Benavides Jerome M, Benavides Linda C, Pumiglia Luke, Stern Caryn A, Stallings Jonathan D, Gurney Jennifer
From the Department of Orthopedics (J.M.B.), and Department of Surgery (L.C.B., L.P.), Madigan Army Medical Center, Tacoma, WA; and Joint Trauma System (C.A.S., J.D.S., J.G.), Defense Health Agency, Joint Base Fort San Houston, San Antonio, TX.
J Trauma Acute Care Surg. 2025 Aug 1;99(3S Suppl 1):S27-S31. doi: 10.1097/TA.0000000000004705. Epub 2025 Jul 3.
The United States has been involved in ongoing combat operations since 2001, the longest period of conflict in the nation's history. This study's intent was to analyze a central Department of Defense casualty database to delineate wound distribution patterns and mechanisms of injury during the conflicts in the Middle East with a particular focus on musculoskeletal injury.
A retrospective analysis of the Military Orthopedic Trauma Registry was completed for all US service members treated for wounds in the Iraq, Afghanistan, and Syria theater of operations injured between January 1, 2001, and December 31, 2023, who were abstracted into Military Orthopedic Trauma Registry. The Abbreviated Injury Scale was used to identify body regions, while injury type was identified by International Classification of Diseases, Ninth Revision and Tenth Revision , codes. Orthopedic specific variables were manually abstracted by trained nurse abstractors. Defense Manpower Data Center data were used to calculate incidence rates.
There were 4,135 battle-injured patients with at least one orthopedic injury included in this study, of which there were 25,458 identified orthopedic injuries. Most wounds were to the extremities, with more than half effecting the lower extremities. The most common mechanism of injury was blast. There were 1,279 amputees, with a total of 4,180 amputation procedures. The majority of amputations were major amputations (n = 3,431, 82%).
The results of this analysis provide vital information on orthopedic injuries and body regions most involved over 20 years of combat operations. These data can inform provider training changes related to battlefield management of orthopedic trauma, improve clinical practice guidelines, and provide a better understanding of the current and future burden orthopedic injuries pose to both the patient and the medical system.
Prognostic and Epidemiological; Level III.
自2001年以来，美国一直参与持续的作战行动，这是美国历史上最长的冲突时期。本研究的目的是分析国防部的一个中央伤亡数据库，以描绘中东冲突期间的伤口分布模式和损伤机制，特别关注肌肉骨骼损伤。
对军事骨科创伤登记处进行回顾性分析，纳入2001年1月1日至2023年12月31日期间在伊拉克、阿富汗和叙利亚行动地区受伤并被录入军事骨科创伤登记处的所有接受伤口治疗的美国军人。使用简明损伤定级来确定身体部位，而损伤类型则通过国际疾病分类第九版和第十版编码来确定。骨科特定变量由训练有素的护士提取员手动提取。国防人力数据中心的数据用于计算发病率。
本研究纳入了4135名至少有一处骨科损伤的战斗受伤患者，共识别出25458处骨科损伤。大多数伤口位于四肢，其中一半以上影响下肢。最常见的损伤机制是爆炸。有1279名截肢者，共进行了4180次截肢手术。大多数截肢为大截肢（n = 3431，82%）。
该分析结果提供了有关20多年作战行动中最常涉及的骨科损伤和身体部位的重要信息。这些数据可为与骨科创伤战场管理相关的医疗人员培训变革提供参考，完善临床实践指南，并更好地了解骨科损伤当前和未来给患者及医疗系统带来的负担。
预后和流行病学；三级。
