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Defining the medical coverage of ballistic protection to the pelvis and thigh
  1. Eluned Lewis1,
  2. R N Fryer2 and
  3. J Breeze3,4
  1. 1 Defence Ordnance and Safety Group (DOSG), Defence Equipment and Support (DE&S), Abbey Wood, Bristol, UK
  2. 2 Platform Systems Division, Defence Science and Technology Laboratory (DSTL), Portsdown West, Fareham, UK
  3. 3 Royal Centre for Defence Medicine (RCDM), Birmingham Research Park, Birmingham, UK
  4. 4 Department of Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  1. Correspondence to Dr Eluned Lewis, Defence Equipment and Support, Bristol, UK; eluned.lewis759{at}


Introduction Pelvis, lower limb and associated genital injury caused by explosive devices was responsible for mortality and considerable long-term morbidity for the UK Armed Forces during combat operations in Afghanistan, resulting in the issue of a pelvic protection system in 2010. The aim of this current research was to determine the medical coverage of the pelvis and thigh and to define the vertical dimensions of ballistic protective material for future pelvic protection (PP).

Method CT scans from 120 male UK Armed Forces personnel were analysed to identify the anthropometric landmarks and vertical boundaries of coverage for the pelvis and thigh. Pelvic height was the vertical distance between the upper border of the iliac crest in the midaxillary plane to the most inferior point of the ischial tuberosity of the pelvis. Upper thigh height was proposed as a 100 mm fixed distance below the ischial tuberosities, enabling a tourniquet to be reproducibly applied. These distances were compared with the ballistic component of the five sizes of tier 1 PP using a paired t-test.

Results The vertical components of coverage measured using CT scans were all significantly less (p<0.01) compared with all five sizes of tier 1 PP; for example, the ballistic component of the smallest size of tier 1 PP measured 410 mm, which was larger than the 99th percentile male, which measured 346 mm on CT scans.

Conclusions While all sizes of tier 1 PP provide coverage to the pelvis and upper thigh structures, there is an opportunity to optimise future PP. For example, comparing the large size of tier 1 PP to the 50th percentile male demonstrated an opportunity to reduce the ballistic protective component by 31%. Reducing the quantity of material used will improve heat dissipation and user comfort and reduce material mass and acquisition costs.

  • pelvis
  • thigh
  • perineum
  • protection
  • ballistic
  • armour
  • genital
  • coverage
  • military

Statistics from


  • Contributors Data collection: JB; reporting: all authors; overall responsibility: all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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