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Amputation rate for US troops twice that of past wars
Doctors cite need for prosthetics as more lives saved

US troops injured in Iraq have required limb amputations at twice the rate of past wars, and as many as 20 percent have suffered head and neck injuries that may require a lifetime of care, according to new data giving the clearest picture yet of the severity of battlefield wounds.

The data are the grisly flip side of improvements in battlefield medicine that have saved many combatants who would have died in the past: Only 1 in 10 US troops injured in Iraq has died, the lowest rate of any war in US history.

But those who survive have much more grievous wounds. Bulletproof Kevlar vests protect soldiers' bodies but not their limbs, as insurgent snipers and makeshift bombs tear off arms and legs and rip into faces and necks. More than half of those injured sustain wounds so serious they cannot return to duty, according to Pentagon statistics....

...In addition to amputations, many soldiers making this journey have head and neck injuries, frequently injured by improvised explosive devices, or IEDs, essentially remote-controlled bombs planted in the ground.

"The angle of the force of these IEDs is right for the neck and face. That's been devastating to folks over there," said Holt, explaining that Kevlar helmets do not protect the underside of heads and necks, where crucial nerves and blood vessels lie.

Lieutenant Colonel Michael S. Xydakis, a military surgeon, released a little-noticed study in September at a medical conference of head and neck surgeons. He found that over a 14-month period, about 1 in 5 US soldiers treated at Landstuhl Regional Medical Center in Germany, which handles most Iraq casualties, had head or neck injuries.

These injuries, surgeons said, have long-term implications, with many involving irreversible brain damage, breathing and eating impairments, blindness, or severe disfiguration. The study prompted the military to add a full-time head and neck surgeon to a Baghdad field hospital.

"These folks are just starting to come back, and they may require care for a long, long time," said Holt.