The military service members and veterans who received injuries resulting in limb loss while serving in Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), and Operation New Dawn (OND) are a unique generation of warfighters. In previous conflicts, gunshot wounds accounted for about one-third of deaths, but in these recent conflicts they account for only 4.6 percent, according to a 2010 study. Explosive devices, including improvised explosive devices (IEDs), account for three-quarters of all combat casualties, with limb injuries reported to comprise about half of all combat wounds sustained during OIF and OEF.Better battlefield medical practices, quicker evacuation to safer locations for medical care, and improved body armor have resulted in lives saved that would have been lost in previous conflicts. However, blast injuries cause a cluster of comorbidities including a far larger number of traumatic brain injuries (TBIs) than in the past, along with vision, hearing, and balance issues; soft tissue injuries; and heterotopic ossification. Healthcare professionals and researchers have had to forge new roads to provide the complex, multidisciplinary care required in treating this new warfare scenario.
