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Identifying Improvements in Treating Extremity Musculoskeletal Injuries During Prolonged Care.
W Brett Johnson1,2, Antuione D Perry2,3, Garrett Flores2,3
1Extremity Trauma and Amputation Center of Excellence, JBSA Ft. Sam Houston, TX 78234, USA.
Military Medicine
|September 20, 2024
Summary
Combat casualty care for extremity musculoskeletal injuries strains resources during delayed evacuations. Developing better splinting for leg and arm fractures can improve unit readiness and preserve combat effectiveness.
Area of Science:
- Tactical Medicine
- Orthopedic Injury Management
- Military Medical Logistics
Background:
- Prolonged care scenarios with delayed medical evacuations critically impact combat unit resources due to extremity musculoskeletal injuries.
- Enhanced splinting techniques are needed to restore casualty mobility and function, thereby reducing the drain on human resources.
- A panel of experts was convened to identify high-impact injuries and available splinting materials.
Purpose of the Study:
- To identify extremity musculoskeletal injuries with the greatest impact on unit capabilities in prolonged care settings.
- To assess the accessibility of materials for splinting these injuries.
- To inform the development of enhanced splinting solutions for improved field medical care.
Main Methods:
- Consolidated and redistributed preliminary lists of injuries and materials to expert panel members for evaluation.
- Experts ranked injuries by frequency and human resource cost, and assessed material accessibility.
- Statistical analysis included Wilcoxon rank-sum tests and Placket Luce models.
Main Results:
- Knee and ankle ligamentous injuries and radial head fractures were most frequent; distal femur fractures, below knee amputations, and open tibia fractures demanded most care.
- Knee and ankle ligamentous injuries and closed tibia fractures had the greatest combined impact on unit readiness (frequency and resource cost).
- A variety of materials are available for splinting or improvising splints.
Conclusions:
- While knee and ankle injuries ranked high, focusing on fractures with higher human resource costs (e.g., leg and arm fractures) may yield greater unit effectiveness gains.
- Developing enhanced splints for specific high-impact fractures can significantly preserve unit readiness in field settings.
- This research provides a data-driven foundation for creating advanced splinting solutions tailored to combat casualty care needs.
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