Khan M Tahir, Husain Faisal N, Ahmed Aftab
Department of Orthopaedic Surgery, King Edward Medical College/Mayo Hospital, Lahore, Pakistan.
Injury. 2002 Mar;33(2):167-71. doi: 10.1016/s0020-1383(01)00092-4.
Landmines were initially developed as anti-tank weapons. They are still used indiscriminately and in a disorganised fashion, violating the United Nations Treaty on their use [United Nations (1980)]. The injury produced by these devices is variable depending upon the construction and strength of the landmine and body parts coming in contact with the landmine at the time of detonation. The purpose of the present study was to report the type of landmine-blast injuries of the lower limbs and the surgical options available to treat them. Twenty-eight patients, all with lower limb injuries were included in the present study. They had received injuries on the control line of the troubled Jammu and Kashmir regions in the north of Pakistan. All were male patients between the age of 13 and 55 years. A salvage procedure for the forefoot was possible on four patients only and all the rest had a below-knee amputation. Time lapsed between the injury and receiving medical help was the crucial determining factor as to the final outcome of the limb. We believe that the pattern of injury, amount of energy dissipation and part of body in contact with the landmine at the time of explosion are the main determining factors for the final outcome. If skin along with the underlying soft tissue and the neuro-vascular structures on the dorsum of the foot are spared then an attempt can be made at limb salvage.
地雷最初是作为反坦克武器研制的。它们仍在被随意且无序地使用，这违反了联合国关于其使用的条约[联合国（1980年）]。这些装置造成的损伤因地雷的构造和强度以及爆炸时与地雷接触的身体部位而异。本研究的目的是报告下肢地雷爆炸伤的类型以及治疗这些损伤的可用手术方案。本研究纳入了28例均有下肢损伤的患者。他们在巴基斯坦北部动荡的查谟和克什米尔地区的控制线受伤。所有患者均为男性，年龄在13至55岁之间。仅4例患者的前足可行挽救手术，其余所有患者均接受了膝下截肢。受伤与获得医疗救助之间的时间间隔是肢体最终结局的关键决定因素。我们认为，损伤模式、能量消散量以及爆炸时与地雷接触的身体部位是最终结局的主要决定因素。如果足部背侧的皮肤连同其下方的软组织以及神经血管结构得以保留，那么可以尝试进行肢体挽救。
