Management of Orthopedic Blast Injuries

Over the past two decades, the complexity and severity of orthopedic blast injuries have increased significantly. This has been the case not only with the combat operations undertaken in Iraq and Afghanistan but also with casualties sustained in terrorist attacks around the globe. Multiple, high-energy extremity injuries are the predominate injury patterns in these scenarios. With greater experience and understanding of these injury patterns, orthopedic management of the blast injury patient has significantly evolved over this time frame. From the initial resuscitation of the patient in the emergency department (ED), to the advent of damage control orthopedics , to the definitive reconstructive care of these patients’ injuries, the evolution in understanding how to properly treat these injuries has led to substantially improved outcomes. As knowledge of how to treat these complex injuries continues to evolve, there has been dramatic improvement in the management of the long-term sequela of these injuries such as infection, heterotopic ossification, chronic pain, PTSD, and functional outcome.