Physical medicine and rehabilitation in the military: The Bosnian mass casualty experience

Abstract

On February 5, 1994, a 120-mm mortar shell crashed into the main Market Square of Sarajevo, Bosnia. The explosion killed 66 and injured 206. The United States evacuated 71 of the injured to Landstuhl Regional Medical Center, where the Physical Medicine and Rehabilitation Service evaluated 28 victims. This mass casualty evacuation underscores the role of Army physiatrists in humanitarian assistance and wartime casualty management. The author collected data regarding demographic factors, injury types, complications, and functional limitations. Seventeen of the 28 patients evaluated were injured during the market bombing, with the rest being injured before the bombing. Of 132 diagnoses in these 28 patients, 31 were fractures, 14 were amputations, 8 were peripheral neuropathies, 3 were spinal cord injuries, and 1 was a traumatic brain injury. Contractures and decubitus ulcers, both complications of immobility, accounted for 18 of the diagnoses. Ambulatory impairments were present in all of the patients, and 4 patients had major impairments in activities of daily living.