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U.S. Department of Veterans Affairs, 2009; Jun 2012. Available from: <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.hsrd.research.va.gov\/for_researchers\/vinci\" xlink:type=\"simple\">http:\/\/www.hsrd.research.va.gov\/for_researchers\/vinci<\/ext-link>"},{"issue":"5","key":"ref18","first-page":"18","article-title":"Deployment-related conditions of special surveillance interests, U.S. Armed Forces, by month and service January 2003\u2013October 2012","volume":"22","year":"2015","journal-title":"Medical Surveillance Monthly Report"},{"key":"ref19","unstructured":"Fischer H. A guide to U.S. military casualty statistics: operation new dawn, operation iraqi freedom and operation enduring freedom. Congressional Research Service Report for Congress, February 19, 2014."},{"issue":"6","key":"ref20","doi-asserted-by":"crossref","first-page":"S438","DOI":"10.1097\/TA.0b013e318275469c","article-title":"Ten years at war: comprehensive analysis of amputation trends","volume":"73","author":"CA Krueger","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.7205\/MILMED-D-10-00102","article-title":"Prevalence of late amputations during the current conflicts in Afghanistan and Iraq","volume":"175","author":"DJ Stinner","year":"2010","journal-title":"Mil Med"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"1924","DOI":"10.1056\/NEJMoa012604","article-title":"An analysis of outcome of reconstruction or amputation of leg-threatening injuries","volume":"347","author":"MJ Bosse","year":"2002","journal-title":"New Engl J Med"},{"issue":"11","key":"ref23","doi-asserted-by":"crossref","first-page":"3270","DOI":"10.1007\/s11999-012-2376-6","article-title":"In brief: Gustilo\u2013Anderson classification. [corrected]","volume":"470","author":"PH Kim","year":"2012","journal-title":"Clin Orthop Relat Res"},{"issue":"5","key":"ref24","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1097\/TA.0b013e3182095b52","article-title":"Combat versus civilian open tibia fractures: the effect of blast mechanism on limb salvage","volume":"70","author":"JJ Doucet","year":"2011","journal-title":"J Trauma"},{"issue":"1","key":"ref25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/HTR.0b013e3181c2993d","article-title":"Prevalence and psychological correlates of traumatic brain injury in Operation Iraqi Freedom","volume":"25","author":"AJ MacGregor","year":"2010","journal-title":"J Head Trauma Rehabil"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"147","DOI":"10.7205\/MILMED-D-09-00120","article-title":"Midterm health and personnel outcomes in recent combat amputations","volume":"175","author":"T Melcer","year":"2010","journal-title":"Mil Med"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1109\/TAC.1974.1100705","article-title":"A new look at the statistical model identification","volume":"AC-19","author":"H Akaike","year":"1974","journal-title":"IEEE Transactions on Automatic Control"},{"key":"ref28","unstructured":"Centers for Disease Control and Prevention. Osteoarthritis [Internet]. Available from: <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.cdc.gov\/arthritis\/basics\/osteoarthritis.htm\" xlink:type=\"simple\">http:\/\/www.cdc.gov\/arthritis\/basics\/osteoarthritis.htm<\/ext-link>"},{"issue":"5","key":"ref29","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1161\/HYPERTENSIONAHA.109.132555","article-title":"Newly reported hypertension after military combat deployment in a large population-based study","volume":"54","author":"NS Granado","year":"2009","journal-title":"Hypertension"},{"key":"ref30","first-page":"1801","article-title":"Long-term persistence of disability following severe lower-limb trauma: results of a 7-year follow-up","volume":"87","author":"EJ MacKenzie","year":"2005","journal-title":"J Bone Joint Surg Am"},{"key":"ref31","first-page":"265","article-title":"Care of the combat amputation","author":"PF Pasquina","year":"2009"},{"issue":"2","key":"ref32","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/S0966-6362(02)00066-8","article-title":"Adjustments in gait symmetry with walking speed in trans-femoral and trans-tibial amputations","volume":"17","author":"L Nolan","year":"2003","journal-title":"Gait Posture"},{"issue":"1","key":"ref33","doi-asserted-by":"crossref","first-page":"57","DOI":"10.5435\/JAAOS-22-01-57","article-title":"Extremity war injuries VIII: sequelae of combat injuries","volume":"22","author":"RC Andersen","year":"2014","journal-title":"J Am Acad Orthop Surg"},{"key":"ref34","article-title":"Bone mineral density loss following combat-related lower extremity amputation","author":"LJ Flint","year":"2013","journal-title":"J Orthop Trauma. 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