Orthopedic Treatment, Complications, and Cost Analysis of 67 Soldiers Injured in a Three-month Period

Abstract

Objectives: This study aims to analyze the musculoskeletal injurytypes, injury mechanisms, treatment modalities, complications,and costs of 67 consecutive soldiers wounded in the battlefield inSyria civil war over a period of three months.Patients and methods: This retrospective study was conductedbetween January 2018 and March 2018 at Kilis State Hospital.The study included 67 male patients (median age 28.5 years;range, 15 to 46 years). Patients' ages, injury mechanisms,fracture types, fracture locations, injury severity scores, mangledextremity severity scores, complications, and treatment costswere evaluated.Results: Twenty-three patients were injured due to handmadeexplosives, 21 patients due to gunshots, 16 patients due tolandmines, five patients due to rockets, and two patients dueto grenades. A total of 35.8% of the patients (n=24) hadconcomitant trauma. The mean hospitalization period was10.2 days (range, 1-45 days). A total of 88 treatments wereperformed on these patients. Thirty-six of these treatments wereexternal fixators, 21 were amputations, 12 were open reductioninternal fixations, seven were closed reduction internal fixations,five were intramedullary nailings, three were cannulated screws,three were fasciotomies, and one was an arthrodesis. Thetreatment costs ranged from 1,577 to 296,286 Turkish Liras.Complications were observed in 17 patients and 11 of themdeveloped infections, three of them had compartment syndrome,and three died during the hospitalization period.Conclusion: The increase in warfare technology is correlatedwith the severity of military injuries in the battlefields. Theseinjuries still lead to high traumatic amputation rates, high-riskcomplications, and high costs.