Characteristics of head injuries based on the specific nature of military conflicts

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Head injuries are among the most serious and severe types of trauma in both peacetime and wartime conditions. This article examines head injuries sustained during various large-scale military conflicts and identifies correlations between the localization and nature of injuries, the tactics of combat operations, the weapons used, and the terrain features. This analysis is particularly relevant in light of the ongoing special military operation and may be utilized in the development of individual protective gear and strategies for treating head injuries in field hospitals.

The article incorporates scientific and specialized literature sourced from eLibrary, ResearchGate, CyberLeninka, and PubMed. A statistical and systemic-structural analysis of the literature was performed using methods such as description, comparison, generalization, and hypothesis formulation. The authors analyzed the Syrian Civil War, as well as the military operations “Iraqi Freedom” and “Enduring Freedom.” Average injury characteristics were derived and classified into groups based on the type of affected structures for better visualization. We revealed that the nature of head injuries varies significantly depending on the specifics of the military conflict. However, the most commonly affected areas in any conflict remain the lower and upper jaw, the orbit, and the nasal region.

This article makes a significant contribution to medical research and may be of value to military physicians as well as researchers and engineers involved in the design and improvement of individual protective gear.

Full Text

Restricted Access

About the authors

Maksim А. Kislov

The Russian National Research Medical University named after N.I. Pirogov

Email: kislov@sechenov.ru
ORCID iD: 0000-0002-9303-7640
SPIN-code: 3620-8930

MD, Dr. Sci. (Medicine), Assistant Professor

Россия, Moscow

Evgeny Kh. Barinov

Russian University of Medicine

Email: ev.barinov@mail.ru
ORCID iD: 0000-0003-4236-4219
SPIN-code: 2112-4568

MD, Dr. Sci (Medicine), Professor

Россия, Moscow

Egor А. Akulinichev

The First Sechenov Moscow State Medical University

Email: egor40rus@icloud.com
ORCID iD: 0009-0002-2142-151X
Россия, Moscow

Dmitriy A. Zotkin

The First Sechenov Moscow State Medical University

Author for correspondence.
Email: zotkin.dmitriy.83@mail.ru
ORCID iD: 0000-0002-2419-5952
SPIN-code: 9263-0002
Россия, Moscow

References

  1. Trotsenko KА. Fighting in Syria: Furthering combined-arms combat and operation methods or a special case? Voyennaya mysl = Military thought. 2020;(12):31–48. EDN: NLBUOM
  2. Isakov VD, Babakhanyan RV, Matyshev LL, et al. Forensic medical expertise of explosive trauma. Saint Petersburg; 1997. 120 р. (In Russ.)
  3. Nechaev EA, Gritsanov AI, Fomin NF, Minnullin IP. Minno-explosive trauma. Saint Petersburg: Al'd; 1994. 488 р. (In Russ.)
  4. Popov VL. Explosion. Forensic and medical aspects: A guide for experts. Saint Petersburg: Yuridicheskii tsentr; 2019. 296 с. (In Russ.)
  5. Popov VL. Certain theoretical-methodological problems of forensic medical expertise of the blast injury. Sudebno-meditsinskaia ekspertiza = Forensic medical expertise. 2015;(4):4–10. EDN: UGWJWP
  6. Popov VL, Tiurin MV, Makarov II, Fradkina NA. The current state and prospects of the development of forensic medical expertise of the blast injury. Sudebno-meditsinskaia ekspertiza = Forensic medical expertise. 2013;(3):25–30. EDN: QCNBPR
  7. Forensic medicine and forensic medical expertise: National manual. Ed. by Y.I. Pigolkin. Moscow: GEOTAR-Media; 2014. Р. 307–328. (In Russ.)
  8. Tomilin VV, Pashinyan GA. Manual on forensic medicine. Moscow: Meditsina; 2001. 576 р. (In Russ.)
  9. Fradkina NA, Kovalev AV, Makarov II. Peculiarities of forensic medical reconstruction of the mechanism of injuries in numerous victims of the explosion of a high-capacity blasting device. Sudebno-meditsinskaia ekspertiza = Forensic medical expertise. 2013;(2):4–6. EDN: PYSSKJ
  10. Kislov MA, Makarov IY, Leonov SV, et al. The current state of the issue on explosive injury. Sudebno-meditsinskaia ekspertiza = Forensic medical expertise. 2021;(4):68–72. EDN: KKOANH doi: 10.17116/sudmed20216404168
  11. Molchanov VI. Forensic medical examination of explosion injuries. Leningrad: Voenno-meditsinskaya akademiya im. S.M. Kirova; 1962. 18 р. (In Russ.)
  12. Arlı C, Özkan M, Karakuş A. Incidence, etiology, and patterns of maxillofacial traumas in Syrian patients in Hatay, Turkey: A 3-year retrospective study. Ulus Travma Acil Cerrahi Derg. 2019;25(1):29–33. doi: 10.5505/tjtes.2018.16243
  13. Ucak M. Shrapnel injuries on regions of head and neck in Syrian war. J Craniofac Surg. 2020;31(5):1191–1195. doi: 10.1097/SCS.0000000000006345
  14. Ucak M. Incidence and severity of maxillofacial injuries during the Syrian civil war in Syrian soldiers and civilians. J Craniofac Surg. 2019;30(4):992–995. doi: 10.1097/SCS.0000000000005440
  15. Neubauer DC, Camacho M, O'Reilly EB, et al. The new face of war: Craniofacial injuries from operation inherent resolve. J Trauma Acute Care Surg. 2022;93(2S, Suppl. 1):S49–S55. EDN: XOSWMR doi: 10.1097/TA.0000000000003700
  16. Hanafi I, Munder E, Ahmad S, et al. War-related traumatic brain injuries during the Syrian armed conflict in Damascus 2014–2017: A cohort study and a literature review. BMC Emerg Med. 2023;23(1):35. EDN: MBDTRS doi: 10.1186/s12873-023-00799-6
  17. Şimşek KB, Dokur M, Uysal E, et al. Characteristics of the injuries of Syrian refugees sustained during the civil war. Ulus Travma Acil Cerrahi Derg. 2017;23(3):199–206. doi: 10.5505/tjtes.2016.95525
  18. Valetsky OV, Girin AV, Markin AV, Neelov VM. Lessons of Iraq. Tactics, strategy and technique in the Iraqi wars of the USA. Moscow: Izdatel' Vorob'ev A.V.; 2015. 212 р. (In Russ.)
  19. Valetsky OV, Neelov VM. Features of combat operations in Afghanistan (2001–2015). A brief essay. Moscow: Izdatel' Vorob'ev A.V.; 2015. 88 р. (In Russ.)
  20. Hauer T, Huschitt N, Kulla M, et al. [Bullet and shrapnel injuries in the face and neck regions. Current aspects of wound ballistics. (In German)]. HNO. 2011;59(8):752–764. doi: 10.1007/s00106-011-2365-1
  21. Brennan J. Head and neck trauma in Iraq and Afghanistan: Different war, different surgery, lessons learned. Laryngoscope. 2013;123(10):2411–2417. doi: 10.1002/lary.24096
  22. Keller MW, Han PP, Galarneau MR, Gaball CW. Characteristics of maxillofacial injuries and safety of in-theater facial fracture repair in severe combat trauma. Mil Med. 2015;180(3):315–320. doi: 10.7205/MILMED-D-14-00345
  23. Lew TA, Walker JA, Wenke JC, et al. Characterization of craniomaxillofacial battle injuries sustained by United States service members in the current conflicts of Iraq and Afghanistan. J Oral Maxillofac Surg. 2010;68(1):3–7. doi: 10.1016/j.joms.2009.06.006
  24. Breeze J, Gibbons AJ, Shieff C, et al. Combat-related craniofacial and cervical injuries: A 5-year review from the British military. J Trauma. 2011;71(1):108–113. doi: 10.1097/TA.0b013e318203304a
  25. Stewart SK, Pearce AP, Clasper JC. Fatal head and neck injuries in military underbody blast casualties. J R Army Med Corps. 2019;165(1):18–21. doi: 10.1136/jramc-2018-000942
  26. Breeze J, Gensheimer W, DuBose JJ. Combat facial fractures sustained during operation resolute support and operation freedom's sentinel in Afghanistan. Mil Med. 2020;185(9-10):414–416. doi: 10.1093/milmed/usaa159

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Foreign body and ultrafragmentary fracture with displacement of the left mandible (a ― preoperatively); restoration with screw implants and miniplates (b ― postoperative period).

Download (181KB)
Indexing metadata
3. Fig. 2. Multiple displaced fragmentary fractures in the right mandibular branch (a ― preoperative); miniplate and screw implant in the right mandibular branch (b ― postoperative period).

Download (169KB)
Indexing metadata
4. Fig. 3. Vectors of possible projectile and shrapnel hits to the head when using a protective helmet.

Download (144KB)
Indexing metadata
5. Fig. 4. Effect of a low-velocity gunshot wound from a P8 pistol on tissue from a close (~4 m) distance: entry wound about 9×9 mm, medial (a); exit wound about 10×10 mm (b); pincer in the bullet canal (c), which is also detectable on the radiograph (d, arrow) due to the location of multiple small bone fragments. Palpation with a sharp spoon revealed a wound channel with a ~4–5 cm through hole in the soft tissue (Afghanistan, Kunduz Rescue Centre, July 2010).

Download (330KB)
Indexing metadata
6. Fig. 5. Bullet and shrapnel wounds to the head and neck compared: secondary wound from a rifle shot (a); indirect facial shrapnel wound after a ‘rocket-propelled grenade’ (b). (Afghanistan, Kunduz Rescue Centre, April 2010).

Download (336KB)
Indexing metadata
7. Fig. 6. Soft tissue and bone defect from an AK-47 assault rifle (a); preoperative (b) and postoperative (c) computed tomography.

Download (334KB)
Indexing metadata

Copyright (c) 2024 Eco-Vector


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 81753 выдано 09.09.2021 г. 
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ФС 77 – 59181 выдано 03.09.2014 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies