Amputations in U.S. military personnel in the current conflicts in Afghanistan and Iraq.
OBJECTIVE
To determine rates of major limb amputation in U.S. military casualties in the current conflicts in Afghanistan and Iraq, to correlate these with mechanism of injury, and compare the rate with that seen in U.S. casualties from the Vietnam War.


METHODS
Retrospective study of all U.S. casualties recorded for the current conflicts from the start in October 1, 2001 to June 1, 2006.


METHODS
Records from U.S. military forward surgical teams (Level IIb) and combat support hospitals (Level III) in theater, evacuation (Level IV, Germany), and major military medical centers (Level V, United States).


METHODS
All recorded U.S. military casualties from the Afghanistan and Iraq theaters with injuries requiring evacuation out of theater or prohibiting the individual from returning to duty for more than 72 hours.


METHODS
None.


METHODS
Major limb injury, level of amputation, principal mechanism of injury.


RESULTS
Over the past 56 months, of the 8058 military casualties meeting the listed criteria, 5684 (70.5%) were recorded as having major limb injuries. Of these, 423 (5.2% of all serious injuries; 7.4% of major limb injuries) underwent major limb amputation or amputation at or proximal to the wrist or ankle joint. The mechanism of injury for 87.9% was some form of explosive device. The major amputation rate during Vietnam was 8.3% of major limb injuries.


CONCLUSIONS
Overall, major limb amputation rates for the current U.S. engagement in Afghanistan and Iraq are similar to those of previous conflicts.
Stansbury
Lynn G
LG
U.S. Army Institute of Surgical Research Extremity Trauma Soft-tissue Branch, Fort Sam Houston, Texas 78234, USA.
Lalliss
Steven J
SJ
Branstetter
Joanna G
JG
Bagg
Mark R
MR
Holcomb
John B
JB
D000346:Afghanistan; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D001134:Arm Injuries / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007493:Iraq; D007869:Leg Injuries / Q000453:epidemiology / Q000601:surgery*; D008887:Military Medicine; D008889:Military Personnel / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014857:Warfare