An Analysis of Orthopedic Surgical Procedures Performed During U.S. Combat Operations from 2002 to 2016.

Introduction: Orthopedic surgery constitutes 27% of procedures performed for combat injuries. General surgeons may deploy far forward without orthopedic surgeon support. This study examines the type and volume of orthopedic procedures during 15 years of combat operations in Iraq and Afghanistan.Mate...

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Publicado en:Military Medicine Vol. 184; no. 11/12; pp. 813 - 820
Autores principales: Stern, Caryn A, Stockinger, Zsolt T, Todd, William E, Gurney, Jennifer M
Formato: pictorial research tables/charts Journal Article
Publicado: Oxford University Press / USA Nov/Dec2019
Acceso en línea:Ver este registro en EBSCOhost
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        atl: An Analysis of Orthopedic Surgical Procedures Performed During U.S. Combat Operations from 2002 to 2016.
      aug:
        au:
          Stern, Caryn A
          Stockinger, Zsolt T
          Todd, William E
          Gurney, Jennifer M
        affil: Joint Trauma System, DoD Center of Excellence for Trauma, 3611 Chambers Dr, Joint Base San Antonio, Fort Sam Houston, TX 78234
      sug:
        subj:
          Orthopedic Surgery Statistics and Numerical Data
          Military Medicine Statistics and Numerical Data
          Debridement Methods
          Orthopedic Surgery Methods
          Amputation Statistics and Numerical Data
          Fractures, Open Epidemiology
          Debridement Statistics and Numerical Data
          Retrospective Design
          Amputation Methods
          Military Medicine Methods
          United States
          Fractures, Open Surgery
          Data Collection
          Questionnaires
          Human
      ab: Introduction: Orthopedic surgery constitutes 27% of procedures performed for combat injuries. General surgeons may deploy far forward without orthopedic surgeon support. This study examines the type and volume of orthopedic procedures during 15 years of combat operations in Iraq and Afghanistan.Materials and Methods: Retrospective analysis of the US Department of Defense Trauma Registry (DoDTR) was performed for all Role 2 and Role 3 facilities, from January 2002 to May 2016. The 342 ICD-9-CM orthopedic surgical procedure codes identified were stratified into fifteen categories, with upper and lower extremity subgroups. Data analysis used Stata Version 14 (College Station, TX).Results: A total of 51,159 orthopedic procedures were identified. Most (43,611, 85.2%) were reported at Role 3 s. More procedures were reported on lower extremities (21,688, 57.9%). Orthopedic caseload was extremely variable throughout the 15-year study period.Conclusions: Orthopedic surgical procedures are common on the battlefield. Current dispersed military operations can occur without orthopedic surgeon support; general surgeons therefore become responsible for initial management of all injuries. Debridement of open fracture, fasciotomy, amputation and external fixation account for 2/3 of combat orthopedic volume; these procedures are no longer a significant part of general surgery training, and uncommonly performed by general/trauma surgeons at US hospitals. Given their frequency in war, expertise in orthopedic procedures by military general surgeons is imperative.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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