Military medicine
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Injuries are the most significant health problem of military services. Military medical surveillance data are useful for determining the magnitude and causes of the injury problem, identifying possible prevention targets and monitoring trends among military personnel. Soldiers serving in the Polish Armed Forces took part in the research. The aim of the study was to identify the most common injuries of the musculoskeletal system and to analyze causes of injuries. An additional goal was to examine whether there is a relationship between selected values of body composition indexes, the result of the functional movement screen (FMS) test and occurrence of an injury. ⋯ Parameters from the body composition analyzer such as body mass index, muscle mass distribution on lower limbs as well as evaluation in the FMS test may be helpful for the initial assessment of predisposition to injury.
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Combat-related injuries have declined substantially in recent years as we have transitioned to a low-volume combat casualty flow era. Surgeons must remain actively committed to training for the next engagement to maintain life and limb-saving skills. Soft tissue coverage procedures were imperative to the management of complex lower extremity trauma that occurred during recent conflicts. The purpose of this study was to evaluate advanced soft tissue coverage procedures performed on the lower extremity over the previous decade on military and civilian trauma patients at a Department of Defense Level 1 trauma center to provide data that can be used to guide future training efforts. ⋯ This data supports prior identified trends in military cases correlating increased number of procedures with increased combat activity related to the conflicts in Iraq and Afghanistan in 2007 and 2011, respectively. The data showed relative stability in the numbers of civilian procedures with a slight uptrend beginning in mid-2012. A comparison after mid-2012 shows military procedures declining and civilian procedures increasing to eventually become equivalent at the end of the data collection. These trends follow previously reported data on tibia fracture fixation procedures and lower extremity amputations for the same time periods. These data demonstrate the importance of the civilian trauma mission for maintaining surgical skills relevant to limb salvage, such as rotational and free flaps, during a low-volume combat casualty flow era.
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The Department of Defense aims to maintain mission readiness of its service members. Therefore, it is important to understand factors associated with treatment seeking in order to identify areas of prevention and intervention early in a soldier's career that can promote positive functioning and increase their likelihood of seeking mental health care when necessary. ⋯ Findings suggest few soldiers-in-training are likely to seek help when experiencing a problem. General efforts to encourage help-seeking when needed are warranted with particular focus on subsets of soldiers-in-training (eg, men, those with a history of some adverse childhood experiences). Strengths of this study include the examination of a large sample of soldiers-in-training to identify possible leverage points for early intervention or prevention prior to entering stressful military operating environments. Limitations of this study include the examination of only one military branch and exclusion of soldiers not "in-training." Future studies could consider replicating the current study using a sample of military personnel longitudinally to track behavioral trends as well as looking at military populations outside of basic combat training.
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Wrist pain commonly affects military members and while most instances are benign, some require urgent orthopedic attention to prevent permanent loss of function. A 27-year-old male Marine while deployed presented with wrist pain after a seemingly benign fall during recreation. Radiographs were initially read as unremarkable and treated as a sprain. ⋯ This case is a reminder that proper evaluation of all injuries is critical. Proper evaluation of wrist injuries includes an attentive physical exam and careful examination of the radiographs; paying close attention to Gilula arcs and collinearity of the radius, lunate, and capitate. Prompt recognition and referral to specialty care for definitive treatment are important to maximize functional outcomes.
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Military free fall or high-altitude low-opening parachute jumps play a key role in special operations tactics, though injury patterns in these operators are not well characterized. In contrast to lower-altitude static line paratroopers, free fall operators require precise parachute deployment after a prolonged descent, with the potential for high-velocity trauma. This report describes a 33-year-old Marine Corps Reconnaissance operator who sustained left comminuted basicervical femoral neck fracture requiring cephalomedullary nail internal fixation with a full recovery. This femoral neck fracture highlights the high-energy injuries experienced by these invaluable operators, especially when conducting combat or night jumps.