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In trauma, there were significant differences in wound debridement policy, use of external fixators for fractures, primary use of circular frames for open tibial fractures and a far more liberal use of bone morphogenetic protein in fracture treatment. Differences in soft tissue reconstruction policy regarding flaps for soft tissue cover over exposed bone, near-universal usage of topical negative pressure dressings and use of Allg\u00f6wer-Donati suture pattern to close all wounds were noted. Ertl amputation osteoplasty, a modified form of transtibial amputation, had also been reintroduced. In rehabilitation, the management of heterotopic ossification, in particular with imaging techniques and excision surgery, was identified. For the upper limb, we observed the patient training required to use a myoelectric hand and the future possibility of targeted muscle re-innervation to make controlling these myoelectric prostheses more natural using innate motor patterns. For the lower limb, we found we used identical above knee prostheses. For patients who have had limb reconstruction and have poor function, an energy-storing orthosis was demonstrated to compensate for the loss of range of motion and muscle power.<\/jats:p>","DOI":"10.1136\/jramc-2013-000032","type":"journal-article","created":{"date-parts":[[2013,3,21]],"date-time":"2013-03-21T20:51:35Z","timestamp":1363899095000},"page":"102-109","source":"Crossref","is-referenced-by-count":12,"title":["Medical lessons learnt from the US and Canadian experience of treating combat casualties from Afghanistan and Iraq"],"prefix":"10.1136","volume":"159","author":[{"given":"Shreshth","family":"Dharm-Datta","sequence":"first","affiliation":[{"name":"Defence Medical Rehabilitation Centre Headley Court, Epsom, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"McLenaghan","sequence":"additional","affiliation":[{"name":"Lower Limb Rehabilitation Group, Defence Medical Rehabilitation Centre Headley Court, Epsom, 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