• Philip J Belmont, Brendan J McCriskin, Mark S Hsiao, Robert Burks, Kenneth J Nelson, and Andrew J Schoenfeld.
• Department of Orthopaedic Surgery, William Beaumont Army Medical Center, Texas Tech University Health Sciences Center, El Paso, TX 79920, USA.
• J Orthop Trauma. 2013 May 1;27(5):e107-13.

ObjectivesThis investigation sought to describe orthopaedic wounds sustained by service members deployed to Iraq or Afghanistan from 2005 to 2009.DesignRetrospective review of prospective data.Setting: Joint Theater Trauma Registry (JTTR).PatientsThe 6092 musculoskeletal casualties contained in the JTTR.InterventionThe JTTR was queried to identify all personnel sustaining musculoskeletal injuries in the period 2005-2009. Demographic information, injury mechanism, and nature of wounds were determined for all individuals. Deployment data for all service members were obtained through the Defense Manpower Data Center and the incidence of orthopaedic injuries and wounding patterns was assessed.Main Outcome MeasurementsPairwise comparisons were made to identify statistically significant differences in incidence, and significant associations, between injury mechanism and injuries/wounding patterns.ResultsThe JTTR contained data on 6092 musculoskeletal casualties with 17,177 wounds. Seventy-seven percent of all casualties sustained a musculoskeletal wound. The incidence of musculoskeletal combat casualties was 3.06 per 1000 deployed personnel per year, with fractures occurring in 3.41 per 1000 and soft-tissue wounds most commonly encountered (4.04 per 1000). Amputations represented 6% of all combat wounds. Most musculoskeletal wounds were caused by explosive blast (P < 0.001), as were nearly all traumatic amputations.ConclusionsThis study represents the most complete description of the scope of orthopaedic war trauma. It also presents injury-specific incidences that have not previously been described for musculoskeletal combat casualties. Musculoskeletal casualties may occur in 3 of every 1000 personnel deployed per year.Level Of EvidencePrognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

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