A Military Case Review Method to Determine and Record the Mechanism of Injury (BioTab) from In-Theater Attacks

A recent study of all mounted vehicle underbody blast attacks found that 21% of Abbreviated Injury Scale Severity 2+ injuries in the Joint Trauma Analysis and Prevention of Injury in Combat network were injuries to the leg and ankle. To develop effective countermeasure systems for these attacks, the epidemiology and mechanisms of injury from this loading environment need to be quantified. The goal of this study was to develop a military correlate of an existing civilian case review framework, the Crash Injury Research and Engineering Network (CIREN), to consider the differences in military event types and the amount of available vehicle/attack information. Additional data fields were added to the CIREN process to cover military-specific data and "certainty" definitions in the proposed injury hypothesis were modified. To date, six group reviews have been conducted analyzing 253 injuries to the foot/ankle, tibia, femur, pelvis, and lumbar spine from 52 occupants. The familiar format and unclassified nature of the presentations allowed for the involvement of biomechanics experts from multiple disciplines.