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Limb amputations are a significant challenge in modern conflicts, with blast injuries and polytrauma increasing risk. Understanding these factors is crucial for improving outcomes for severely injured combatants.

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Area of Science:

  • Trauma Surgery
  • Military Medicine
  • Orthopedics

Background:

  • Extremity trauma is common in modern conflicts, leading to high rates of limb amputations.
  • Amputations present significant challenges for survivors and healthcare systems.

Purpose of the Study:

  • To determine the rates, characteristics, and risk factors of limb amputations in patients with serious extremity trauma during the 2023 conflict in Israel.

Main Methods:

  • Nationwide retrospective cohort study using the Israel National Trauma Registry (October 7–December 31, 2023).
  • Included patients with serious extremity injuries (Abbreviated Injury Score ≥3).
  • Compared amputees with non-amputees; used multivariable logistic regression to identify risk factors.

Main Results:

  • Of 451 patients with serious limb injuries, 11.5% (52) underwent amputation.
  • Amputees were more likely to sustain blast injuries (76.9%), have high Injury Severity Scores (ISS ≥16) (75.0%), and polytrauma (46.1%).
  • Independent risk factors for amputation included explosions (aOR 9.74), fasciotomy (aOR 8.51), and polytrauma (aOR 1.98).

Conclusions:

  • Rising amputation rates in conflicts are linked to advanced weaponry and improved survival.
  • Patients with blast injuries, polytrauma, or requiring fasciotomies face elevated amputation risk.