Craniomaxillofacial Battle Injuries: Injury Patterns, Conventional Treatment Limitations and Direction of Future Research

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.

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%.