A prospective evaluation of orthopedic patients evacuated from Operations Desert Shield and Desert Storm: The Walter Reed experience

A prospective review of all orthopedic casualties received from the southwest Asia theater of operations during Operations Desert Shield and Desert Storm was carried out at Walter Reed Army Medical Center. An injury analysis of the 181 orthopedic patients revealed 143 total fractures in 69 patients, with the remaining patients sustaining soft tissue injuries from trauma, overuse, or pre-existing conditions. Seventy percent of the fractures were open, of which 23% were treated with external fixators and 41% eventually underwent an operative stabilization procedure. An analysis of the distribution of injuries is given as well as the incidence of amputations, nerve injuries, and arterial injuries. Early multidisciplinary involvement in the care of these casualties proved to be greatly beneficial.