{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:09:56Z","timestamp":1790784596444,"version":"4.1.0"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There remains a paucity of literature surrounding chest wall injury within military trauma. The purpose of this study was to examine the US Military Trauma database hypothesizing differences in chest wall injury patterns and rates given the different mechanisms of injury within this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Records of injuries that occurred between 2004 and 2020 from the US Military Trauma database were evaluated. Patients\u2019 injury characteristics were coded based on mechanism of injury (MOI) and injury severity score (ISS). Individuals with secondary injury types (ITs) were coded as combined injuries. Anatomic injuries were also coded. Statistical analysis was performed with SPSSv.30.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      1173 patients were evaluated whose ages were 18-22 (38.4%), 23-27 (31.5%), 28-32 (15.4%), 33-37 (9.3%), 38-42 (3.4%), and 43-47 (1.9%), 97.8% male, and ISS 25 (IQR 17-35). Battle-related injuries made up 90.6% of injuries and 11.7% died. The primary IT was penetrating (P) (57.7%) followed by blunt (B) (22.1%) and blunt\/penetrating (BP) (20.2%). The top 3 MOI were explosive device (65.8%), bullet\/firearm (25.2%), and motor vehicle collision (5.4%). There were significantly different incidences of injury to the thorax based on IT: Lung B (25.5%), P (18.0%), and BP (30.4%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001); Hemothorax B (8.1%), P (14.9%), and BP (3.8%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002); Pneumothorax B (6.6%), P (7.2%), and BP (15.6%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.005); Hemopneumothorax B (6.6%), P (7.2%),and BP (15.6%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.005); Rib Fracture B (17.4%), P (14.0%), and BP (25.7%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001); Sternal Fracture B (1.9%), P (0.9%), and BP (3.8%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.011).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Deployed military personnel experience significantly different rates of thoracic injury comparing B, P, and BP injury types. The high rate of rib fractures in each IT suggests the presence of chest wall injury in this patient population is a marker of high-energy multisystem trauma with the potential for significant associated injuries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261494132","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:23:22Z","timestamp":1790659402000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Injury Type Related to the Severity of Thoracic and Chest Wall Trauma in Deployed Military Soldiers"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9409-2193","authenticated-orcid":false,"given":"Zachary M.","family":"Bauman","sequence":"first","affiliation":[{"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6016-1644","authenticated-orcid":false,"given":"Lilia","family":"Crew","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3899-4271","authenticated-orcid":false,"given":"Jayanjali","family":"Bodavula","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Bankhead","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Matos","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reynold","family":"Henry","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evert A.","family":"Eriksson","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000004750"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-022-01058-6"},{"issue":"4","key":"e_1_3_4_4_2","first-page":"440","article-title":"Effect of presence of rib fracture on mortality and morbidity in blunt thoracic traumas","volume":"28","author":"Kozanh F","year":"2020","unstructured":"Kozanh F, Guler O. Effect of presence of rib fracture on mortality and morbidity in blunt thoracic traumas. Turkish J Trauma Emerg Surg. 2020;28(4):440-445.","journal-title":"Turkish J Trauma Emerg Surg"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000694"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usaa165"},{"issue":"1","key":"e_1_3_4_7_2","first-page":"85","article-title":"Management of rib fractures in the combat environment","volume":"23","author":"Smith S","year":"2024","unstructured":"Smith S, Hilsden R, Patton P, Vogt K, Beckett A, Ball IM. Management of rib fractures in the combat environment. 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Rib fixation in patients with severe rib fractures and pulmonary contusions: is it safe? 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