Orthopedic injuries in U.S. casualties treated on a hospital ship during Operation Iraqi Freedom

From March to May 2003, the USNS Comfort was deployed to the Persian Gulf in support of combat operations for Operation Iraqi Freedom. The onboard orthopedic service treated 58 U.S. casualties during that period. Eighty-seven percent of the injuries were to the appendicular skeleton. Twenty-four percent were battle injuries, and 72% were nonbattle injuries. Patients with battle injuries tended to be younger and required more orthopedic operations than did patients with nonbattle injuries. Moreover, all patients with battle injuries were evacuated to higher echelons for further care, whereas 19% of patients with nonbattle injuries returned to duty in the short term. Complications were few, with no infections, amputations, or deaths. A descriptive review of the types of injuries, orthopedic care, and eventual disposition is presented.