MUSCULOSKELETAL INJURY OUTCOMES FROM OP HERRICK 14: BATTLE INJURY VERSUS NON-BATTLE INJURY

Abstract

Incidence of Non Battle Injuries (NBI) have historically always exceeded Battle Injuries (BI) in deployed military populations, yet long term functional outcome of NBI is not well understood. This study examined the incidence and outcomes of significant musculoskeletal BI and NBI experienced by 3 Commando Brigade (3 Cdo Bde) units following a six month deployment on Op HERRICK 14 in Afghanistan. METHOD: All deployed 3 Cdo Bde units were identified and resulting casualty incidence data extracted from the Defence Medical Information Capability Program (DMICP) using a redundant injury identification code. Data was cross referenced with aeromedical evacuation listings from the Defence Patient Tracking System (DPTS), with identified individuals classified into four specific injury care pathways. Relative functional outcome was determined via interrogation of DMICP to determine medical employment grading. Data was collected approximately 18 months post deployment. RESULTS: After exclusions, a total of 93 injured personnel were identified as either having been aeromedically evacuated or having presented at primary care post tour. N = 90 were male (96.8%) with an average age of 26. N = 55 (59.1%) were upgraded at 18 months. Those treated through primary care (n = 61) had best outcome with 82% (n = 50) upgraded compared to 13% (n = 5) requiring secondary care or DMRC admission. BI represented 67% (n = 62) of presentations, with 50% (n = 31) upgraded compared to 74% (n = 23) of those suffering NBI. Of the most seriously injured (n = 31), 87% remained under active care. Blast injuries were most common incidence, followed by lower back pain and gunshot 3 wounds (GSW). Injury incidence increased over the tour duration. SUMMARY: BI inflicts the most severe injuries suffered by UK troops with lowest functional recovery. NBI remain a significant attritional risk with 25% remaining downgraded at 18 months. UK military rehabilitation is effective at returning injured troops to duty, with 82% of recoverable troops restored to active duty at 18 months.