Page 12 - Journal of Special Operations Medicine - Fall 2014

Table 1 Pelvic Hematoma After Parachute Injury
Number of
Timing of Initial Presentations to Initial Blood
ED Presentation Physician or Disposition Products
Patient Summary Chief Complaint After Trauma Other Provider at ED Required
37-year-old US Army Anterior, bilateral Discharge,
Soldier (Cunningham lower abdominal pain 4 days 4 conservative None
et al. ) management
2
Bilateral lower
36-year-old US Army abdominal and pelvic <6 hours 1 ICU admission 2U PRBCs
Soldier (case 1)
pain
41-year-old US Army Bilateral pelvic pain <6 hours 1 ICU admission None
Soldier (case 2)
Admission to
29-year-old USAF Left hip and inguinal <6 hours 1 general surgery None
Soldier (case 3) pain
floor
30-year-old US Army Lumbago and 12 hours 1 Transfer to facility None
Soldier (case 4) bilateral hip pain with ICU care
Admission to step-
Right lower quadrant 2U PRBCs,
27-year-old US Army abdominal pain, <6 hours 2 down unit (initial 2U FFP, 1 pack
Soldier (case 5) ED discharge
difficulty urinating platelets
previous day)
Note: ED, emergency department; FFP, fresh frozen plasma; ICU, intensive care unit; PRBC, packed red blood cell.

Discussion Figure 6 T-11 Parachute.
Airborne units of the US Military, to include Special Op-
erations Forces of the US Army, Navy, Air Force, and
Marines and Conventional Forces of the US Army, such
as the US 82nd Airborne Division, continue to employ
parachute operations in both training and combat. As
with military operations in general, significant inher-
ent risk exists. Official military estimates of injury with
parachute operations range from 1.6 per 1000 jumps to
more than 11 per 1000. In recent years, the US Army
1,2
began transition from the T-10 parachute, which has
been in use since the 1950s, to the T-11 parachute (Fig-
ure 6), which has a reduced rate of descent (19' per sec-
ond, or 5.8m per second) compared with the T-10 (22'
per second, or 6.7m per second) and a postulated lower Source: Available from http://www.dvidshub.net/image/1025359
injury incidence (by some estimates, a 47% decrease). 1 /spartan-brigade-leaders-jump-with-armys-t-11-parachute#.UwrO
lYXWow8. Accessed 23 February 2014.
The types of injury from parachute mishap vary signifi-
cantly in incidence and severity but most often occur on present five additional cases from a single institution—
landing and commonly are the result of blunt trauma. all of which required hospital admission. Of interest,
3
Pelvic hematoma without pelvic fracture exists as a rela- not one of the individuals in our case series underwent
tively underreported injury in general and especially anticoagulant or antiplatelet therapy BEFORE their in-
after military parachute injury. In our series, we define jury. Each of these individuals was young, strong, and
the pelvis as that area composed of and bounded by the with no previous known vascular, hematologic, or mus-
innominates (comprising the ilium and ischium) on ei- culoskeletal compromise.
ther side, the pubis in front, and the sacrum and coccyx
behind. Extensive literature review yielded one single The consequences of traumatic pelvic hematoma may be
case of pelvic vascular injury without fracture from as- significant, especially in an organization that depends
sociated military parachute injury. In this article, we on the physical readiness of its members to succeed in its
2

4 Journal of Special Operations Medicine Volume 14, Edition 3/Fall 2014