Abstract
It has been shown that extremity injuries form a large proportion of the operative surgical workload in conflict situations. Injuries to the hands are an important subgroup and hand surgery has a long association with military surgery. While most hand injuries do not require surgical intervention, those that do, require that military surgeons should be well versed in the principles of hand surgery. The concepts of staging and/or damage control surgery are well applied to this region.
The nature of military medical support necessarily changes in the transition from war fighting to a post-conflict phase. We examine the activity in the sole British Military Hospital serving a multi-national divisional area in Iraq over 2004. During this post conflict phase, the spectrum of hand trauma is characterised.
The overwhelming majority of hand trauma resulted in soft tissue injury. There was a clear predisposition to hand trauma for males, manual workers, combat soldiers and engineers/mechanics. X-ray imaging is heavily used in this environment. Even where soldiers are returned to duty they are often restricted in the duties that they can perform.
The results of this study reinforce the relevance of basic principles of hand trauma management, particularly in challenging environments. These knowledge and skill requirements should be emphasised for the war surgeon and the emergency physician. Hand surgery is an evolving speciality that continues to find clear and direct applications for the military surgeon.
Correspondence should be addressed to Major S A Adams, Orthopaedic Department, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA.
