Brooke Army Medical Center, Fort Sam Houston, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA.
J Orthop Trauma. 2012 Jan;26(1):43-7. doi: 10.1097/BOT.0b013e31821c0ec1.
Despite the high incidence of battlefield orthopaedic injuries, long-term outcomes and return to duty (RTD) status have rarely been studied. Our purpose was to determine the RTD rate for soldiers who sustained Type III open tibia fractures in active combat.
One hundred fifteen soldiers who sustained battle-related Type III open tibia fractures were retrospectively reviewed. The Army Physical Evaluation Board database was reviewed to determine which soldiers were able to RTD and the disability ratings of those not able to RTD.
The overall RTD rate was 18%, isolated open fractures had a RTD rate of 22%, salvaged extremities had a RTD rate of 20.5%, and amputees had a RTD rate of 12.5%. Older age and higher rank were both significant factors in increasing the likelihood of RTD and amputees had significantly higher disability ratings than those with salvaged extremities.
Despite the severe nature of combat extremity wounds, 20% of patients with salvaged Type III open tibia fractures and 22% with isolated injuries were able to return to active duty. These rates are similar to those reported for civilian amputees. Amputees in our cohort were less likely to RTD.
尽管战场上骨科损伤的发生率很高,但长期结果和重返工作岗位(RTD)的情况很少被研究。我们的目的是确定在实战中发生 III 型开放性胫骨骨折的士兵的 RTD 率。
回顾性分析了 115 名在实战中发生与战斗相关的 III 型开放性胫骨骨折的士兵。对陆军身体评估委员会数据库进行了审查,以确定哪些士兵能够重返工作岗位,以及无法重返工作岗位的士兵的残疾等级。
总体 RTD 率为 18%,单纯开放性骨折的 RTD 率为 22%,保肢的 RTD 率为 20.5%,截肢的 RTD 率为 12.5%。年龄较大和军衔较高都是增加 RTD 可能性的重要因素,截肢患者的残疾等级明显高于保肢患者。
尽管战斗性四肢创伤的性质严重,但 20%的保肢 III 型开放性胫骨骨折患者和 22%的单纯损伤患者能够重返现役。这些比率与平民截肢患者相似。我们队列中的截肢患者重返工作岗位的可能性较小。