Combat wounds in Iraq and Afghanistan from 2005 to 2009

Pelvic, spinal and extremity wounds among combat-specific personnel serving in Iraq and Afghanistan (2003–2011): A new paradigm in military musculoskeletal medicine

“…Their methodology has been extensively described [2][3][4]7,8,[10][11][12]14,17] with both systems maintained to contain clinical information on as many as 90% of combat casualties. For the most part, the DoDTR contains details on soldiers who survived wounding to the point where they could be evacuated from theatre.…”

“…Enhanced access to military casualty registries and recognition of the potential for realities in the current engagements to inform combat-casualty care in the future have culminated in an unprecedented number of publications regarding various medical aspects of the battlefronts in Iraq and Afghanistan [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. In spite of these achievements, however, complete information is lacking in several arenas, including an understanding of the precise types of musculoskeletal injuries sustained, particularly among soldiers who engage directly in combat.…”

“…The two largest conflagrations, the wars in Afghanistan (2001-present) and Iraq (2003Iraq ( -2011, have combined to produce approximately 58,000 coalition casualties [1] These conflicts have witnessed the introduction of novel implements of warfare and new wounding mechanisms, such as the use of highly destructive improvised explosive devices (IEDs) and explosively formed projectiles (EFPs) against military vehicles which have been up-armoured over time [2][3][4][5]. Despite such increases in weapons' lethality, advances in battlefield medical care and improvements in casualty evacuation and the capacity for effective surgical intervention in theatre have led to lower case fatality rates than ever recorded in the history of military medicine [5][6][7].…”

Blast Injury

“…During the recent military conflicts in Iraq and Afghanistan, a higher proportion of casualties were caused by blast injuries compared with previous conflicts, because of the widespread adoption of improvised explosive devices (IEDs) by enemy forces. 1,2 Coupled with a decreased case fatality rate, 3 this means that a larger number of survivors of blast injuries have been treated in military and Veteran's Administration medical systems, which has brought increasing appreciation of the long-term effects of blast injury on the brain, even in less severely injured casualties.…”

Challenges in definitive fracture management of blast injuries

“…Today, explosives, particularly improvised explosive devices (IEDs), account for roughly 80 % of combat injuries and deaths [1]. Explosives produce systemic polytrauma across multiple body systems by simultaneous mechanisms.…”