Outcomes of internal fixation in a combat environment

Area of Science:

• Orthopedic Surgery
• Combat Medicine
• Trauma Surgery

Background:

• Internal fixation is often discouraged in battlefield settings due to wound and environmental factors.
• Limited data exists on the outcomes of internal fixation in deployed combat environments.

Purpose of the Study:

• To evaluate the outcomes of internal fixation procedures performed in combat theater hospitals.
• To assess complication rates and healing success for fractures treated with internal fixation in a deployed setting.

Main Methods:

• Retrospective review of patient records from combat theater hospitals.
• Analysis of demographics, injury characteristics, surgical procedures, and patient outcomes.
• Inclusion of 50 fractures in 47 patients undergoing internal fixation.

Main Results:

• Internal fixation was performed on 50 fractures in 47 patients, with hip, forearm, and ankle fractures being most common.
• 32% of fractures were open injuries, with an average Injury Severity Score of 11.4.
• 78% of fractures healed without complications; one infection and one acute surgical complication occurred.

Conclusions:

• Internal fixation can be performed successfully in the combat environment when used judiciously.
• Complication rates for internal fixation in combat settings are comparable to those reported in non-combat environments.
• This review supports the consideration of internal fixation for specific fractures in deployed military settings.