Background: There are considerable differences in the shape and composition of military and civilian projectiles.
Materials and methods: Five different projectiles with the same kinetic energy were fired into the heads of freshly sacrificed pigs (n=30) through the submental region in the occipital direction. Computed tomography (CT) and 3D face scans of the animal skulls were obtained before and after firing. The image data sets were fused and provided the basis for a quantitative analysis of destruction patterns.
Results: As a result of the destruction of the parietal bone at the potential exit site, there were significant volume difference between the Action 4 (6.45 +/- 3.42 ml) and the Hydra-Shok projectile (12.71 +/- 2.86 ml). The partial metal-jacketed projectile showed a minor increase in volume (4.89 +/- 1.47 ml) and a partial loss of soft projectile components. Radiology showed differences between the various projectiles in fragmentation and bone and soft-tissue destruction.
Conclusions: Although the projectiles had the same kinetic energy, there were considerable differences in injury patterns between full metal-jacketed projectiles, which are the only projectiles permitted for military use under the Geneva Conventions, and the other investigated projectiles. These injuries present a major medical challenge to both first responders and surgeons.