Journal of Trauma and Injury

Review Article

Heat-related illnesses in the Republic of Korea Armed Forces: epidemiology, comparative analysis, and preventive strategies: Sunju Kim, Kun Hwang; Received September 1, 2025 Accepted January 2, 2026 Published online September 2, 2026; DOI: https://doi.org/10.20408/jti.2025.0212 [Epub ahead of print]

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Abstract PDF: Heat-related illnesses (HRIs) represent an increasingly critical threat to the health and operational readiness of the Republic of Korea (ROK) Armed Forces. Rising global temperatures, combined with Korea’s humid summers and intensive military training, have increased both the incidence and severity of HRIs among soldiers. This paper provides a comprehensive review of HRIs in the ROK military, beginning with an overview of their pathophysiology and classification, ranging from heat cramps to exertional heat stroke—the most severe and life-threatening form. We then examine recent epidemiological trends, which reveal over 1,200 documented cases between 2018 and 2023, with new recruits disproportionately affected. A comparative analysis across service branches indicates that Army personnel, who engage in high-intensity outdoor training, bear the greatest burden, while Navy and Air Force members face distinct occupational exposures in engine rooms and on airfields, respectively. The risk in the ROK military is striking in international comparison: odds ratios suggest that soldiers face more than 27 times the risk of HRIs compared with the civilian population, exceeding reported burdens in allied militaries such as the United States and Japan. Lessons from other nations, particularly the use of real-time surveillance, wearable technologies, and structured acclimatization programs, offer valuable models for ROK. Preventive strategies must therefore extend beyond medical management to include leadership accountability, environmental engineering, digital monitoring, and a cultural shift that promotes reporting. In an era of accelerating climate change, HRIs must be reframed not only as medical conditions but also as preventable threats to combat readiness, soldier welfare, and national security.; Summary

Original Articles

Traumatic peripheral nerve injuries in young Korean soldiers: a recent 10-year retrospective study: Chul Jung, Jae-hyun Yun, Eun Jin Kim, Jaechan Park, Jiwoon Yeom, Kyoung-Eun Kim; J Trauma Inj. 2024;37(3):192-200. Published online August 8, 2024; DOI: https://doi.org/10.20408/jti.2024.0001

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Purpose
Traumatic peripheral nerve injury (PNI), which occurs in up to 3% of trauma patients, is a devastating condition that often leads to permanent disability. However, knowledge of traumatic PNI is limited. We describe epidemiology and clinical characteristics of traumatic PNI in Korea and identify the predictors of traumatic complete PNI. Methods: A list of enlisted soldier patients who were discharged from military service due to PNI over a 10-year period (2012–2021) was obtained, and their medical records were reviewed. Patients were classified according to the causative events (traumatic vs. nontraumatic) and injury severity (complete vs. incomplete). Of traumatic PNIs, we compared the clinical variables between the incomplete and complete PNI groups and identified predictors of complete PNI. Results: Of the 119 young male patients who were discharged from military service due to PNI, 85 (71.4%) were injured by a traumatic event; among them, 22 (25.9%) were assessed as having a complete injury. The most common PNI mechanism (n=49, 57.6%), was adjacent fractures or dislocations. Several injury-related characteristics were significantly associated with complete PNI: laceration or gunshot wound, PNI involving the median nerve, PNI involving multiple individual nerves (multiple PNI), and concomitant muscular or vascular injuries. After adjusting for other possible predictors, multiple PNI was identified as a significant predictor of a complete PNI (odds ratio, 3.583; P=0.017). Conclusions: In this study, we analyzed the characteristics of enlisted Korean soldiers discharged due to traumatic PNI and found that the most common injury mechanism was adjacent fracture or dislocation (57.6%). Patients with multiple PNI had a significantly increased risk of complete injury. The results of this study contribute to a better understanding of traumatic PNI, which directly leads to a decline in functioning in patients with trauma.

Summary

Citations

Citations to this article as recorded by

Lymphatic vessel regulates tertiary lymphoid structure formation and inflammatory intensity in peripheral nerve allografts
Beibei Xu, Hui Zhou, Yuan Liu, Nianci Huo, Junyang Gao, Jiaqi Liu, Nan Zhou
International Immunopharmacology.2026; 188: 117287. CrossRef
Nerve injury: the role of electroneuromyography and ultrasound in diagnostics
A. V. Klimkin, M. A. Irikova, V. B. Voitenkov, E. Yu. Skripchenko
Russian neurological journal.2025; 30(1): 51. CrossRef
Analysis of Penetrating Injuries to the Sciatic Nerve, Highlighting Insights From Sudan
Albra Kamal, Momen M. Mohamed, Amin M. Yassin, Hozifa Mohamed, Mohamed Dirar
Plastic and Reconstructive Surgery - Global Open.2025; 13(6): e6901. CrossRef

One year of treating patients with open fractures of the lower extremity in a new military trauma center in Korea: a case series: Ji Wool Ko, Giho Moon, Jin Geun Kwon, Kyoung Eun Kim, Hankaram Jeon, Kyungwon Lee; J Trauma Inj. 2023;36(4):376-384. Published online December 19, 2023; DOI: https://doi.org/10.20408/jti.2023.0041

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Abstract PDF

Purpose
The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity.
Methods
In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients’ mode of transport.
Results
This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder.
Conclusions
This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

Summary

Citations

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The PTSD-Bone Axis: Evidence, Mechanisms, and Management
Olivia X. Jones, Kirsten D. Kelly, Stephanie K. Khoo, Ryan R. Kelly, Sara J. Sidles, Amanda C. LaRue
Current Osteoporosis Reports.2026;[Epub] CrossRef
Changes in the characteristics of civilian patients admitted to a military hospital before and during the healthcare system crisis: a retrospective cohort study
Changsin Lee, Sang Mok Lee, Kyungwon Lee
Journal of Trauma and Injury.2026; 39(1): 14. CrossRef
Injuries from blank cartridge shots in suicide attempts within the South Korean military: a case series of five patients
Jeong Il Joo, Changsin Lee, Kyungwon Lee
Journal of Trauma and Injury.2024; 37(4): 262. CrossRef

Case Report

Inhalation injury after a landmine explosion: a case report: Woojung Kim, Donghoon Kim, Sung Yub Jeong, Yoonhyun Lee, Hojun Lee; J Trauma Inj. 2022;35(Suppl 1):S35-S39. Published online June 23, 2022; DOI: https://doi.org/10.20408/jti.2022.0005

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Abstract PDF

Blast injuries are divided into four classes, and inhalation injuries are a quaternary class of blast injuries. An inhalation injury can be critical to the patient due to the possibility of related complications, such as airway obstruction resulting from upper airway edema and pneumonia. Once diagnosed, an inhalation injury should be treated with early intubation, aerosol therapy, and antibiotics as soon as possible. We should suspect this injury in circumstances involving fire and especially bomb attacks in a military setting. Antipersonnel landmines designed to damage the soldier by amputating the leg can cause blast injuries, but their power is limited to the lower extremity. However, we found an inhalation injury in a victim whose leg had been amputated by an antipersonnel landmine. As soon as we suspected an inhalation injury, we intubated the patient to preserve his airway and started acetylcysteine/heparin aerosol therapy. The patient also was treated with proper antibiotics for right lower lung pneumonia that developed as a sequela of inhalation injury. We could extubate the patient without any complications such as airway obstruction on the third day of intensive care, after which the patient was transferred to the general ward for active rehabilitation. This report presents the first known case of inhalation injury due to a landmine explosion.

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Citations

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The Genesis of Long Bone Defects Resulting from Modern Combat Trauma: Part 1. Defect Localization
S. O. Guryev, S. V. Hariian, V. A. Kushnir, O. S. Soloviov, O. S. Tsybulskyi
The Ukrainian Journal of Clinical Surgery.2026; 93(4): 82. CrossRef

Original Article

Qualitative Analysis of the Tetanus Antibody in Korean Army personnel after Visiting a Tertiary Armed Forces Hospital: Chung Kwon Kim, Jong Hwan Shin; J Korean Soc Traumatol. 2007;20(2):65-71.

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Abstract PDF: PURPOSE
In the Korean armed forces, vaccination against tetanus is done when personnel join the military service, but we do not know how many military personnel are vaccinated and how many soldiers have protection against tetanus. We performed a qualitative analysis of the tetanus antibody in Korean military personnel by using the TQS (Tetanus Quick Stick) METHODS: This study used a prospective collection method for military personnel visiting to the emergency department of a tertiary armed forces hospital from July 2005 to January 2007. We performed an analysis by using the TQS and asked whether the personnel had been inoculated during military service.
RESULTS
The number of enrolled military personnel was 474. Among them, 412 had been vaccinated against tetanus after entering the military service. The positive rate of TQS was 91.3% (373 patients) after vaccination for tetanus.
CONCLUSION
Many military personnel were inoculated with tetanus toxoid during military service and have protective antibodies for tetanus. According as TQS should be used for military personnel who visit the emergency department of an armed forces hospital. Also, anti-tetanus immunoglobulin should not normally be used a positive TQS for tetanus prophylaxis.; Summary

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