Missile Fragment Research Articles

Missile Fragment Embolism of the Coronary Artery in a Patient with Coronary Artery Disease

A 51-year-old war veteran referred to us with typical chest pain and dyspnea on exertion. He had a history of hypertension from several years before, for which he had been prescribed anti-hypertensive medications. He also gave a history of missile fragment injury to his chest from the Iran-Iraq war, for which he had been hospitalized, but had received conservative medical treatment only. After admission and initial workup, echocardiography revealed mild left ventricular dysfunction with an ejection fraction of 45% and a metallic fragment at the diaphragmatic surface of the right ventricle. Coronary angiography showed significant stenosis at the LAD – Diagonal bifurcation, as well as a metallic fragment occluding the PDA branch of the right coronary artery. Coronary artery bypass surgery was performed successfully and the patient was discharged uneventfully. To the best of our knowledge, this is the first report of an embolized missile fragment to the coronary artery found incidentally in a patient undergoing surgery for coronary artery disease.

Fragment capture simulation for MANPADS test arena optimization

The assessment of aircraft survivability against explosive munitions is an expensive undertaking. Test articles for both aircraft and weapon are scarce due to their high costs, leading to a limited supply of test data. The development of newer, hopefully more effective weaponry and protection measures continues despite the short supply of test articles. Therefore, test organizations need to explore methods for increasing the quality of test results while looking for ways to decrease the associated costs. This research focuses on the Man-Portable Air-Defense System (MANPADS) as the weapon of choice and live-fire arena testing as the experimental data source. A proof-of-concept simulation infrastructure is built and used to assess and potentially optimize live-fire test arena configuration to improve missile fragment velocity estimates. Several research questions are explored: measuring potential data quality, comparing arena designs, and improving arena configurations based on fragment pattern predictions.

Sakral Osteomiyelit Olgusunun Tedavisi ve Literatür Derlemesi

This a unique case report of an otherwise healthy 54 year-old man who was sustained a battle-field injury from high-velocity gun-shots leading to right knee disarticulation and sacral fracture and subsequent sacral osteomyelitis, which are extremely rare. Sacral osteomyelitis and sacral fracture without neurologic injury has not been reported, and, to our knowledge, this is only the first case of sacral osteomyelitis without neurologic compromise due to a foreign body and its management in the English literature. Of 23 reported cases of sacral osteomyelitis (secondary to non biological materials that was used in the index procedure or unknown etiology), there is not one reported case of sacral osteomyelitis secondary to a missile fragment. Our case was described in detail, including the method of osteomyelitis management, and a review of the literature regarding the etiology of the condition also is presented.

Management of Gunshot Pelvic Fractures With Bowel Injury: Is Fracture Debridement Necessary?

Low-velocity pelvic gunshot injuries occur commonly in urban trauma centers, occasionally involving concomitant intestinal viscus injury leading to potential fracture site contamination. Surgical debridement of the fractures may be necessary to prevent osteomyelitis, although not routinely performed in many centers. The purpose of this study was to determine whether fracture debridement should be done to prevent osteomyelitis in these injuries. A 5-year retrospective review of all patients older than 12 years with low-velocity gunshot pelvic fractures was performed at an urban Level I trauma center. Medical records and radiographs/computed tomographic scans were reviewed, and data regarding fracture location, concomitant intestinal viscus injury, orthopedic surgical intervention, antibiotic treatment, and bone and/or joint infection were recorded. Of a total of 103 patients identified, 19 had expired within 48 hours and were excluded, resulting in a total of 84 study subjects for review. Fifty of 84 patients (59%) had a perforated viscus with 31 large bowel injuries and 30 small bowel injuries. Eighteen patients (21%) had intra-articular fractures, 15 of which involved the hip joint. Orthopedic surgical fracture debridement was done only in intra-articular fractures with retained bullet fragments (seven cases). Deep infection occurred in one patient with a missile injury to the hip joint with concomitant intestinal spillage. Immediate joint debridement was performed in this case, but successful missile fragment removal was not achieved until the second debridement after 48 hours. No infections occurred in any extra-articular fractures, regardless of the presence of intestinal spillage. Extra-articular gunshot pelvic fractures do not require formal orthopedic fracture debridement even in cases with concomitant intestinal viscus injury. However, debridement with bullet removal should be done in cases with intra-articular involvement, particularly if there are retained bullet fragments in the joint, to prevent deep infection.

Penetration resistance of steel fiber reinforced concrete containment structure to high velocity projectile

Containment structures not only are leak-tight barriers, but also may be subjected to impacts caused by tornado-generated projectiles, aircraft crashes or the fragments of missile warhead. This paper presents the results of an experimental study of the impact resistance of steel fiber-reinforced concrete against 45 g projectiles at velocity around 2500 m/s. An explosively formed projectile (EFP) was designed to generate an equivalent missile fragment. The formation and velocity of EFP are measured by flash x-ray. A switch made of double-layered thin copper sheets controlled the exposure time of each flash x-ray. The influence of the fiber volume fraction on the crater diameter of concrete slab and the residual velocity of the projectile were studied. The residual velocity of the projectile decreased as the fiber volume fractions increased. In this work, the residual velocity of the projectile was to 44% that of plain concrete when the fiber volume fraction exceeded 1.5%. Based on the present finding, steel fiber reinforced concrete with the fiber volume fraction exceeding 1.5% appear to be more efficient in protection against high velocity fragment impact.

Method for Assessing Vulnerability of Aircraft to Spray Fragments of Missile

Abstract A method is proposed for calculating the vulnerability of aircraft to spray fragments of a missile. The input data of aircraft or components for vulnerability assessment is organized by the finite element models. First, the `shot line scanning method' is used to calculate the single-hit vulnerability of aircraft by a fragment of missile. Utilizing Markov-Chain method, the vulnerability of aircraft is obtained at the threat of multiple hits by spray fragments. An example that shows the distributions of probability of kill at the typical missile detonation locations around the aircraft has been provided. In this example, the interaction regions of aircraft with fragments of missile are analyzed and the correctness and feasibility of the proposed method are demonstrated. Application shows that (1) the proposed method is generic and easy to be programmed; (2) to provide a realistic and effective aircraft vulnerability assessment, the method has taken into consideration the factors such as missile velocity, missile detonation location, missile charge ratio, fragment shape, air drag, aircraft altitude, and aircraft velocity; (3) the vulnerability assessment of aircraft to fragments of missile is useful for aircraft survivability enhancement design, missile effectiveness assessment, and optimizing missile fuse design.

Should Colon-Penetrating Small Missiles Be Removed? An Experimental Study of Retrocolic Wound Tracks

Small-fragment injury to the colon may occur in approximately 5% of battlefield casualties. The surgical management aims to reduce the risk of retrocolic infection and provide optimal conditions for colonic wound healing. This study aimed to quantify the risk of retrocolic infection. Steel fragments were fired through exteriorized porcine colon and caught in 20% gelatin. The fragments, and resultant tracks, were extracted and subjected to quantitative bacteriological examination to determine the extent of contamination. The median bacterial count for complete tracks was 1.2 104 CFU/g (interquartile range 1.8 103 to 2.7 104). Counts were highest in the initial 1 cm of the track and reduced along its length. This study does not support wound track excision or missile fragment removal in cases of retrocolic trauma following penetrating colonic injury. Either or both procedures will increase local trauma and are likely to prejudice colonic wound repair.

Remarkable recovery after a cranio-cerebral injury produced by an impacted hot missile fragment: apparent 'regeneration' of the temporal lobe

A facio-cranio-cerebral injury due to a large piece of shrapnel causing direct and heat damage to the temporal lobe is described. It was managed by initial dural repair which was followed by sloughing and repeated wound débridement, leaving an open cerebral wound communicating with a facial wound. Auto-rotation of the temporal lobe occurred, allowing split-skin grafting onto arachnoid mater to obtain dural closure. Further treatment of the facial wound by skin-grafting the cavity and prosthetic reconstruction allowed early return to society and a full rehabilitation programme.

Survival following gunshot wound of the pons: neuroanatomic considerations

The successful treatment of a civilian gunshot wound of the vermis and pons is described. A large missile fragment was removed from a depth of 2 cm within the pons at the level of the facial colliculus. Despite initial coma and subsequent irregular respiration with sleep apnea, the patient survived. Neurological, radiographic, and operative findings are correlated with the anatomy of the pons.