{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:39:33Z","timestamp":1792449573861,"version":"4.5.0"},"reference-count":30,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"4","license":[{"start":{"date-parts":[[2012,4,1]],"date-time":"2012-04-01T00:00:00Z","timestamp":1333238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery. British volume"],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:p> We describe 261 peripheral nerve injuries sustained in war by 100 consecutive service men and women injured in Iraq and Afghanistan. Their mean age was 26.5 years (18.1 to 42.6), the median interval between injury and first review was 4.2 months (mean 8.4 months (0.36 to 48.49)) and median follow-up was 28.4 months (mean 20.5 months (1.3 to 64.2)). The nerve lesions were predominantly focal prolonged conduction block\/neurapraxia in 116\u00a0(45%), axonotmesis in 92 (35%) and neurotmesis in 53 (20%) and were evenly distributed between the upper and the lower limbs. Explosions accounted for 164 (63%): 213\u00a0(82%) nerve injuries were associated with open wounds. Two or more main nerves were injured in 70 patients. The ulnar, common peroneal and tibial nerves were most commonly injured. In 69 patients there was a vascular injury, fracture, or both at the level of the nerve lesion. Major tissue loss was present in 50 patients: amputation of at least one limb was needed in 18. A total of 36 patients continued in severe neuropathic pain. <\/jats:p><jats:p> This paper outlines the methods used in the assessment of these injuries and provides information about the depth and distribution of the nerve lesions, their associated injuries and neuropathic pain syndromes. <\/jats:p>","DOI":"10.1302\/0301-620x.94b4.28483","type":"journal-article","created":{"date-parts":[[2012,3,20]],"date-time":"2012-03-20T11:48:31Z","timestamp":1332244111000},"page":"523-528","source":"Crossref","is-referenced-by-count":83,"title":["Nerve injuries sustained during warfare"],"prefix":"10.1302","volume":"94-B","author":[{"given":"R.","family":"Birch","sequence":"first","affiliation":[{"name":"War Nerve Injury Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Misra","sequence":"additional","affiliation":[{"name":"Peripheral Neuropathy Unit, Imperial College\rLondon, Hammersmith Hospital, Du\rCane Road, London W12 0NN, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. P. M.","family":"Stewart","sequence":"additional","affiliation":[{"name":"James\rCook Hospital, Marton Road, Middlesbrough\rTS4 3BW, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. G. P.","family":"Eardley","sequence":"additional","affiliation":[{"name":"Royal Centre for Defence Medicine, Academic\rDepartment of Military Surgery and Trauma, Birmingham\rResearch Park, Vincent Drive, Birmingham\rB15 2SQ, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Ramasamy","sequence":"additional","affiliation":[{"name":"Royal Centre for Defence Medicine, Academic\rDepartment of Military Surgery and Trauma, Birmingham\rResearch Park, Vincent Drive, Birmingham\rB15 2SQ, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Brown","sequence":"additional","affiliation":[{"name":"Royal Centre for Defence Medicine, Academic\rDepartment of Military Surgery and Trauma, Birmingham\rResearch Park, Vincent Drive, Birmingham\rB15 2SQ, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Shenoy","sequence":"additional","affiliation":[{"name":"Peripheral Neuropathy Unit, Imperial College\rLondon, Hammersmith Hospital, Du\rCane Road, London W12 0NN, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Anand","sequence":"additional","affiliation":[{"name":"Peripheral Neuropathy Unit, Imperial College\rLondon, Hammersmith Hospital, Du\rCane Road, London W12 0NN, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Clasper","sequence":"additional","affiliation":[{"name":"Royal Centre for Defence Medicine, Academic\rDepartment of Military Surgery and Trauma, Birmingham\rResearch Park, Vincent Drive, Birmingham\rB15 2SQ, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Dunn","sequence":"additional","affiliation":[{"name":"Odstock Centre for Burns, Plastic and\rMaxillofacial Surgery, Salisbury District\rHospital, Salisbury, Wiltshire\rSP2 0BJ, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Etherington","sequence":"additional","affiliation":[{"name":"Defence Medicine Rehabilitation Centre, Headley\rCourt, Epsom, Surrey KT18\r6JW, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"r1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e31802f78fb"},{"key":"r2","unstructured":"Coupland RM. War wounds of limbs: surgical management. Oxford: Butterworth-Heinemann, 1993:92\u201394."},{"key":"r3","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181d86a0d"},{"key":"r4","doi-asserted-by":"publisher","DOI":"10.1007\/BF02066991"},{"key":"r5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2007.07.007"},{"key":"r6","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-197403000-00001"},{"key":"r7","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199712000-00009"},{"key":"r8","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2006.07.009"},{"key":"r9","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/66.4.237"},{"key":"r10","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.35.5.638"},{"key":"r11","first-page":"433","volume":"113","author":"Ochoa J","year":"1972","journal-title":"J Anat"},{"key":"r12","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2006.02.044"},{"key":"r13","doi-asserted-by":"crossref","unstructured":"Birch R. 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