Maxillofacial Injuries Sustained in Afghanistan During Operation Enduring Freedom
Objective: Injuries sustained in the theater of war are generally, and fortunately, unique to the theater of war itself. A significant percentage of these injuries occur to the maxillofacial region. The aim of this study was to evaluate the incidence and etiology of maxillofacial injuries that presented to a high echelon level of care in a theater hospital.
Study Design: A retrospective analysis of data was performed. Data was collected from our personal surgical logs during our tours at the NATO Role 3 Mulitnational Medical Unit in Kandahar, Afghanistan from August 2011 to July 2012**. Cause of injury, nature of injury and nationality of the patient (coalition forces vs. Afghan) were the parameters evaluated.
Results:
Total number of patients sustaining facial injuries: 487
Number of Afghan patients (ANSF, local nationals and enemy combatant detainees): 334
Number of coalition forces’ patients: 153
Total number of trauma patients overall: 2005
Percentage of patients with facial injuries: 24%
Conclusions: Most of the injuries sustained during Operation Enduring Freedom (OEF) in Afghanistan are caused by a variety of different types of improvised explosive devices (IEDs), but also from high-velocity gunshot wounds, motor vehicle collisions and other accidents. In our experience, facial injuries sustained by the Afghan people tended to be more severe and greater in number than those sustained by coalition (NATO) forces. This can be attributed to the fact that the soldiers of the coalition forces wear protective eyewear and the members of the Afghan forces, friendly or combatant, do not. The percentage of patients sustaining facial injuries is very close to what has been reported earlier in OEF and for OIF (Operation Iraqi Freedom).1,2
**These numbers are an extrapolated estimate for right now based on our data up to 10 March 2012. The exact number will be reported and presented once my tour is complete in July. Based on recent events, the total number will likely be slightly higher than what is reported here, but the percentage of total patients should be about the same.
References:
- Powers, DB. Distribution of civilian and military maxillofacial surgical procedures performed in an Air Force theatre hospital: implications for training and readiness. J R Army Med Corps 2010 Jun; 156(2)117-121.
- Lew TA, Walker JA, Wenke JC, Blackbourne LH, Hale RG.Characterization of craniomaxillofacial battle injuries sustained by Unted States service members in the current conflicts of Iraq and Afghanistan. JOMS 2010 Jan;68(1) 3-7.
- Breeze J, Gibbons AJ, Combes JG, Monaghan AM. Oral and maxillofacial surgical contributions to 21 months of operating theatre activity in Kandahar Field Hospital: 1 February 2007 to 31 October 2008. J R Army Med Corps. 2010 Jun;156(2):125-8.