U.s. Military experience with junctional wounds in war from 2001 to 2010.
BACKGROUND
In 2012, we reported on junctional wounds in war, but only of the few injuries that were critically severe.


OBJECTIVE
The purpose of the present study is to associate a wide range of junctional wounds and casualty survival over a decade in order to evidence opportunities for improvement in trauma care within a large healthcare system.


METHODS
We retrospectively surveyed data from a military trauma registry. We associated survival and injuries at the junction of the trunk and appendages in the current war (2001 to 2010).


RESULTS
The junctional injury rate rose 14-fold from 0%, its minimum in 2001, to 5%, its maximum in 2010. Of the 833 casualties with junctional injury in the study, the survival rate was 83%; its change was not statistically significant over time. Most casualties had severe extremity injuries and associated injuries of other body regions such as the face and head.


CONCLUSIONS
Junctional injury is common, severe, disabling, and lethal. The findings of this study may increase awareness of junctional injury. Opportunities for improvement which we identified included further research on the future addition of junctional codes (such as neck diagnoses) in order to align research methods to clinical care.
John F
JF
Kragh
Michael A
MA
Dubick
James K
JK
Aden
Anne L
AL
McKeague
Todd E
TE
Rasmussen
Smiley
S
Billings
Lorne H
LH
Blackbourne
D006801:Humans; D008889:Military Personnel; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate; D014857:Warfare