Orthopedic Injuries during Carrier Battle Group Deployments

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

What Injuries Occurred: Injury Regions and Types

The most commonly injured region for both deployments was the hand and wrist (Table I). This was followed closely by back and neck injuries. The shoulder and knee were also important areas of injury. The most common type of injury for both deployments was joint sprains or muscle strains (Table II). Soft tissue contusions and lacerations also made up a large number of injuries. The "other" category in Table II consisted of nonacute complaints, such as arthritis, bursitis, carpal tunnel syndrome, nontraumatic low back pain, cellulitis, myofascial pain syndrome, and patella-femoral pain syndrome.

The hand or wrist region accounted for the majority of both lacerations and fractures. On the USS Stennis, there were 112 lacerations, of which 98 (88%) were of the hand or wrist. In addition, there was a total of 81 fractures during the deployment with 48 (59%) of the hand or wrist, followed by the foot (12%), ankle (11%), arm/forearm (9%), tibia/fibula (2%), and femur (1%) (Tables I and II).

Who Was Injured

There were more injuries in the enlisted personnel (97%) than in the officer ranks (3%). The majority of these injuries occurred in enlisted personnel below E-6 with the highest percent found in the rank of E-3 (30%). The largest percentage of injuries occurred in those dealing with air operations, which included the squadron (33%) and the aircrews (12.7%) (Tables III and IV).

Where and When Injuries Occur

Injury patterns showed that approximately 84% of all injuries on the USS Stennis were job related with the remaining occurring during off-duty recreation or port-call visits. The largest percentage of injuries occurred during air operations in both the squadron (33%) and the aircrews (12.7%). The next closest areas were the supply (7.2%), reactor (7.1%), and engineering (6.9%) departments. The highest rate of injury occurred during the middle 3 months of the deployment. This included monthly injury percentages of 18.7%, 19.4%, and 20.7%, respectively (Table IV).

How Injuries Occurred (Mechanisms of Injury)

A review of accident and injury reports collected by the USS Enterprise safety department revealed some common mechanisms of injury:

* Cut hand while opening cans (in the galley), working with sheet metal, or using knives (n = 34);

* Slammed door on finger or hand (n = 17);

* Cut knees/elbows on bulkheads or exposed bolts/valves (n= 13);

* Fell down ladder (n = 12);

* Injured knee/ankle playing basketball or Volleyball (n = 8);

* Punching (object or person) (n = 7).

A review of accident and injury reports collected by the USS Stennis medical department revealed other common mechanisms of injuries to be ship transit injuries (doors, ladders, bulkheads, etc.), working on aircraft, running into aircraft, working on other machinery, and recreational injuries playing sports.

Medical Evacuations

Of all of the medivacs that were required during the USS Enterprise deployment, 10 (18%) were for orthopedic injuries, all of which were fractures. This included an assortment of fractures including three tibia fractures and three fibula fractures (Table V).