Open Access Case report

Identical fracture patterns in combat vehicle blast injuries due to improvised explosive devices; a case series

Joris Commandeur1, Robert Jan Derksen2*, Damian MacDonald3 and Roelf Breederveld2

Author affiliations

1 Department of surgery/ traumatology, VU medical center, De Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands

2 Department of surgery/ traumatology, Red Cross Hospital Beverwijk, Beverwijk, The Netherlands

3 Department of surgery/ traumatology, 1 Canadian Field Hospital Ottawa Detachment, Canadian Forces Health Service, Ottawa, Canada

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Citation and License

BMC Emergency Medicine 2012, 12:12  doi:10.1186/1471-227X-12-12

Published: 10 October 2012



In November 2008, a surgical team from the Red Cross Hospital Beverwijk, the Netherlands, was deployed in Afghanistan for three months to attend in the army hospital of Kandahar.

During their stay, four incidents of armored personnel carriers encountering an improvised explosive device were assessed. In each incident, two soldiers were involved, whose injuries were strikingly similar.

Case presentation

The described cases comprise paired thoracic vertebral fractures, radial neck fractures, calcaneal fractures and talar fractures. Moreover, the different types of blast injury are mentioned and related to the injuries described in our series. Acknowledging the different blast mechanisms is important for understanding possible injury patterns.


From this case series, as well as the existing literature on injury patterns caused by blast injuries, it seems appropriate to pay extra attention to bodily areas that were injured in other occupants of the same vehicle. Obviously, the additional surveillance for specific injuries should be complementary to the regular trauma work-up (e.g., ATLS).

Improvised explosive devices; Identical injuries; Blast injury