Hindfoot injuries due to landmine blast accidents

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.