Muscle-related Disability Following Combat Injury Increases With Time.

BACKGROUND: Combat injuries are most often to the extremities, resulting in a majority of long term disabilities being of orthopaedic nature. Some injuries are expected to improve with time. The Army Physical Evaluation Board (PEB) gives consideration for conditions that may improve with further care by placing eligible patients on a temporary retirement list. While this may be appropriate for some conditions, injuries such as those to skeletal muscle can be irrecoverable. We aimed to examine combat injured subjects with known muscle injuries who were placed in temporary retirement status to determine if their muscle conditions improved. We hypothesized that muscle-related disability would not improve despite additional time for recovery.
METHODS: The PEB results of 33 combat wounded service members were reviewed to determine what individuals were placed in temporary retirement status. We compared what muscle conditions were present at each PEB examination including the initial review, internal temporary retirement reexaminations, and the final adjudication. We also compared if the disability rating assigned to the muscle condition changed with time.
FINDINGS: Eighteen of the 33 subjects were placed in temporary retirement status prior to their final retirement. None of the subjects experienced improvement in their muscle condition as measured by disability ratings. Seven subjects worsened while 9 subjects had muscle conditions recognized at their final disposition that were not recognized at initial exam. Two subjects have muscle disability ratings that were unchanged.
CONCLUSIONS: While temporary retirement status provided opportunities for injured service members to experience additional improvement prior to permanent retirement, not all conditions can be expected to improve. This study demonstrates that the Army PEB ratings for muscle conditions did not improve despite additional recovery time being granted to the subjects on temporary retirement status.