Bone scintigraphy in the evaluation of ejection injuries.

Area of Science:

• Aerospace Medicine
• Orthopedics
• Radiology

Background:

• Ejection seat incidents in the Royal Air Force (RAF) frequently result in back injuries among aviators.
• Radiographic examination reveals vertebral fractures in 50% of affected personnel, often leading to extended grounding.
• A significant portion of remaining aviators show positive bone scans, complicating return-to-flight decisions.

Purpose of the Study:

• To evaluate the RAF's policy regarding aviators with back injuries sustained from ejection seat use.
• To assess the necessity of prolonged flight restriction for pilots with asymptomatic findings on bone scans.
• To recommend updated management strategies for RAF personnel with ejection seat-related back injuries.

Main Methods:

• Review of RAF experience with ejection seat-related back injuries.
• Analysis of radiographic and bone scan findings in affected aviators.
• Comparison of current and proposed management policies for injured pilots.

Main Results:

• 50% of aviators experience vertebral fractures post-ejection, with or without symptoms, leading to >3 months of restricted flying duties.
• Approximately 50% of the remaining aviators exhibit positive bone scans.
• Recent RAF policy changes incorporate recommendations for annual orthopedic review and return to flying for asymptomatic individuals.

Conclusions:

• Asymptomatic aviators with positive bone scans following ejection seat incidents should be managed differently from those with radiographic fractures.
• Annual orthopedic assessment is recommended to monitor long-term sequelae in affected pilots.
• Policy updates now allow asymptomatic individuals to return to flying duties, optimizing aviator availability.