Experience, challenges, and system optimization related to extremity war injury management in high-intensity warfare: a comparative study based on the Russia-Ukraine conflict and historical precedents

The Russia-Ukraine conflict that broke out in 2022 has highlighted the distinct features of modern warfare. As a type of high-incidence injury on the battlefield, limb injuries are characterized by complexity, high risk of infection, delayed evacuation leading to aggravated conditions, increased rates of amputation, and high incidence of psychological trauma. During the treatment of limb injuries, both sides of the conflict accumulated practical experience in forward deployment of forces, application of concepts of damage control surgery, establishment of a three-dimensional evacuation system, and more effective rehabilitation. However, such problems were exposed as insufficient frontline treatment training, poor coordination in material support, and the lack of psychological treatment. This article reviews the characteristics of limb injuries, treatment regimens and takeaways from the Russia - Ukraine conflict, and conducts comparative analyses based on data on historical conflicts such as World War Ⅱ and the U.S. wars in Afghanistan and Iraq in the hope of providing targeted references for the PLA to enhance its ability to manage limb injuries and improve its medical support system in high-intensity combat environments.