EL PASO, TX—Of the around 60,000 U.S. military servicemembers injured in combat during the Afghanistan and Iraq wars, 40% have suffered fractures, traumatic amputations and injuries to the spine.

With about 64% percent of those with combat-related bone and joint injuries also becoming permanently disabled, they are significant users of inpatient care resources at VHA hospitals, according to a new review published in the Journal of the American Academy of Orthopaedic Surgeons.1

Yet, according to the study team led by William Beaumont Army Medical Center researchers, most of the musculoskeletal injuries to active-duty personnel were not related to combat.

In fact, deployed military servicemembers who were engaged in sustained combat operations over a 15-month period were three times more likely to suffer noncombat musculoskeletal injuries than combat musculoskeletal injuries, according to the epidemiological study.

In addition, the lead author, retired Army Col. Philip J. Belmont, MD, pointed out that, although 75% of musculoskeletal injuries are noncombat related, “80.5 percent of military air medical transports were for disease and noncombat injuries.”

“Some common noncombat bone and joint injuries that military servicemembers report when they return from their deployment include anterior cruciate ligament (ACL) injuries of the knee and shoulder dislocations,” Belmont said. “Those injuries occur nearly five times more often among military servicemembers than they do in the civilian population. Also common are ankle sprains and plantar fasciitis.”

Previous researchers found that among servicemembers who completed their deployments, 19% required an orthopedic consultation. Of those, 4% underwent orthopedic surgery, with half of the procedures on the knee or shoulder.

While military tactical gear technology, such as body armor and Kevlar helmets, continues to improve and reduce the overall number of life-threatening wounds, “soldiers who in previous conflicts would have succumbed to injuries on the battlefield are now surviving, yet they still have devastating orthopedic injuries that require extensive treatment,” Belmont added.

“The nature of combat over the last decade has led to precipitous increases in severe orthopaedic injuries, including traumatic amputations and injuries to the spine,” the study authors concluded.” Nearly 75% of all injuries sustained in combat now are caused by explosive mechanisms, and fractures comprise 40% of all musculoskeletal injuries. Injuries to the axial skeleton are more frequent among personnel exposed to combat, and spinal trauma is identified in nearly 40% of those killed.”

1 Belmont PJ, Owens BD, Schoenfeld AJ. Musculoskeletal Injuries in Iraq and Afghanistan: Epidemiology and Outcomes Following a Decade of War. J Am Acad Orthop Surg. 2016 Jun;24(6):341-8. doi: 10.5435/JAAOS-D-15-00123. PubMed PMID: 27115793.