(i) An overview of the pathophysiology of blast injury with management guidelines

Explosive weapons remain the leading cause of death, injury, and disability to combatants in battle. Recent conflicts in Iraq and Afghanistan have seen considerable advances in the surgical knowledge and skills needed to save life and limb of multiply injured casualties. Global terrorism has seen explosive weapons move from battlefield to urban centres, often with devastating effects. Orthopaedic training prepares for the management of general civilian trauma scenarios, but blast injury pathophysiology and management is rarely considered. It is important that future trauma surgeons have a working knowledge of blast injury and how it affects the musculoskeletal system so that they can manage such patients. A Ramasamy MA PhD MRCS RAMC Specialist Registrar in Trauma and Orthopaedics, The Royal British Legion for Blast Injury Studies, Imperial College London, London, UK. GA Cooper MBBS MRCS Specialist Registrar in Trauma and Orthopaedics, Department of Trauma and Orthopaedics, University Hospital Birmingham, Birmingham, UK. ID Sargeant OBE FRCS (Tr&Orth) RAFMS Consultant Trauma and Orthopaedic Surgeon, Department of Trauma and Orthopaedics, University Hospital Birmingham, Birmingham, UK. D Evriviades MD FRCS (Plast) RAFMS Consultant Plastic Surgeon, Department of Plastic and Reconstructive Surgery, University Hospital Birmingham, Birmingham, UK. K Porter KBE FRCS Consultant Trauma and Orthopaedic Surgeon, Department of Trauma and Orthopaedics, University Hospital Birmingham, Birmingham, UK. JM Kendrew FRCS (Tr&Orth) RAFMS Consultant Trauma and Orthopaedic Surgeon, Department of Trauma and Orthopaedics, University Hospital Birmingham, Birmingham, UK. ORTHOPAEDICS AND TRAUMA 27:1 1