Reconstructive Challenges of Complex Battlefield Injury

Throughout our current conflicts in both Iraq and Afghanistan, the likelihood of surviving a battlefield injury has been near 90% according to reports provided by the US Army Medical Research and Materiel Command. This is the highest survival rate recorded in modern combat. Advancements in protective equipment, rapid evacuation of casualties from point of injury to both stabilization and definitive care, improved medic and corpsmen personnel, more readily available resuscitation, and forward positioned surgical units have all significantly decreased troop mortality. Along with this phenomenon of increased survival, however, has come a surge in the number and significance of injuries seen by the medical community. As a result, orthopaedists have been forced to confront reconstructive challenges and difficult decisions in an often highly motivated patient population with high functional expectations. The objective of this article is to outline a few examples of difficult challenges encountered in battlefield trauma care and discuss the treatments utilized. (Journal of Surgical Orthopaedic Advances 19(1):77–84, 2010)