Bulavin V.V.1, Kal’manov A.S.1, Vorona A.A.1, Amirov A.M.2, Sobolenko A.K.3

1 Scientific Research and Testing Center of Aerospace Medicine and Military Ergonomics of the Central Scientific Research Institute of Air Force of the Ministry of Defense of the Russian Federation, Moscow, Russian Federation

2 Occupational health facility of the Ministry of the Interior of the Republic of Dagestan, Makhachkala, Russian Federation

3 Federal State Budgetary Institution “State Scientific Research Test Institute of Military Medicine”, St. Petersburg, Russian Federation

The medical expert outcomes of treatment of 680 servicemen wounded in limbs in counterterrorist operation in Dagestan in 1999–2001 in hospitals of the first, second and third echelons is presented.
It is noted that 330 of 680 soldiers wounded in the limbs were examined. The most affected anatomical segments were foot, shin and thigh. Isolated and combined injuries of the neurovascular bundle were revealed in 19.5% of cases, and in 14.9% – wounds of large joints. As a result of the examination of these persons, 42 per cent were found fit for limited military service; 38 per cent were found not fit for military service; 20 per cent fit for military service with minor restrictions.
A retrospective analysis of the outcomes of limb injuries showed that they were explained by three factors: the severity of the injury – simultaneous damage of blood vessels, nerve trunks and bones of the limbs; defects in treatment during medical evacuation, primarily and mainly – the shortcomings in the organization of rehabilitation; incorrect assessment of state of health of those wounded by military medical commission with premature conclusion about unfitness for military service.
The analysis of the results of treatment of servicemen with limb injuries at the stages of medical evacuation allowed drawing the following conclusion: the fewer stages of medical evacuation the wounded had to pass and the faster he enters a specialized medical institution, the shorter his stay in hospital bed and the better the outcomes of his treatment.

Key words: servicemen with limb wounds, medical-expert treatment outcomes, counter-terrorist operations, local armed conflicts, structure of wounds, stages of medical evacuation

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