A Focus on Non-Amputation Combat Extremity Injury: 2001-2018

Area of Science:

• Military medicine
• Trauma surgery
• Combat casualty care

Background:

• Extremity injuries are the most common battlefield injuries in modern U.S. conflicts.
• Previous reports often focused only on severe injuries, neglecting the full spectrum of combat extremity trauma.

Purpose of the Study:

• To identify and characterize the complete range of non-amputation combat-related extremity injuries from post-9/11 conflicts.
• To extend the findings of prior research by including mild to severe injuries.

Main Methods:

• Utilized the Expeditionary Medical Encounter Database to identify extremity-injured service members (SMs) in post-9/11 conflicts (through July 2018).
• Included only combat-incurred injuries, excluding major amputations and fatalities.
• Categorized injuries by body region, nature, severity, and analyzed demographics and event characteristics.

Main Results:

• 17,629 SMs sustained 42,740 extremity injuries across 18,004 events.
• Blast weaponry caused 75% of injuries, affecting lower (52%) and upper (48%) extremities.
• Open wounds (48%) and fractures (20%) were most common; 56% of injuries were mild (median ISS of 3).

Conclusions:

• This is the first study to comprehensively document the spectrum of non-amputation combat extremity injuries from post-9/11 conflicts.
• The high incidence of these injuries in a young population will have long-term implications for military healthcare systems.