Amputation cases among troops hit post-9/11 high in 2011

By CHRIS CARROLL
Stars and Stripes
Published: February 9, 2012

WASHINGTON — More U.S. troops lost limbs in 2011 than in any previous year of fighting since the 9/11 attacks, recently published Pentagon data shows.

The grisly toll, 240 cases of deployed troops with at least one arm or leg amputated, appears to mainly reflect the ongoing troop surge in Afghanistan, along with an increased emphasis on foot patrols in areas where insurgents are active.

Amputation cases were up from 196 in 2010 and exceeded the previous high of 205 during the 2007 Iraq surge, according to figures published this month by the Armed Forces Health Surveillance Center. The Marine Corps was hit hardest by far, with 129 Marines suffering amputations in 2011. The Army, which has more troops in the country, had 100 amputation cases. Six sailors and five airmen also lost limbs.

But there’s a flip side to the grim statistics, officials say. The rising numbers are also believed to reflect recent advances in battlefield first aid, medical treatment and protective gear that make the current conflict “the most survivable war in the history of combat,” according to Adm. William Gortney, director of the Pentagon’s Joint Staff, speaking Jan. 31 at the Military Health System Conference in Washington.

In previous wars, or even several years earlier in the current one, some of the amputation cases would likely have been battlefield fatalities, said Col. Jonathan Jaffin, chief of the Army Surgeon General’s Dismounted Complex Blast Injury Task Force. From 2010 to 2011, though amputations increased, total U.S. troop deaths in from combat fell to 368 from 437, according to the Defense Manpower Data Center.

“These are grievous injuries, yes, but when you see them back here with their families having survived, these guys are all grateful to be alive,” Jaffin said.

The task force also found an increase in severe injuries in recent years. It sounds bad, Jaffin said, but actually means that troops are surviving worse injuries than before. Better and more widely distributed protective gear, including groin-protecting armor that many troops began receiving in 2011, are helping stop injuries to vital organs that previously could have proved fatal, Jaffin said.

First-aid knowledge among the rank and file has increased, and ground troops in Afghanistan now carry tourniquets they are trained to use if a limb is severed, he said.

“We’ve heard anecdotally that some of the guys are going out on patrol with tourniquets already in place, so if they get hurt, all you have to do is pull them taut,” Jaffin said.

Once injured troops reach the hospital, the level of care that’s evolved over a decade of war is world-class, said a Navy doctor who served in Afghanistan.

“I could accurately say it’s the most effective trauma system on the planet,” said Navy Capt. Mike McCarten, who in 2010 and 2011 commanded a NATO Role 3 hospital in Kandahar, one of three in the country with a full spectrum of medical care.

Improvised explosive devices caused the majority of amputations McCarten saw at the hospital, he said. Roughly half of the injured troops had a limb or limbs blown off in the field, and the rest arrived with arms and legs too mangled to save.

“It was at least several times weekly, and at some points it was several times daily,” he said.

Survivability has increased because the U.S. military has been closely monitoring and studying medical outcomes throughout the current wars, and the lessons learned are being put into use. Perhaps the most effective lesson learned was the importance of first aid, he said.

“The work being done at the Role 3 hospitals is magnificent, but really a lot of credit for that survival goes to medics and hospital corpsmen on the battlefield,” McCarten said. “[Injured troops] would come to us with two or three tourniquets on two or three amputated limbs, and they actually didn’t have bad blood pressure because of the care they received in the field.”