Mobility Solutions After a Lower Extremity Fracture and Applicability to Battlefield and Wilderness Medicine

Lee W. Childers, Joseph F. Alderete, Travis D. Eliason, Stephen M. Goldman, Daniel P. Nicolella, Sarah N. Pierrie, Gerald E. Stark, Nicholas M. Studer, Joseph C. Wenke, Jonathan B. Wilson, Christopher L. Dearth

Research output: Contribution to journalArticlepeer-review


The potential for delayed evacuation of injured Servicemembers from austere environments highlights the need to develop solutions that can stabilize a wound and enable mobility during these prolonged casualty care (PCC) scenarios. Lower extremity fractures have traditionally been treated by immobilization (splinting) followed by air evacuation – a paradigm not practical in PCC scenarios. In the civilian sector, treatment of extremity injuries sustained during remote recreational activities have similar challenges, particularly when adverse weather or terrain precludes early ground or air rescue. This review examines currently available fracture treatment solutions to include splinting, orthotic devices, and biological interventions and evaluates their feasibility: 1) for prolonged use in austere environments and 2) to enable patient mobilization. This review returned three common types of splints to include: a simple box splint, pneumatic splints, and traction splints. None of these splinting techniques allowed for ambulation. However, fixed facility-based orthotic interventions that include weight-bearing features may be combined with common splinting techniques to improve mobility. Biologically-focused technologies to stabilize a long bone fracture are still in their infancy. Integrating design features across these technologies could generate advanced treatments which would enable mobility, thus maximizing survivability until patient evacuation is feasible.

Original languageEnglish (US)
Pages (from-to)91-99
Number of pages9
JournalJournal of special operations medicine : a peer reviewed journal for SOF medical professionals
Issue number3
StatePublished - Sep 1 2023
Externally publishedYes


  • Prolonged casualty care
  • combat fractures
  • lower extremity
  • mobility
  • splinting
  • wilderness

ASJC Scopus subject areas

  • General Medicine


Dive into the research topics of 'Mobility Solutions After a Lower Extremity Fracture and Applicability to Battlefield and Wilderness Medicine'. Together they form a unique fingerprint.

Cite this