title: Comparative outcome of bomb explosion injuries versus high-powered gunshot injuries of the upper extremity in a civilian setting.
abstract: BACKGROUND
  Explosion injuries to the upper extremity have specific clinical characteristics that differ from injuries due to other mechanisms.
  
  
  OBJECTIVE
  To evaluate the upper extremity injury pattern of attacks on civilian targets, comparing bomb explosion injuries to gunshot injuries and their functional recovery using standard outcome measures.
  
  
  METHODS
  Of 157 patients admitted to the hospital between 2000 and 2004, 72 (46%) sustained explosion injuries and 85 (54%) gunshot injuries. The trauma registry files were reviewed and the patients completed the DASH Questionnaire (Disabilities of Arm, Shoulder and Hand) and SF-12 (Short Form-12) after a minimum period of 1 year.
  
  
  RESULTS
  Of the 157 patients, 72 (46%) had blast injuries and 85 (54%) had shooting injuries. The blast casualties had higher Injury Severity Scores (47% vs. 22% with a score of > 16, P = 0.02) and higher percent of patients treated in intensive care units (47% vs. 28%, P = 0.02). Although the Abbreviated Injury Scale score of the upper extremity injury was similar in the two groups, the blast casualties were found to have more bilateral and complex soft tissue injuries and were treated surgically more often. No difference was found in the SF-12 or DASH scores between the groups at follow up.
  
  
  CONCLUSIONS
  The casualties with upper extremity blast injuries were more severely injured and sustained more bilateral and complex soft tissue injuries to the upper extremity. However, the rating of the local injury to the isolated limb is similar, as was the subjective functional recovery.
authors: Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. shail@hadassah.org.il
authors: Shai
authors: S
authors: Luria
authors: Gurion
authors: G
authors: Rivkin
authors: Malka
authors: M
authors: Avitzour
authors: Meir
authors: M
authors: Liebergall
authors: Yoav
authors: Y
authors: Mintz
authors: Ram
authors: R
authors: Mosheiff
mesh_terms: D015998:Abbreviated Injury Scale; D000293:Adolescent; D000328:Adult; D001134:Arm Injuries / Q000145:classification / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D001753:Blast Injuries / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D054042:Bombs; D005107:Explosions; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007557:Israel / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D020127:Recovery of Function; D012042:Registries / Q000706:statistics & numerical data; D013514:Surgical Procedures, Operative / Q000145:classification / Q000379:methods / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D014193:Trauma Centers / Q000706:statistics & numerical data; D034941:Upper Extremity / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D014948:Wounds, Gunshot / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery