Craniomaxillofacial battle injuries: injury patterns, conventional treatment limitations and direction of future research

RESULTS: We have identified 7770 BI. About 26% had CMF BI. There were 4783 CMF BI among the 2014 BI (2.4 injuries per soldier). Majority of CMF BI were male (98%). Average age was 26 years. CMF BI by branch of service was Army 72%, Marines 24%, Navy 2% and Air Force 1%. Penetrating soft tissue injuries and fractures were 58% and 27%, respectively; 76% of fractures were open and 24% of soft tissue injuries were noted as complicated. Frequency of facial fractures was mandible 36%, maxilla/zygoma 19%, nose 14%, and orbit 11%. Remaining 20% not otherwise specified. Primary mechanism of injury was explosive devices (84%).

CONCLUSIONS: Twenty-six per cent of all BI were to CMF area. CMF BI account for a disproportionate number of injuries observed in Iraq and Afghanistan compared with the previous American Wars. Mechanism of CMF BI involves explosive devices 84%.

UNLABELLED: This study analyses the US Army Joint Theatre Trauma Registry database for craniomaxillofacial (CMF) battle injuries (BI) experienced by US Service Members in Iraq/Afghanistan conflict to describe type, distribution and mechanism of injury.

METHODS AND MATERIALS: Joint Theatre Trauma Registry was queried from 19 October 2001 to 12 December 2007 for CMF BI entered in the database using ICD-9 codes; the data was compiled for BI soldiers.