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SURGERY Modern warfare has changed over recent decades. The causes of injury are particular to the individual conflict, nation and 9 armed service. Historically , penetrating trauma was predom inantly sustained by combat infantry , whereas naval and air person...

Secondary blast injury Secondary blast injury refers to the e ff ect of fragments that are accelerated away from the device following detonation. Sources of fragments include: /uni25CF the casing of the device; /uni25CF purposefully placed fragments within t...

Tertiary blast injury Tertiary blast injury is the result of gross movement of person - nel, objects or infrastructure by blast wind. Tertiary injury is variety of injuries to all organ systems. Traumatic amputation is typically included within this category...

WEAPON EFFECTS Ballistics The ability to manage conflict injuries relies on an under - standing of the underlying mechanism of wounding, which - is likely to be di ff erent from that in civilian trauma. As stated, while ballistic injuries are no longer the ...

Ankle ( Figure 35.37 ) /uni25CF Dorsiflexion . Test dorsiflexion with the knee both flexed and extended. If restriction is greater with the knee extended than flexed, the contracture is principally in the gastrocnemius. Restriction that is equal in all knee posi ...

Ankle stability Trauma to the ankle is a common cause of instability . Accurate assessment may be di ffi cult in the acute setting because of pain. /uni25CF Anterior draw test . With the foot resting over the bed, hold the heel with one hand and the front of ...

Anterior cruciate ligament The most sensitive test for evaluation of the ACL is the Lachman test. /uni25CF The Lachman test ( Figure 35.32 ). Flex the knee to 15–30° and pull the proximal tibia gently forwards. Exces - sive laxity may indicate rupture of the...

Assessment of joint hypermobility Increased movement and flexibility of a joint can often cause joint pain and symptoms of instability . A formal assessment of joint mobility can help document the degree of mobility . The Beighton score alone cannot be used ...

CLINICAL EXAMINATION OF THE FOOT AND ANKLE The foot can be divided into three parts: the hindfoot (calca neus, talus), the midfoot (navicular, cuboids, cuneiforms) and the forefoot (metatarsals and phalanges). CLINICAL EXAMINATION OF THE FOOT AND ANKLE The foo...