Coupland R M, Hoikka V, Sjoeklint O G, Cuenod P, Cauderay G C, Doswald-Beck L
International Committee of the Red Cross, Medical Division, Geneva, Switzerland.
Lancet. 1992 Jan 4;339(8784):35-7. doi: 10.1016/0140-6736(92)90152-s.
Under international humanitarian law, the Hague Declaration of 1899 forbids the use of small arms ammunition that disrupts in the body after impact. However, assessment of whether bullets have undergone disruption is subjective and accusations that one or both sides of a conflict have used such ammunition cannot be substantiated. We describe a method by which disruption of bullets after impact can be assessed objectively. We reviewed 1287 wound radiographs of 1201 patients in four International Committee of the Red Cross hospitals. Radiographs were scored according to the F (fracture) and M (presence of metallic bodies) variables of the Red Cross wound classification; bullet disruption is evidenced by metallic fragments on the radiograph. One hospital had a significantly higher proportion of patients wounded by bullets that disrupted after impact; these wounds were associated with comminuted fractures. The findings show that the presence of metallic fragments on a radiograph is a reliable indicator of wound severity and bullet disruption. The study has important implications for the upholding of international humanitarian law, because with our method the use and manufacture of bullets that contravene the Hague Declaration can be identified.
根据国际人道法，1899年《海牙宣言》禁止使用撞击后在体内破裂的小武器弹药。然而，判断子弹是否发生破裂是主观的，关于冲突一方或双方使用此类弹药的指控无法得到证实。我们描述了一种可以客观评估子弹撞击后是否破裂的方法。我们查阅了红十字国际委员会四家医院1201名患者的1287张伤口X光片。根据红十字伤口分类的F（骨折）和M（金属物体的存在）变量对X光片进行评分；X光片上的金属碎片证明子弹发生了破裂。一家医院中，受撞击后破裂子弹致伤的患者比例显著更高；这些伤口与粉碎性骨折有关。研究结果表明，X光片上金属碎片的存在是伤口严重程度和子弹破裂的可靠指标。这项研究对维护国际人道法具有重要意义，因为通过我们的方法，可以识别出违反《海牙宣言》的子弹的使用和制造情况。
