title: Return to duty after type III open tibia fracture.
abstract: BACKGROUND
  Despite the high incidence of battlefield orthopaedic injuries, long-term outcomes and return to duty (RTD) status have rarely been studied. Our purpose was to determine the RTD rate for soldiers who sustained Type III open tibia fractures in active combat.
  
  
  METHODS
  One hundred fifteen soldiers who sustained battle-related Type III open tibia fractures were retrospectively reviewed. The Army Physical Evaluation Board database was reviewed to determine which soldiers were able to RTD and the disability ratings of those not able to RTD.
  
  
  RESULTS
  The overall RTD rate was 18%, isolated open fractures had a RTD rate of 22%, salvaged extremities had a RTD rate of 20.5%, and amputees had a RTD rate of 12.5%. Older age and higher rank were both significant factors in increasing the likelihood of RTD and amputees had significantly higher disability ratings than those with salvaged extremities.
  
  
  CONCLUSIONS
  Despite the severe nature of combat extremity wounds, 20% of patients with salvaged Type III open tibia fractures and 22% with isolated injuries were able to return to active duty. These rates are similar to those reported for civilian amputees. Amputees in our cohort were less likely to RTD.
authors: Brooke Army Medical Center, Fort Sam Houston, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA. jessica.cross@us.army.mil
authors: Jessica D
authors: JD
authors: Cross
authors: Daniel J
authors: DJ
authors: Stinner
authors: Travis C
authors: TC
authors: Burns
authors: Joseph C
authors: JC
authors: Wenke
authors: Joseph R
authors: JR
authors: Hsu
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D004185:Disability Evaluation; D005260:Female; D005597:Fractures, Open / Q000175:diagnosis / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D023821:Limb Salvage / Q000534:rehabilitation; D008297:Male; D008887:Military Medicine; D008889:Military Personnel; D012179:Retirement; D012189:Retrospective Studies; D018582:Sick Leave; D013978:Tibial Fractures / Q000175:diagnosis / Q000534:rehabilitation / Q000601:surgery*; D015599:Trauma Severity Indices; D014857:Warfare; D014950:Wounds, Penetrating / Q000601:surgery*