SPINE INJURIES IN COMBAT TROOPS - PANAMA, 1989

Operation Just Cause was until recently the largest American combat op eration since Vietnam, and remains the largest night-time parachute op eration since World War II. All 252 casualties were airlifted to San A ntonio, Texas. for medical treatment. Greater than 80% sustained ortho pedic injuries. Sixteen patients were admitted for injuries to the bac k or neck. Three of the four patients with significant fractures or fr acture-dislocations were paraplegic. Two of the three patients with gu nshot wounds to the back required extensive reconstruction for wound m anagement. In addition to the 252 casualties, there were 23 fatalities , among whom 7 suffered major injuries to the spine. Spine injuries re presented the most significant source of long-term morbidity among tho se soldiers wounded in combat, in Panama, and were common among the fa talities. Noteworthy in these cases was the high percentage of severe neurologic injuries in patients with significant fractures (75%), part icularly fractures associated with gunshot wounds. Also of interest we re the cases of major soft tissue injury associated with high-velocity gunshot wounds (66%) and the extensive soft tissue surgery needed to treat these injuries.