Orthopedic Injuries during Carrier Battle Group Deployments

Military Medicine, Mar 2004 by Hebert, Daniel J, Pasque, Charles B

Orthopedic injuries account for a large number of sick call visits during carrier battle group (CBG) deployments. The purpose of this study was to profile the orthopedic injuries during two CBG deployments to help both the line and medical communities better prepare their personnel and supplies. The current study confirmed that orthopedic injuries resulted in the greatest number of sick call visits to the CBG medical departments. Injury analysis revealed a significant number of hand/wrist and back/neck injuries during both carrier deployments. The groups with the highest number of injuries were the air squadrons and aircrews. These findings support the need for continued increased training and supplies for the care of orthopedic injuries. Emphasis should be placed on the care of hand/wrist and back/neck injuries. In addition, all CBG personnel should continue to improve their safety standards, especially in high-risk areas such as the aviation departments.

Introduction

Carrier battle group (CBG) deployments are a vital factor in allowing the U.S. military to maintain a forward overseas presence. A CBG usually consists of an aircraft carrier and the supporting surface warfare ships such as cruisers, destroyers, and frigates. There is also usually an amphibious assault group deployed in the same region with its various Navy and Marine Corps elements. Together, these vessels actively participate in various missions such as peacekeeping support, maritime embargoes, military exercises with other countries, and any local emergencies that may arise.

The personnel and resources needed to support CBG missions are very large because of the size of the personnel group and the wide variety of jobs required in this floating industrial city. These battle groups endure extensive preparation and training before their 6-month deployments overseas to become as efficient and independent as possible. This is very important because deployments are long distances from the U.S. mainland, often leaving the CBG isolated to deal with their own problems.

Each ship in the CBG has its own medical department to care for the daily medical needs of the crew. This ranges from full medical and surgical teams on the carriers to independent duty corpsman and associated staff on the smaller ships. It is widely held that orthopedic injuries account for a significant portion of sick call visits to these medical departments during an active deployment of a CBG, thus consuming a large portion of the resources available in both supplies and personnel. Few previous studies have been performed on this topic.1-3 Any information detailing these orthopedic injuries such as types, mechanisms, treatment, and possible preventive measures would be helpful in planning for future CBG deployments. The purpose of this study was to profile the orthopedic injuries during an active CBG deployment to help both the line and medical communities better prepare their personnel and supplies.

Materials and Methods

This study involved the analysis of orthopedic injuries that occurred during two CBG deployments. The first deployment was of the USS Enterprise to the Mediterranean from June 20, 1996 to December 20, 1996. The orthopedic injuries were analyzed retrospectively from existing medical department records and safety center information to identify common injury types and locations. This information was then used to determine missing information that would be helpful in designing a database for future CBG deployments. The database was then used to prospectively record orthopedic injuries during the deployment of the USS Stennis to the Mediterranean from February 26, 1999 to August 26, 1999. A computerized spreadsheet database was made available in the medical departments to record specific information detailing each individual injury during the deployment. The information included the rank of the patient, job description, date of injury, location of injury, mechanism of injury, and final diagnosis. In addition, treatment and follow-up requirements were recorded, including the total number of workdays lost and whether a medivac (medical evacuation off the ship) was required. The database information was then analyzed to better understand the injury patterns as well as the specific requirements and needs of the medical departments during active deployments.

Results

All information reported in the Results section refers to data from the prospective USS Stennis deployment unless specifically referenced to the retrospective USS Enterprise deployment.

Total Musculoskeletal Sick Call Visits

The two deployments had similar overall findings for their number of musculoskeletal sick call visits and the percentage of these visits compared with all other sick call types. The USS Stennis had 1,357 visits, which were 43% of their total sick call load. The USS Enterprise had 1,633 musculoskeletal sick call visits, which were 40% of their total sick call load. In addition, the USS Enterprise had an onboard physical therapist who recorded approximately 622 visits for various musculoskeletal complaints involving mainly back and knee conditions. When included with the rest of the medical department visits, musculoskeletal visits accounted for 55% of the total sick call load. Other major types of sick call visits recorded for both deployments included medical readiness visits or checkups, general medicine visits such as cold and flu symptoms, skin conditions, general surgery problems, and psychiatric evaluations.