abstract
Penetrating trauma by energized fragments is the most common injury from explosive devices, the main threat in the contemporary battlefield. Such devices produce projectiles dependent upon their design, including preformed fragments, casings, glass, or stones; these are subsequently energized to high velocities and cause serious injuries to the body. Current body armor focuses on the essential coverage, which is mainly the thoracic and abdominal area, and can be heavy and cumbersome. In addition, there may be coverage gaps that can benefit from the additional protection provided by one or more layers of lightweight ballistic fabrics. This study assessed the performance of single layers of commercially available ballistic protective fabrics such as Kevlar®, Twaron®, and Dyneema®, in both woven and knitted configurations. Experiments were carried out using a custom-built gas-gun system, with a 0.78-g cylindrical steel fragment simulating projectile (FSP) as the impactor, and ballistic gelatine as the backing material. FSP velocity at 50% risk of material perforation, gelatine penetration, and high-risk wounding to soft tissue, as well as the depth of penetration (DoP) against impact velocity and the normalized energy absorption were used as metrics to rank the performance of the materials tested. Additional tests were performed to investigate the effect of not including a soft-tissue simulant backing material on the performance of the fabrics. The results show that a thin layer of ballistic material may offer meaningful protection against the penetration of this FSP. Additionally, it is essential to ensure a biofidelic boundary condition as the protective efficacy of fabrics was markedly altered by a gelatine backing.
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Affiliation(s)
- Thuy-Tien N Nguyen
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - George Meek
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - John Breeze
- Department of Bioengineering, Imperial College London, London, United Kingdom.,Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | - Spyros D Masouros
- Department of Bioengineering, Imperial College London, London, United Kingdom
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Nguyen TTN, Carpanen D, Stinner D, Rankin IA, Ramasamy A, Breeze J, Proud WG, Clasper JC, Masouros SD. The risk of fracture to the tibia from a fragment simulating projectile. J Mech Behav Biomed Mater 2019; 102:103525. [PMID: 31877527 DOI: 10.1016/j.jmbbm.2019.103525] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 10/11/2019] [Accepted: 11/05/2019] [Indexed: 11/25/2022]
Abstract
Penetrating injuries due to fragments energised by an explosive event are life threatening and are associated with poor clinical and functional outcomes. The tibia is the long bone most affected in survivors of explosive events, yet the risk of penetrating injury to it has not been quantified. In this study, an injury-risk assessment of penetrating injury to the tibia was conducted using a gas-gun system with a 0.78-g cylindrical fragment simulating projectile. An ovine tibia model was used to generate the injury-risk curves and human cadaveric tests were conducted to validate and scale the results of the ovine model. The impact velocity at 50% risk (±95% confidence intervals) for EF1+, EF2+, EF3+, and EF4+ fractures to the human tibia - using the modified Winquist-Hansen classification - was 271 ± 30, 363 ± 46, 459 ± 102, and 936 ± 182 m/s, respectively. The scaling factor for the impact velocity from cadaveric ovine to human was 2.5. These findings define the protection thresholds to improve the injury outcomes for fragment penetrating injury to the tibia.
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Affiliation(s)
| | | | - Daniel Stinner
- Department of Bioengineering, Imperial College London, UK
| | - Iain A Rankin
- Department of Bioengineering, Imperial College London, UK
| | - Arul Ramasamy
- Department of Bioengineering, Imperial College London, UK; Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, UK; Academic Department of Trauma and Orthopaedics, Queen Elizabeth Hospital Birmingham, UK
| | - Johno Breeze
- Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, UK
| | - William G Proud
- Institute of Shock Physics, Department of Physics, Imperial College London, UK
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