Head, face, and neck injuries during Operation Iraqi Freedom II: results from the US Navy-Marine Corps Combat Trauma Registry.

BACKGROUND: Head, face, and neck injuries (HFNIs) are an important source of combat mortality and morbidity. The objective of this study was to document the characteristics and causes of HFNIs during Operation Iraqi Freedom II.
METHODS: A retrospective review of HFNIs sustained by US military casualties between March 1, 2004 and September 30, 2004 was performed. Data were collected from the Navy-Marine Corps Combat Trauma Registry.
RESULTS: During the study period, 39% of all injury casualties in the registry had HFNIs. Of the 445 HFNI patients, one-third presented with multiple wounds to the head, face, and neck. Four percent of battle HFNI patients died from wounds, and nearly 40% of the surviving wounded were evacuated for treatment. Improvised explosive devices (IEDs) were the most frequent cause of battle HFNIs. Nonbattle HFNIs were most often the result of motor vehicle crashes. The majority (65%) of all HFNIs were to the face. Head injuries, overall, were more severe than face or neck wounds according to the Abbreviated Injury Scale.
CONCLUSIONS: The proportion of combat-related HFNIs is increasing and is primarily caused by IEDs. Improved protection for the vulnerable facial region is needed. Continued research on the changing nature of warfare and distribution of HFNIs is necessary to enhance the planning and delivery of combat casualty medical care.