Severe leg trauma – are engineers better than surgeons?

19 December 2011

Col Jon Clasper

Defence Professor Trauma & Orthopaedics
Visiting Professor in Bioengineering, Royal British Legion Centre for Blast Injury Studies, Imperial College London

Col Clasper provided an insight into how engineers and clinicians are combining their skills to develop new approaches to severe leg trauma.

This has been applied to injuries such as the calcaneus (heel bone), a common type of injury among military personnel who are exposed to blast injuries.

His work with Anthony Bull, Professor of Musculoskeletal Mechanics at Imperial College London, has involved the analysis of data on these injuries, particularly the long-term outcomes. Many patients with severe calcaneal fractures do not undergo amputation in the short-term but later elect to undergo this procedure due to long-term challenges to rehabilitation.

This has led to a reassessment of the way these injuries are treated on the battlefield and during initial treatment at hospital. Similar changes have taken place in the treatment of pelvic injuries, with new procedures for dressing open pelvic fractures to improve long-term outcomes.

The close collaboration of engineering colleagues has led to recommendations for changes to the design of military vehicles to ameliorate the effects of certain types of blast injuries to passengers.

This relates specifically to injuries sustained when foreign bodies are able to penetrate the body as a result of the blast; close analysis of clinical data has led to modifications of the vehicles to reduce the incidence of these injuries.

He praised the high quality of databases which are kept of the injuries and, in particular, the follow-up care each patient receives both within the military and through the NHS. This provides a wealth of information about long-term outcomes. This type of information is not readily available to nations such as the United States, which have many more military patients but do not have a unified civilian health system in which they can track all patients.