Citation

Belmont PJ, Owens BD, Schoenfeld AJ. J. Am. Acad. Orthop. Surg. 2016; 24(6): 341-348.

Affiliation

From the Department of Orthopedic Surgery and Rehabilitation, William Beaumont Army Medical Center, El Paso, TX (Dr. Belmont), the Department of Orthopedics, Keller Army Community Hospital, West Point, NY (Dr. Owens), and the Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Dr. Schoenfeld).

Copyright

(Copyright © 2016, American Academy of Orthopaedic Surgeons)

DOI

10.5435/JAAOS-D-15-00123

PMID

27115793

Abstract

The combined wars in Afghanistan and Iraq represent the longest ongoing conflicts in American military history, with a combined casualty estimate of >59,000 service members. The nature of combat over the last decade has led to precipitous increases in severe orthopaedic injuries, including traumatic amputations and injuries to the spine. Nearly 75% of all injuries sustained in combat now are caused by explosive mechanisms, and fractures comprise 40% of all musculoskeletal injuries. Injuries to the axial skeleton are more frequent among personnel exposed to combat, and spinal trauma is identified in nearly 40% of those killed. Musculoskeletal injuries are expensive and generate some of the highest rates of long-term disability. Noncombat musculoskeletal injuries are endemic within deployed military service members and occur at a greater than threefold rate compared with combat musculoskeletal injuries. Service members with musculoskeletal injuries or behavioral health conditions, such as posttraumatic stress disorder, depression, and psychosis, and those occupying a low socioeconomic status, have an increased risk of inferior outcomes.

Language: en