LIMB AMPUTATIONS IN MILITARY PERSONNEL DUE TO ARTILLERY STRIKES IN THE AREA OF THE ANTITERRORIST OPERATION (ATO) IN EAST UKRAINE
Abstract
The aim – to investigate and evaluate amputations of extremities due to the trikes of artillery against military personnel of the Armed Forces of Ukraine (AFU) within the area of the Antiterrorist Operation (ATO) in East Ukraine.
Patients and methods. All military personnel of the AFU within ATO was eligible for the study with diagnosis of limb amputations in the period from 01.06.2014 to 30.06.2016, and who were treated in hospitals of the Ministry of Defense of Ukraine. Among 7091 patients with injuries, 152 patients with limb amputations were identified.
Results and discussion. Out of 152 patients, 73 (48%) amputations were due to artillery strikes or mine shelling, while other causes of amputation were identified in 79 (52%) of the wounded. Amputations of the middle 1/3 of the arm were more frequently diagnosed in the artillery injury group as compared to the group of another cause of amputation (p = 0.011). The use of artillery by the terrorists against the AFU resulted in more often in amputation of one limb, which was detected in 70 (96%) patients in this group, as compared with 65 (82%) patients in the group of another cause of amputation (p = 0.0093). Analyses of the number of amputated extremities revealed 1 (1.4%) patient with amputation of 2 lower extremities in the artillery fire group, which was 9 times less frequently observed as compared to 9 (11%) patients in the group of another cause of amputation (p = 0.019).
Conclusions: The results of the study confirmed significant role of artillery strikes for the amputation of one limb. High-energy artillery weapons play a minor role in terms of amputations at the level of the middle 1/3 of the upper limb and amputation of the two lower limbs.
References
Chandler, H, MacLeod, K, Penn-Barwell, J. G., & Group, S. L. E. C.
T. S. S. (2017). Extremity injuries sustained by the UK military in the Iraq
and Afghanistan conflicts: 2003-2014. Injury, 48f7), 1439-1443.
doi: 10.1016/j. injury. 2017.05.022
Ebrahimzadeh, M. H, Moradi, A., Khorasani, M. R., Hallaj- Moghaddam, M., & Kachooei, A. R. (2015). Long-term clinical outcomes of war-related bilateral lower extremities amputations. Injury, 46(2), 275- 281. doi: 10.1016/j. injury. 2014.10.043
Edwards, D. S., Guthrie, H. C., Yousaf S., Cranley, M., Rogers, B. A., & Clasper, J. C. (2016). Trauma-related amputations in war and at a civilian major trauma centre-comparison of care, outcome and the challenges ahead. Injury, 47(5), 1806-1810. doi: 10.1016/
j. injury. 2016.05.029
Khomenko, I, Shapovalov, V, Tsema, I, Makarov, G., Palytsia, R., Zavodovskyi, I, Dinets A., Mishalov, V. (2017). Hydrodynamic rupture of liver in combat patient: a case of successful application of “damage control” tactic in area of the hybrid war in East Ukraine. Surg Case Rep, 3(1), 88. doi:10.1186/s40792-017-0363-6
Oh, J. S., Tubb, С. C., Poepping, T. P, Ryan, P, Clasper, J. C., Katschke, A. R., Murray, M. J. (2016). Dismounted Blast Injuries in Patients Treated at a Role 3 Military Hospital in Afghanistan: Patterns of Injury and Mortality. Mil Med, 18179), 1069-1074. doi: 10.7205/MILMED- D-15-00264
Stansbury, L. G., Lalliss, S. J., Branstetter, J. G., Bagg, M. R., & Holcomb, J. B. (2008). Amputations in U.S. military personnel in the current conflicts in Afghanistan and Iraq. J Orthop Trauma, 22(1), 43-46. doi:10.1097/BOT.0b013e31815b35aa
Buryanov, A. A., Kazmirchuk P. A., Yarmolyuk Yu. A., Vakulich M. V. Analysis of the system for providing surgical assistance to the victims with gunshot trauma skeletal // Kharkiv Surgical School. — 2016. — 80(5): p. 81-85.
Tsema, I, Khomenko, I, Bespalenko, A., Dinets, A., Koval, B., Mishalov, V, & Buryanov, 0. (2017). Damage factors and causes of limb amputations in combat-related patients within the area of war conflict in the East of Ukraine. Surgery of Ukraine, 62(2), 7-13.
Zeljko, B., Lovrж, Z., Атж, E., Busi.w, V, Lovrж, L., & Markovж, I. (2006). War injuries of the extremities: twelve-year follow-up data. Mil Med, 171(7), 55-57.
Zivkovic, 0., Poljak-Guberina, R., Muljacic, A., & Guberina, M. (2009). Our experience with modified osteomyoplasty for reamputation of war-related transtibial amputees. Mil Med, 174(79), 1118-1122.
Korol S.O., Bespalenko A.A. The use of modern methods specialized trauma treat the wounded with gunshot fractures long bones (IV level of provision health care) // Litopys of traumatology and prthopedics. — 2015. (1-20): p. 28-30.
Poroshenko P.O. Law of Ukraine about features of state politics for providing of state sovereignty at temporary occupied areas in Donetsk and Luhansk oblasts, in 7163, Verhovna Rada of Ukraine, 2018: Kyiv.
Strafun, S.S., Hayovych, V. V, Hayovych, I. V, Науко, O.V, & Borzych, N. 0. (2015). Treatment of damage of limbs nerves due to gun-shot injury. Vistnik of rothopedics, traumatology and prothesis (2), 1-5.
Tsema I, Khomenko I, Bespalenko A., Dinets A., Zavodovskyi I., Koval B., Mishalov V, Buryanov 0. Damage factors and causes of limb amputations in combat-related patients within the area of war conflict in the East of Ukraine // Sutrgery of Ukraine. — 2017. — 62(2): p. 7-13.
Shteinle A.V The analysis of the results of the treatment of wounded men with injuries of main arteries ’ of extremities in the course of counterterrorist operations in the Nothern Caucasia // Siberia Medical Journal. — 2010.-25(1): p. 31-36.
This work is licensed under a Creative Commons Attribution 4.0 International License.
ISSN 
ISSN 
