Attention to detail: injuries at altitude among U.S. Army Military static line parachutists

Altitude injuries, defined as injuries sustained by military static line parachutists before ground impact, have not been reviewed for 50 years. There are indications that these injuries are increasing at Fort Bragg, North Carolina. Between May 1, 1994, and April 30, 1996, surveillance was conducted for parachute-related injuries and altitude injuries at Fort Bragg. The incidence of all jump-related injuries was 8.1/1,000 aircraft exits. Significant risk factors for injury included being 30 years of age or older (p < 0.001) and being female (p = 0.003). The overall incidence of altitude injuries was noted to be 0.46/1,000 aircraft exits. Risk factors for altitude injury included being 40 years of age or older (p = 0.005) and in the rank of E-1 to E-3 (p = 0.0001). Fifty-four percent of injuries occurred during exiting before complete parachute deployment, and 46% occurred during the opening shock of the parachute. Mechanisms of injury included static line entanglement (33%), riser/suspension-line entanglement (46%), aircraft strikes (21%), unsecured equipment strikes (1%), and opening shock deceleration (1%). The majority of severe altitude injuries are caused by riser/suspension-line entanglement (63%) and involve the knee joint (37%). Although the incidence of altitude injury is quite small, the potential risk for career-threatening and/or life-threatening injury is great. This risk can be reduced by appropriate training and attention to detail.