Abstract
Injury patterns in Afghanistan have altered from ballistic trauma in 2006 to blast trauma in 2010–2011. Surgeons have had to alter their surgical resuscitation strategies. Improvised explosive device (IED) yields have increased, typically causing bilateral high transfemoral amputations and increasing the likelihood of pelvic and perineal injury.1 Forty per cent of bilateral transfemoral amputations in 2009 had an associated pelvic fracture. This led to a UK military policy of applying a pelvic binder to all IED victims in the pre-hospital environment.
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