Page 93 - JSOM Spring 2021

FIGURE 3 Lateral radiographs of the right index finger demonstrating a comminuted, intra-articular fracture of the distal phalanx.

(A)

(B) (C)

(A) Distal phalanx with 100% fracture displacement and apex dorsal angulation. (B) Post-reduction
lateral radiograph demonstrating the comminuted, intra-articular fracture in acceptable alignment in
an AlumaFoam splint. (C) Six-week follow-up: lateral radiograph demonstrating appropriate healing.

being aware of other available resources and proper usage
can augment the clinical care provided, ensuring that medical
readiness and mission capability are never compromised.

Disclaimer
The opinions or assertions contained herein are the private
views of the authors and are not to be construed as official or
reflecting the views of the Department of Defense or US Gov-
FIGURE 4 Clinical image ernment. The authors are employees of the US Government.
taken while obtaining a lateral This work was prepared as part of their official duties and, as
radiograph of the right foot such there is no copyright to be transferred.
for evaluation of possible
calcaneal fracture. Radiographs
demonstrated no fracture, Financial Disclosure
allowing for expedited patient The authors have indicated they have no financial relationship
care and evacuation. related to this article to disclose.
Author Contributions
CH, SV, RL, and KAS treated the patients. CH, SV, and KAS
developed the manuscript. RL provided critical edits. All au-
thors read and approved the final manuscript.

References
1. Joint Chiefs of Staff. Joint Publication 4-02: Joint Health Services.
Washington, DC: National Defense University Press; 2017.
radiation safety of these devices is not rated for human use. 2. Cota SA. Refining SOF surgical support to meet joint force de-
mand. Combat & Casualty Care. 2018;Spring:8–19.
Future studies should seek to evaluate the radiation exposure 3. United States Government US Army. Field Manual 4-02.25. Em-
of these devices, as well as the implications of image settings ployment of Forward Surgical Teams: Tactics, Techniques, and
on patient dose exposure. Permanent inclusion of portable Procedures. Washington, DC: Department of the Army; 2003.
x-ray to the modified table of organization and equipment will 4. United States Government US Army. Field Manual 4-30. Ordnance
require further investigation to determine the cost and feasibil- Operations. Washington, DC: Department of the Army; 2004.
ity to equip all FSTs/FRSTs. 5. Milda GS, McGranahan ME. Explosive ordinance disposal team
equipment and its use in diagnosing extremity trauma. Mil Med.
2002;167(12):1044.
In the forward-deployed setting, providers in the FST/FRST 6. Lin EC. Radiation risk from medical imaging. Mayo Clin Proc.
are likely to be presented with clinical scenarios in which plain 2010;85(12):1142–1146.
radiography may be beneficial in optimizing patient care and 7. Belmont PJ, Owens BD, Schoenfeld AJ. Musculoskeletal injuries
minimizing excessive resource utilization. Although plain radi- in Iraq and Afghanistan: epidemiology and outcomes following a
ography is not a component of the team’s deployed equipment, decade of war. J Am Acad Orthop Surg. 2016;24(6):341–348.

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