Emergency War Surgery NATO Handbook: Part III: General Considerations of Wound Management: Chapter XIX: Wounds and Injuries of Bones and Joints

Sprains and Dislocations

United States Department of Defense

Ligamentous injuries (sprains) are frequently encountered in the combat zone These injuries do not have the inherent seriousness of penetrating missile injuries of joints as previously described, but they may be severe and disabling in terms of combat effectiveness. Support of the joint by bandaging, splinting or casting usually will facilitate healing. The use of immobilization and casting particularly for lower extremity injuries, may allow the individual soldier to return to limited duty.

Closed dislocations of joints, which are encountered less frequently than sprains, are usually more disabling. Dislocated joints should be considered a surgical emergency and the joint should be reduced as soon as possible. This reduction can usually be carried out without the administration of anesthetic, with the possible exception of the hip and knee joint dislocations. The distal neurovascular status of the extremity should always be checked both before and after reduction. The post-reduction radiographs are extremely important to insure complete reduction and to rule out the presence of iatrogenic fractures.

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Operational Medicine 2001

Health Care in Military Settings

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