Lew Timothy A, Walker John A, Wenke Joseph C, Blackbourne Lorne H, Hale Robert G
Oral and Maxillofacial Surgery, Brooke Army Medical Center, US Army Institute of Surgical Research, Fort Sam Houston, TX 78234, USA.
J Oral Maxillofac Surg. 2010 Jan;68(1):3-7. doi: 10.1016/j.joms.2009.06.006.
To characterize and describe the craniomaxillofacial (CMF) battlefield injuries sustained by US Service Members in Operation Iraqi Freedom and Operation Enduring Freedom.
The Joint Theater Trauma Registry was queried from October 19, 2001, to December 11, 2007, for CMF battlefield injuries. The CMF injuries were identified using the "International Classification of Diseases, Ninth Revision, Clinical Modification" codes and the data compiled for battlefield injury service members. Nonbattlefield injuries, killed in action, and return to duty cases were excluded.
CMF battlefield injuries were found in 2,014 of the 7,770 battlefield-injured US service members. In the 2,014 injured service members were 4,783 CMF injuries (2.4 injuries per soldier). The incidence of CMF battlefield injuries by branch of service was Army, 72%; Marines, 24%; Navy, 2%; and Air Force, 1%. The incidence of penetrating soft-tissue injuries and fractures was 58% and 27%, respectively. Of the fractures, 76% were open. The location of the facial fractures was the mandible in 36%, maxilla/zygoma in 19%, nasal in 14%, and orbit in 11%. The remaining 20% were not otherwise specified. The primary mechanism of injury involved explosive devices (84%).
Of the injured US service members, 26% had injuries to the CMF region in the Operation Iraqi Freedom/Operation Enduring Freedom conflicts during a 6-year period. Multiple penetrating soft-tissue injuries and fractures caused by explosive devices were frequently seen. Increased survivability because of body armor, advanced battlefield medicine, and the increased use of explosive devices is probably related to the elevated incidence of CMF battlefield injuries. The current use of "International Classification of Diseases, Ninth Revision, Clinical Modification" codes with the Joint Theater Trauma Registry failed to characterize the severity of facial wounds.
对在伊拉克自由行动和持久自由行动中美国军人所遭受的颅颌面（CMF）战场损伤进行特征描述。
查询2001年10月19日至2007年12月11日联合战区创伤登记处有关CMF战场损伤的信息。使用“国际疾病分类第九版临床修订本”编码以及为战场受伤军人汇编的数据来识别CMF损伤。排除非战场损伤、阵亡及重返岗位的病例。
在7770名战场受伤的美国军人中，有2014人存在CMF战场损伤。在这2014名受伤军人中共有4783处CMF损伤（每名士兵2.4处损伤）。按军种划分，CMF战场损伤的发生率为：陆军72%；海军陆战队24%；海军2%；空军1%。穿透性软组织损伤和骨折的发生率分别为58%和27%。在骨折中，76%为开放性骨折。面部骨折的部位如下：下颌骨占36%，上颌骨/颧骨占19%，鼻骨占14%，眼眶占11%。其余20%未另行说明。主要致伤机制为爆炸装置（84%）。
在6年期间的伊拉克自由行动/持久自由行动冲突中，26%的受伤美国军人存在CMF区域损伤。常见由爆炸装置导致的多处穿透性软组织损伤和骨折。由于防弹衣、先进的战场医疗以及爆炸装置使用的增加，生存率提高，这可能与CMF战场损伤发生率上升有关。目前联合战区创伤登记处使用“国际疾病分类第九版临床修订本”编码未能描述面部伤口的严重程度。
