Characterisation of explosive fragments injuring the neck

Penetrating explosive fragments are the most common cause of neck injuries sustained by UK service personnel deployed to Afghanistan. Analysis of these fragments will enable future ballistic protective materials to be tested with appropriate projectiles. However, only a small number of fragments excised from the neck have been available for analysis and they are potentially unrepresentative. We analysed computed tomograms (CTs) of 110 consecutive UK soldiers whose necks were wounded by explosive fragments. Fragments were classified according to shape, and their dimensions used to estimate volume and mass. These calculations were then compared with the actual measurements of the excised fragments using a general linear model. The 2 most common shapes were cylinders (52%) and spheres (21%). Known and estimated masses were not significantly different (p = 0.64). A fragment-simulating projectile of 0.49 g represented 85% of fragments retained in the neck. CT can accurately delineate the shape and mass of fragments, which increases the number from which the most appropriate simulated projectile can be designed. We think that this methodology should be applied to fragments retained in other parts of the body to enable broader recommendations to be made regarding the testing of ballistic materials used to protect service personnel. Crown Copyright (C) 2013 Published by Elsevier Ltd. on behalf of The British Association of Oral and Maxillofacial Surgeons. All rights reserved.